# MYCOPLASMA IST3 Results and Antimicrobial Susceptibility in PCR-Positive Urine Samples for Ureaplasma spp

## TL;DR

This study shows that Ureaplasma and Mycoplasma species can be detected in urine samples using PCR and MYCOPLASMA IST3, and highlights the importance of antimicrobial susceptibility testing to guide treatment.

## Contribution

The study demonstrates the utility of MYCOPLASMA IST3 for detecting and testing antimicrobial susceptibility of Ureaplasma and Mycoplasma in clinical urine samples.

## Key findings

- MYCOPLASMA IST3 detected growth in 93.33% of Ureaplasma spp. PCR-positive urine samples.
- Resistance to levofloxacin and tetracycline was observed in 15.7% and 12.9% of Ureaplasma isolates, respectively.
- No resistance to levofloxacin or moxifloxacin was observed in Mycoplasma hominis isolates.

## Abstract

Background: Ureaplasma spp. and Mycoplasma hominis are urogenital pathogens that may be missed by routine culture, particularly in patients with genitourinary symptoms in whom conventional methods fail to identify an etiologic agent. Limited routine implementation of targeted diagnostics and antimicrobial susceptibility testing (AST) for these organisms may contribute to diagnostic uncertainty and treatment failure. Methods: Seventy-five midstream urine samples submitted for suspected urinary tract infection and positive for Ureaplasma spp. according to a q-PCR urinary panel (Bioeksen, İstanbul, Türkiye) were tested the same day with MYCOPLASMA IST3 (bioMérieux, Marcy-l’Étoile, France) to assess growth and antimicrobial susceptibility. Results: q-PCR detected U. parvum in 54/75 (72%), U. urealyticum in 15/75 (20%), and both species in 6/75 (8%); M. hominis was not included in the PCR panel. MYCOPLASMA IST3 showed growth in 70/75 samples (positive percent agreement, 93.33%), while 5/75 (discordance, 6.66%) showed no growth. Among culture-positive samples, 57/70 (81.42%) yielded Ureaplasma spp. alone, and 13/70 (18.58%) yielded Ureaplasma spp. together with M. hominis. Resistance to levofloxacin and tetracycline was observed in 15.7% and 12.9% of Ureaplasma spp. isolates, respectively; resistance to moxifloxacin, erythromycin, and telithromycin was observed in 2.9% of isolates for each agent. In M. hominis isolates, no resistance to levofloxacin, moxifloxacin, or tetracycline was observed, whereas clindamycin resistance was observed in 7.7% of isolates. Conclusions: In addition to intrinsic resistance, acquired antimicrobial resistance in Ureaplasma and Mycoplasma species appears to be increasing; therefore, treatment decisions should be guided by AST whenever feasible. Clinical laboratories should implement appropriate diagnostic methods for these organisms and perform susceptibility testing when indicated to support clinical decision making and optimize antimicrobial selection.