Mycoplasmosis disease. Mycoplasmosis. Symptoms. Diagnostics. Treatment. Price of drugs for the treatment of mycoplasmosis

Mycoplasmosis is a pathological process, the formation of which is influenced by the bacteria Mycoplasma hominis and the genitalium. These microorganisms have a negative impact on the performance of the genitourinary system and cause various ailments. If the body is infected with Mycoplasma pneumonia, then this is a threat to the development of upper respiratory tract diseases.

Risk factors

There are 11 types of mycoplasmas in the human body, but only Mycoplasma genitalium, pneumonia and hominis can provoke pathology. Until now, scientists are debating the pathogenesis of these bacteria. Therefore, it is not possible to accurately determine the causes of the development of the disease.

Transmission of infection through contact and household methods is completely excluded today.

Manifestations of the disease

The symptoms of mycoplasmosis are different, since it all depends on the type of microorganism that caused the pathological process.

Mycoplasmosis caused by Mycoplasma genitalium

This disease can be diagnosed in both women and men. When urinating, the patient experiences a burning sensation or pain. This condition suggests that damage to the urethra has caused inflammation of the adjacent tissues, so their sensitivity is exacerbated.

Mycoplasmosis in women, acquired during sexual intercourse, due to the close proximity of the walls of the urethra to the vagina, is characterized by severe and sharp pain. As a rule, the onset of an acute form of the disease is preceded by a latent period, so only after 7–10 days can the first symptoms of urogenital mycoplasmosis appear.

Mycoplasmosis in men manifests itself in the form of slight discharge from the urethra. If the bacteria is not detected in time and treatment is not started, then mycoplasmosis in men can provoke symptoms such as itching of the external genitalia, pain during urination and sexual intercourse.

Respiratory damage

If Mycoplasma pneumoniae was detected in swabs from the throat and in the patient’s blood, this indicates the presence of a disease such as respiratory mycoplasmosis. It proceeds similarly. Symptoms of mycoplasmosis are characterized by a severe cough, during which scanty sputum may be produced. Respiratory mycoplasmosis can provoke an increase in temperature to 38 degrees. Patients may experience the following symptoms:

• cough;
• sore throat;
• nasal congestion;
• redness of the oral mucosa.

When respiratory mycoplasmosis is accompanied by inflammation of the bronchial branch, the person is diagnosed with wheezing and hard breathing. In complicated cases of respiratory mycoplasmosis, damage is caused to the heart and nervous system. Deaths occur with this pathology extremely rarely.

Urogenital lesion

This disease is characterized by the presence of a saprophytic microorganism, which is located in the urinary tract. Under specific conditions, urogenital mycoplasmosis can cause serious complications. Symptoms of mycoplasmosis are associated with pain during urination. There are cases when urogenital mycoplasmosis and its symptoms are recognized as manifestations or. After several weeks from the date of infection, urogenital mycoplasmosis in women is accompanied by vaginal discharge, and during sexual intercourse they experience severe pain and discomfort. The reason is that inflammation has affected the ureter.

Consequences of pathology

Mycoplasmosis is an infectious disease that is often a fundamental factor in the development of gynecological problems. Let us take a closer look at the complications of this pathology in women and men.

Damage to the female body

Mycoplasmosis in women can damage the vagina and cervical canal. It’s another matter when the pathology arose during the period of bearing a child. If mycoplasmosis during pregnancy occurs in a latent form, then complications of the disease may include:

• miscarriage;
• pathologies of placental development;
• polyhydramnios.

The chronic form causes complications such as secondary infertility. The female body, which has already suffered mycoplasmosis, can also be affected. This manifests itself as an inflammatory process in the pelvic organs, when the infection is transmitted from mother to fetus through the placenta, and in the first trimester of pregnancy this can lead to spontaneous abortion (miscarriage).

Damage to the male body

The presented disease very rarely affects the male body. But he can act as a carrier of infection. For this reason, in the absence of symptoms, antibodies to the pathogen are detected in his blood.

About 40% of cases of mycoplasmosis in men develop in a latent form, but during stressful situations or weakened defenses, the pathogen is activated, which leads to various complications. These include pulling pain in the groin, discharge in the morning, burning sensation when going to the toilet.

If mycoplasmosis causes damage to the testicular tissue, then this is complicated by hyperemia and an increase in the size of the testicles. This condition often provokes a disruption of the process of spermatogenesis.

Often the causative agent of mycoplasmosis is the cause of the development of arthritis, and even.

Diagnostic measures

Before starting treatment for mycoplasmosis, it is necessary to carry out a number of diagnostic measures, which include diagnosing a smear on the flora under a microscope. In women, a smear is taken from the cervix, urethra, and vagina. In men - only from the urethra.

Diagnostics may also include the method of bacteriological culture. It is characterized by growing bacteria from a smear. For these purposes, a special nutrient medium is used. This diagnostic method is considered the most accurate. But it will take a week to implement it. As a supplement, the polymerase chain reaction method and the immunofluorescence method can be performed.

Therapeutic measures

If mycoplasmas have been detected in the body, this is not yet a reason to treat mycoplasmosis. Only in the case of severe symptoms characteristic of the described pathologies will it be necessary to carry out therapeutic measures.

It is extremely rare that microorganisms themselves provoke the formation of an inflammatory process. Subsequent treatment of the disease will depend on the type of mycoplasma diagnosed and associated infections.

Complex treatment of mycoplasmosis is based on the use of antifungal, antiprotozoal medications, and irrigation of the urethra with liquid medications.

Treatment of complicated mycoplasmosis involves antibiotics. They have a wide range of actions. Antibiotics must be taken for 10 days. The following antibiotics are used:

• Tetracycline;
• Josamycin;
• Midecamycin;
• Clarithromycin;
• Erythromycin.

Because antibiotics destroy mycoplasmas, they also harm the natural microflora. Therefore, when the patient has finished taking antibiotics, the doctor prescribes a course of antibacterial therapy to restore the microflora.

Since the pathology has a high risk of relapse, treatment of mycoplasmosis can be successful if extracorporeal antibacterial therapy is used. A certain dose of antibacterial drugs is injected into the human blood in order to clean it.

Mycoplasmosis is a disease that is most often transmitted through sexual intercourse and from mother to child. You can avoid it if you use contraception and undergo testing on time. The disease does not cause anything terrible if its therapy was carried out on time and efficiently. In this case, there can be no talk of any complications.

The site provides reference information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. Consultation with a specialist is required!

Mycoplasmosis is an infectious disease provoked by microbes from the group mycoplasma. There are a number of varieties of this microorganism that provoke diseases of the respiratory system, as well as the urinary and reproductive organs. Mycoplasmosis can develop in a respiratory form or in a urogenital form. The manifestations of these forms of mycoplasmosis are different, so this article will discuss both forms of the disease.

Respiratory or pulmonary form of the disease

Pulmonary form of mycoplasmosis is a contagious disease that affects the respiratory system. The respiratory form is caused by a microorganism called Mycoplasma pneumoniae ( Mycoplasma pneumonia), as well as a number of other varieties of mycoplasma that are less common. Pneumoplasma (another name for the pathogen) provokes certain changes in lung cells, leading to their destruction, and also provokes a powerful autoimmune response, as a result of which the body begins to destroy its own tissues.

What are the manifestations of pulmonary mycoplasmosis?

The first manifestations are an increase in body temperature to thirty-eight degrees ( short-lived), burning in the throat, cough, increased activity of the sweat glands, nasal congestion, hyperemia of the mucous membranes of the pharynx and oral cavity. Due to the fact that the disease covers the tissues in stages, when the infection penetrates the bronchi, a non-productive, severe cough is observed, in some cases accompanied by the release of a small amount of mucus. If the disease is not treated at this stage, mycoplasma develops ( atypical) pneumonia . In general, the manifestations of pulmonary mycoplasmosis are very similar to those of influenza, but the course of the disease is very long. If with influenza the symptoms develop over the course of a day or two and disappear within seven days, then with mycoplasmosis the symptoms appear one after another and for quite a long time.

In the respiratory form of the disease, symptoms also subside gradually over three to four weeks, and in some cases even up to two to three months. In adolescents, the transition of the acute form of the disease to the chronic form often causes the formation bronchiectasis (incurable dilatation of the bronchial lumen), and pneumosclerosis (formation of conglomerates of connective fibers).

What methods are used to determine respiratory mycoplasmosis?

• polymerase chain reaction (PCR) - detects DNA particles typical only for this pathogen, which are present in bronchial mucus, as well as in nasopharyngeal mucus. This method makes it possible to get an answer within half an hour or an hour. It gives very accurate results.
• cultural method- on certain media in the laboratory, a culture of microorganisms obtained from the patient’s body is grown. This method is the most accurate. But to get the result you will have to wait from four to seven days.
• immunofluorescence method (RIF immunofluorescence reaction) – indicates the presence of antibodies that are characteristic only in the presence of mycoplasma in the body.
• testing for paired sera is a method in which the presence of special antibodies is determined before the sixth day, as well as after ten to fourteen days. This method makes it possible to understand how effective the therapy technique used is.

What is the treatment for respiratory mycoplasmosis?
The most effective means for treating the respiratory form of mycoplasmosis are drugs from the macrolide group. The most widely used of these is the drug macropen.
This drug is used in the treatment of pulmonary mycoplasmosis in mature patients, but it is also allowed to be used in the treatment of children from eight years of age. The medicine usually does not cause side effects in patients.
The drug is not prescribed to patients suffering from complex liver diseases (cirrhosis, hepatitis) and patients with impaired renal function.

For small patients weighing over thirty kilograms, the dosage of macrofoam is four hundred milligrams three times a day. There is macrofoam in the form of syrup, which greatly facilitates its use.
In the treatment of pulmonary mycoplasmosis, drugs from the tetracycline group are also used ( the most commonly used drug is doxycycline). Medicines from this group are most effective if the disease is caused by several types of pathogenic microflora ( mycoplasma pneumoniae + streptococcus pyogenes). The amount of the drug is prescribed at the rate of four milligrams per kilogram of body weight on the first day, then two milligrams per kilogram of body weight. The number of days of admission is prescribed only by the doctor.

Urogenital (genitourinary) mycoplasmosis

Urogenital or genitourinary mycoplasmosis is a disease of an infectious nature, which consists of inflammation of the urinary and reproductive organs. The disease is caused by microbes of the group mycoplasmaea – mycoplasma urealiticus or mycoplasma hominis .

How does the infection spread?

The spreader of mycoplasma is an infected person or a carrier of the microorganism. The duration of the epidemiological danger of the patient is currently unknown to doctors. Mycoplasma is spread through sexual contact during unprotected copulation.
Infection of the fetus from the mother is also possible, since the infection can penetrate the placenta during childbirth.
In representatives of the stronger sex, the pathogen is usually localized in the urethra, and in women on the vaginal mucosa.

After recovery from mycoplasmosis, the body practically does not develop immunity, so once cured, you can become infected an unlimited number of times ( This is facilitated by the weakening of defense mechanisms).
The latent period for this form of mycoplasmosis is three to five weeks.

How does the disease progress?

Only fifteen percent of the disease exhibits the classic picture. In the vast majority of diseases, mycoplasmosis is combined with gonococcus, chlamydia or other pathogens. In this regard, the manifestations of the disease are usually mixed.
In the fairer sex, the disease may not cause any symptoms at all, so therapeutic measures are often delayed and the disease becomes chronic. Representatives of the stronger sex may also develop a latent form of the disease.

Patients suffering from urogenital mycoplasmosis experience the discharge of specific mucus from the vagina or urethra. The color of the mucus varies from yellowish to colorless. Often the discharge of mucus is combined with pain or burning during urination or during intercourse. Patients suffer from itching in the urethra. Sometimes hyperemia of the urethral outlet, itching in the anus and pain in the groin are detected.
If the disease is not treated, the pathogen spreads to the internal organs of reproduction and disrupts the condition of the fallopian tubes, uterus, ovaries, testicles in men and the vas deferens. If such changes have already begun, men complain of pain in the scrotum, perineum, and rectum. Women experience pain in the groin and lower back.

Sometimes mycoplasma affects the joints and causes arthritis or the mucous membrane of the eyes and causes conjunctivitis.
There is evidence that this pathogen alone or together with other types of pathogenic microbes can disrupt blood production, suppress immunity, and also provoke autoimmune processes ( a malfunction of the immune system, in which protective bodies attack the tissues of their own body).

What diagnostic methods are used to detect urogenital mycoplasmosis?

The following diagnostic methods are used to determine this disease:

• polymerase chain reaction ( PCR), which indicates the presence of pathogen DNA in urine, genital secretions,
• cultural way,
• processing of paired serums,
• immunofluorescence (RIF).

Each of these methods has already been discussed in more detail above.

Therapy of urogenital mycoplasmosis

Because the disease usually goes away without any special symptoms, patients come to consult a gynecologist or urologist only when the disease has become chronic or has caused complications.
Therapy for urogenital mycoplasmosis is carried out using methods that suppress and destroy the infection.
Therapeutic measures are prescribed strictly individually; their choice is influenced by the complexity of the clinical picture, the course of the disease, and the presence of other diseases or complications.

Antibiotics from the tetracycline group are used as the main measures against infection ( metacycline, tetracycline, doxycycline ), azalides ( josamycin, erythromycin, azithromycin ), as well as fluoroquinolones ( pefloxacin, ofloxacin ).
If, in addition to mycoplasma, the patient is affected by other types of infection, in addition to the antibiotic, agents are prescribed to destroy these infections ( antifungals, metronidazole ). The therapy must be supervised by a doctor, and the control lasts for quite a long time.

A number of medications and dosages that are used in the treatment of urogenital infections:

– a urogenital infection caused by Mycoplasma genitalium/hominis and occurring in women in the form of urethritis, vaginitis, cervicitis, endometritis, salpingitis, adnexitis. It may have a latent course or be accompanied by itching of the genitals, burning during urination, transparent, light leucorrhoea, pain in the lower abdomen and lower back, intermenstrual bleeding, habitual miscarriage, infertility. Laboratory tests are of decisive importance in the diagnosis of mycoplasmosis in women: culture, PCR, ELISA, RIF. In the treatment of mycoplasmosis, antibiotics (tetracyclines, fluoroquinolones, macrolides), local therapy (suppositories, douching), and immunomodulators are used.

General information

Mycoplasmosis in women is a group of genitourinary tract infections caused by Mycoplasma genitalium and Mycoplasma hominis. According to various researchers, from 10 to 50% of the population are carriers of M. hominis. At the same time, mycoplasmas are found in 25% of women suffering from recurrent miscarriage, and 51% of women who gave birth to children with intrauterine developmental defects. The highest incidence of mycoplasmosis is observed among sexually active women of fertile age. Today, in the structure of STIs, ureaplasmosis and mycoplasmosis prevail over classical sexually transmitted diseases (gonorrhea, syphilis). The upward trend in the prevalence of mycoplasma infection in the population and the potential threat to reproductive health make this problem relevant for a number of disciplines: gynecology, urology, venereology.

Causes of mycoplasmosis in women

• M. pneumoniae (causes acute respiratory infections, atypical pneumonia)
• M. hominis (involved in the development of bacterial vaginosis, mycoplasmosis)
• M. genitalium (causes urogenital mycoplasmosis in women and men)
• M. incognitos (causes a poorly understood generalized infection)
• M. fermentans and M. penetrans (associated with HIV infection)
• Ureaplasma urealyticum/parvum (causes ureaplasmosis)

The leading route of transmission of mycoplasma infection is sexual (unprotected genital, oral-genital contacts). Co-infections of mycoplasmosis in women are often other urogenital diseases - candidiasis, chlamydia, genital herpes, trichomoniasis, gonorrhea. Of lesser importance is contact-household infection, which can occur through the use of shared bed linen, towels and washcloths, toilet seats (including in public toilets), and unsterile gynecological and urological instruments. The possibility of non-sexual intrafamilial infection with mycoplasmosis is confirmed by the fact that M. hominis is detected in 8-17% of schoolgirls who are not sexually active. The vertical path leads to intrauterine infection of the fetus. In addition, transmission of the infection is possible during childbirth: M. hominis is detected on the genitals of 57% of newborn girls born to women with confirmed mycoplasmosis.

Mycoplasmas can live on the mucous membranes of the genitals without causing disease - such forms are regarded as mycoplasma carriage. Women are asymptomatic carriers of mycoplasmas more often than men. Factors that increase the pathogenicity of microorganisms and the likelihood of mycoplasmosis in women may include infection with other bacteria and viruses, immunodeficiency, bacterial vaginosis (changes in vaginal pH, a decrease in the number of lactobacilli and bifidum bacteria, the predominance of other opportunistic and pathogenic species), pregnancy, hypothermia.

Symptoms of mycoplasmosis in women

In approximately 10% of cases, mycoplasmosis in women has a latent or subclinical course. Infection activation usually occurs under the influence of various stress factors. However, even latent infection poses a potential threat: under unfavorable conditions, it can initiate severe septic processes (peritonitis, post-abortion and puerperal sepsis), and intrauterine infection of the fetus increases the risk of perinatal mortality.

The incubation period lasts from 5 days to 2 months, but more often it is about two weeks. Mycoplasmosis in women can occur in the form of vulvovaginitis, cervicitis, endometritis, salpingitis, oophoritis, adnexitis, urethritis, cystitis, pyelonephritis. The disease does not have clearly defined specific signs; the symptoms of urogenital mycoplasma infection depend on its clinical form.

Mycoplasma vaginitis or cervicitis is accompanied by light, clear vaginal discharge, itching, burning during urination, pain during sexual intercourse (dyspareunia). With inflammation of the uterus and appendages, the patient is bothered by nagging pain in the lower abdomen and lower back. Symptoms of cystitis and pyelonephritis include an increase in body temperature to 38.5°C, painful urination, abdominal pain, and lower back pain. Mycoplasma endometritis is also manifested by menstrual irregularities and intermenstrual bleeding. Frequent complications of this form of infection include infertility in women.

Mycoplasmosis poses a great danger to pregnant women. The infection can provoke spontaneous miscarriages, preeclampsia, fetoplacental insufficiency, chorioamnionitis, polyhydramnios, early rupture of amniotic fluid, and premature birth. Premature pregnancy in women infected with mycoplasmas is observed 1.5 times more often than in clinically healthy pregnant women. Intrauterine mycoplasmosis in children can occur in the form of a generalized pathology with multisystem damage, mycoplasma pneumonia, meningitis. Infected children have a higher rate of birth defects and stillbirths.

Diagnosis of mycoplasmosis in women

It is not possible to diagnose mycoplasmosis in women only on the basis of clinical signs, anamnesis, examination data in a chair, or a smear on the flora. The presence of infection can only be reliably confirmed using a set of laboratory tests.

The most informative and fastest method is molecular genetic diagnostics (PCR detection of mycoplasma), the accuracy of which is 90-95%. The material for analysis can be scrapings of the epithelium of the urogenital tract or blood. Bacteriological culture for mycoplasmosis allows detecting only M. hominis; it is more complex and takes longer to obtain the result (up to 1 week), but at the same time allows one to obtain an antibiogram. For microbiological analysis, discharge from the urethra, vaginal vault, and cervical canal is used. A range of more than 104 CFU/ml is considered diagnostically significant. The determination of mycoplasma by ELISA and RIF methods, although quite common, is less accurate (50-70%).

Ultrasound methods are of auxiliary importance in the diagnosis of mycoplasmosis in women: ultrasound of the general body, ultrasound of the kidneys and bladder, since they help to identify the degree of involvement of the genitourinary system in the infectious process. Women planning pregnancy (including through IVF), suffering from chronic PID and infertility, and having a burdened obstetric history must undergo examination for mycoplasmosis.

Treatment and prevention of mycoplasmosis in women

The issue of treatment for asymptomatic carriage of M. hominis remains controversial. At the present stage, more and more researchers and clinicians are of the opinion that mycoplasma hominis is a component of the normal microflora of a woman and under normal conditions in a healthy body does not cause pathological manifestations. Most often, this type of mycoplasma is associated with bacterial vaginosis, so treatment should be aimed at correcting the vaginal microbiome, and not eliminating mycoplasma.

Etiotropic treatment of mycoplasmosis in women is prescribed taking into account the maximum sensitivity of the pathogen. The most commonly used antibiotics are tetracycline antibiotics (tetracycline, doxycycline), macrolides, fluoroquinolones, cephalosporins, aminoglycosides, etc. Sometimes the introduction of antimicrobial agents is used as part of the procedure. For local treatment, vaginal creams and tablets containing clindamycin and metronidazole are used. Instillations of the urethra and douching with antiseptics are carried out. Along with antibiotic therapy, antifungal agents, immunomodulators, multivitamin complexes, and eubiotics are prescribed. Ozone therapy and magnetic laser therapy are carried out.

Not only the woman, but also her sexual partner should undergo treatment for mycoplasmosis. The standard course lasts 10-15 days. 2-3 weeks after completion of the course, a culture test is repeated, a month later - PCR diagnostics, on the basis of which conclusions about recovery are made. Treatment resistance occurs in approximately 10% of patients. During pregnancy, treatment for mycoplasmosis is carried out only if the infection poses a danger to the mother and child.

Prevention of mycoplasmosis among women involves the use of barrier methods of contraception, regular gynecological examinations, and timely detection and treatment of urogenital infections.

Today it is believed that feline mycoplasmosis is not dangerous for humans and that other animal species cannot serve as a source of infection. However, discussions on this matter do not subside. Some veterinarians and infectious disease doctors argue that due to mutation and high adaptability, animal mycoplasmas can pose a danger to humans. Especially if his body is weakened by other infections.

Therefore, when communicating with homeless animals or when caring for sick pets, you must take the following precautions:

• If the animal is sick, it is necessary to promptly contact a veterinarian and get tested.
• Change the animal's bedding regularly, as mycoplasmas can survive in it for up to 7 days.
• Wash your hands after interacting with and caring for animals, do not touch mucous membranes with dirty hands.

Why does mycoplasmosis develop in children? What are the symptoms of mycoplasmosis in children?

25% of pregnant women are asymptomatic carriers of mycoplasmas. In the vast majority of cases, the placenta and membranes protect the fetus during pregnancy. But if the amniotic sac is damaged or during childbirth, mycoplasmas can enter the child’s body and cause infection.

Infection with mycoplasmosis in children can occur:

• in case of infection of amniotic fluid during pregnancy;
• if the placenta is damaged;
• during the passage of the birth canal;
• when communicating with sick relatives or carriers of mycoplasmas.

The entry points for infection can be:

• conjunctiva of the eyes;
• mucous membranes of the oral cavity and respiratory tract;
• mucous membranes of the genital organs.

In healthy full-term infants, contact with mycoplasmas rarely leads to the development of disease. But premature babies, who suffered from chronic placental insufficiency during intrauterine development, are very sensitive to mycoplasmas due to the immaturity of the immune system.

When infected with mycoplasmas, children may develop:

How dangerous is mycoplasmosis during pregnancy?

Question: “How dangerous is mycoplasmosis during pregnancy?” causes heated discussions among gynecologists. Some argue that mycoplasmas are definitely pathogenic microorganisms that are very dangerous for pregnant women. Other experts reassure that mycoplasmas are ordinary representatives of the microflora of the genital tract, which cause disease only with a significant decrease in the local and general immunity of a woman.

Mycoplasmosis during pregnancy can cause:

• spontaneous abortions;
• intrauterine infection and fetal death;
• development of congenital defects in a child;
• postpartum sepsis in a newborn;
• birth of low birth weight children;
• inflammation of the uterus after childbirth.

At the same time, some gynecologists completely disagree with the statement that mycoplasmas are dangerous to the health of pregnant women. They indicate that Mycoplasma hominisfound in 15-25% of pregnant women, and complications for the fetus develop in 5-20% of them. Therefore, it is believed that mycoplasmas can harm the health of mother and child only under certain conditions:

• in association with other pathogenic microorganisms, mainly ureaplasma;
• with decreased immunity;
• with massive damage to the genital organs.

Symptoms of mycoplasmosis in pregnant women

In 40% of cases, mycoplasmosis is asymptomatic and the woman has no health complaints. In other cases, with genital forms of mycoplasmosis, the following symptoms occur:

• itching and burning when urinating;
• pain in the lower abdomen with damage to the uterus and its appendages;
• copious or scanty clear vaginal discharge;
• early discharge of amniotic fluid;
• fever during childbirth and the postpartum period.

When these symptoms appear, laboratory diagnosis of mycoplasmosis is performed. Based on its results, the doctor decides on the need to take antibiotics. When treating pregnant women for mycoplasmosis, 10-day courses of Azithromycin are used. The source of infection is sick people and asymptomatic carriers. The disease is transmitted by airborne dust. When coughing, mucus particles containing mycoplasmas fall on objects and settle on house dust, and subsequently on the mucous membranes of the respiratory tract. Young people under 30 years of age are most often affected.

weakness, weakness, muscle aches are the result of poisoning with a neurotoxin secreted by mycoplasmas;

annoying dry cough with slight release of mucopurulent sputum, less often mixed with blood;

in the lungs there are dry or moist fine bubbling rales, the lesion is usually focal and one-sided;

the face is pale, the sclera is reddened, sometimes blood vessels are visible;

Some patients experience nausea and vomiting.

Depending on the degree of the disease and the intensity of immunity, the disease can last from 5 to 40 days. Antibiotics are used to treat respiratory forms of mycoplasmosis.

Mycoplasma is a family of small prokaryotic organisms of the Mollicutes class, which is characterized by the absence of a cell wall. Representatives of this family, which has about 100 species, are divided into:

Mycoplasmas occupy an intermediate position between viruses and bacteria - due to the absence of a cell membrane and microscopic size (100-300 nm), mycoplasma is not visible even with a light microscope, and this brings these microorganisms closer to viruses. At the same time, mycoplasma cells contain DNA and RNA, can grow in a cell-free environment and reproduce autonomously (binary fission or budding), which brings mycoplasma closer to bacteria.

• Mycoplasma, which causes mycoplasmosis;
• Ureaplasma urealyticum (ureaplasma), causing.

Three types of mycoplasmas (Mycoplasma hominis, Mycoplasma genitalium and Mycoplasma pneumoniae), as well as Ureaplasma urealyticum, are currently considered pathogenic for humans.

Mycoplasma was first identified in Pasteur's laboratory by French researchers E. Nocard and E. Rous in 1898 in cows sick with pleuropneumonia. The pathogen was originally named Asterococcus mycoides, but it was later renamed Mycoplasma mycoides. In 1923, the pathogen Mycoplasma agalactica was identified in sheep suffering from infectious agalaxia. These pathogens and later identified microorganisms with similar characteristics were designated PPLO (pleuropneumonia-like organisms) for 20 years.

In 1937, mycoplasma (species M. hominis, M. fermentans and T-strains) was identified in the human urogenital tract.

In 1944, Mycoplasma pneumoniae was isolated from a patient with non-purulent pneumonia, which was initially classified as a virus and was named “Eton's agent.” The mycoplasma nature of Eaton's agent was proven by R. Chanock by cultivating the original formulation on a cell-free medium in 1962. The pathogenicity of this mycoplasma was proven in 1972 by Brunner et al. by infecting volunteers with a pure culture of this microorganism.

The species M. Genitalium was identified later than other species of genital mycoplasmas. In 1981, this type of pathogen was discovered in the urethral discharge of a patient suffering from nongonococcal urethritis.

Mycoplasma, which causes pneumonia, is distributed throughout the world (can be both endemic and epidemic). Mycoplasma pneumonia accounts for up to 15% of all cases of acute pneumonia. In addition, mycoplasma of this species is the causative agent of acute respiratory diseases in 5% of cases. Mycoplasmosis of the respiratory type is more often observed in the cold season.

Mycoplasmosis caused by M. pneumoniae is observed more often in children than in adults (most patients are school-age children).

1. Hominis is detected in approximately 25% of newborn girls. In boys, this pathogen is observed much less frequently. In women, M. Hominis occurs in 20-50% of cases.

The prevalence of M. genitalium is 20.8% in patients with nongonococcal urethritis and 5.9% in clinically healthy people.

When examining patients with chlamydial infection, mycoplasma of this type was detected in 27.7% of cases, while the causative agent of mycoplasmosis was more often detected in patients without chlamydia. M. genitalium is thought to cause 20–35% of all cases of non-chlamydial nongonococcal urethritis.

In 40 independent studies in women considered to be at low risk, the prevalence of M. genitalium was about 2%.

In women at high risk (more than one sexual partner), the prevalence of this type of mycoplasma is 7.8% (in some studies up to 42%). Moreover, the frequency of detection of M. genitalium is associated with the number of sexual partners.

Mycoplasmosis is more common in women, since in men the urogenital type of the disease can resolve on its own.

Forms

Depending on the location of the pathogen and the pathological process developing under its influence, the following are distinguished:

• Respiratory mycoplasmosis, which is an acute anthroponotic infectious and inflammatory disease of the respiratory system. It is provoked by a mycoplasma of the species M. pneumoniae (the influence of other types of mycoplasmas on the development of respiratory diseases has not yet been proven).
• Urogenital mycoplasmosis, which refers to infectious inflammatory diseases of the genitourinary tract. Caused by mycoplasma species M. Hominis and M. Genitalium.
• Generalized mycoplasmosis, in which extra-respiratory mycoplasma lesions are detected. Mycoplasma infection can affect the cardiovascular and musculoskeletal systems, eyes, kidneys, liver, and cause the development of bronchial asthma, polyarthritis, pancreatitis and exanthems. Extra-respiratory organ damage usually occurs due to the generalization of respiratory or urogenital mycoplasmosis.

Depending on the clinical course, mycoplasmosis is divided into:

• spicy;
• subacute;
• sluggish;
• chronic.

Since the presence of mycoplasmas in the body is not always accompanied by symptoms of the disease, carriage of mycoplasmas is also distinguished (with carriage there are no clinical signs of inflammation, mycoplasmas are present in a titer of less than 103 CFU/ml).

Pathogen

Mycoplasmas are classified as anthroponotic human infections (pathogens can only exist in the human body under natural conditions). The amount of genetic information of mycoplasmas is less than that of any other microorganisms known to date.

All types of mycoplasma are different:

• lack of a rigid cell wall;
• cell polymorphism and plasticity;
• osmotic sensitivity;
• resistance (insensitivity) to various chemical agents aimed at suppressing cell wall synthesis (penicillin, etc.).

These microorganisms are gram-negative and are more amenable to Romanovsky-Giemsa staining.

The causative agent of mycoplasmosis is separated from the environment by a cytoplasmic membrane (contains proteins that are located in lipid layers).

Five types of mycoplasma (M. gallisepticum, M. pneumoniae, M. genitalium, M. pulmonis and M. mobile) have “sliding motility” - they are pear-shaped or bottle-shaped and have a specific terminal formation with an adjacent electron-dense zone. These formations serve to determine the direction of movement and take part in the process of adsorption of mycoplasma onto the cell surface.

Most members of the family are chemoorganotrophs and facultative anaerobes. Mycoplasmas require cholesterol contained in the cell membrane to grow. These microorganisms use glucose or arginine as an energy source. Growth occurs at a temperature of 30C.

Pathogens of this genus are demanding on the nutrient medium and cultivation conditions.

The biochemical activity of mycoplasmas is low. The following types are distinguished:

• capable of decomposing glucose, fructose, maltose, glycogen, mannose and starch, forming acid;
• not capable of fermenting carbohydrates, but oxidizing glutamate and lactate.

Urea is not hydrolyzed by members of the genus.

They are distinguished by a complex antigenic structure (phospholipids, glycolipids, polysaccharides and proteins), which have species differences.

The pathogenic properties of mycoplasmas have not been fully studied, so some researchers classify pathogens of this genus as opportunistic microorganisms (they cause a painful condition only in the presence of risk factors), while others classify them as absolute pathogens. It is known that mycoplasmas present in the genital organs at a titer of 102–104 CFU/ml do not cause inflammatory processes.

Transmission routes

The source of infection can be a sick person or a clinically healthy carrier of pathogenic mycoplasma species.

Infection with mycoplasmas of the species M. pneumoniae occurs:

• By airborne droplets. This is the main route of spread of this type of infection, but since mycoplasmas are characterized by low resistance in the environment (from 2 to 6 hours in a humid, warm environment), the infection spreads only through close contact (families, closed and semi-closed groups).
• Vertical way. This route of transmission of infection is confirmed by cases of detection of the pathogen in stillborn children. Infection can be either transplacental or during the passage of the birth canal. The disease in this case occurs in a severe form (bilateral pneumonia or generalized forms).
• By everyday means. It is observed extremely rarely due to the instability of mycoplasmas.

Infection with urogenital mycoplasmas occurs:

• Sexually, including orogenital contact. It is the main route of distribution.
• Vertically or during childbirth.
• Hematogenously (microorganisms are transported through the bloodstream to other organs and tissues).
• Contact-household way. This route of infection is unlikely for men and is about 15% likely for women.

Pathogenesis

The mechanism of development of mycoplasmosis of any type includes several stages:

1. The pathogen invades the body and multiplies in the area of ​​the entrance gate. M.pneumoniae affects the mucous membrane of the respiratory tract, multiplying on the surface of cells and in the cells themselves. M.hominis and M.genitalium affect the mucous membrane of the urogenital tract (does not penetrate cells).
2. When mycoplasma accumulates, the pathogen itself and its toxins penetrate the blood. Dissemination (spread of the pathogen) occurs, which can result in direct damage to the heart, central nervous system, joints and other organs. The hemolysin secreted by the pathogen causes the destruction of red blood cells and damages ciliated epithelial cells, which leads to impaired microcirculation and the development of vasculitis and thrombosis. Ammonia, hydrogen peroxide and neurotoxin released by mycoplasmas are toxic to the body.
3. As a result of adhesion (adhesion) of mycoplasmas and target cells, intercellular contacts, cellular metabolism and the structure of cell membranes are disrupted, which leads to dystrophy, metaplasia, death and (desquamation) of epithelial cells. As a result, microcirculation is disrupted, exudation increases, necrosis develops, and in infants the appearance of hyaline membranes is observed (the walls of the alveoli and alveolar ducts are covered with loose or dense eosinophilic masses, which consist of hemoglobin, mucoproteins, nucleoproteins and fibrin). At the early stage of development of serous inflammation, the leading role in the genesis of cell damage belongs to the direct cytodestructive effects of mycoplasmas. At subsequent stages, when the immune component of inflammation attaches, cell damage is observed due to close contact between the cell and mycoplasma. In addition, the affected tissues are infiltrated by macrophages, plasma cells, monocytes, etc. At 5-6 weeks of the disease, the main role belongs to the autoimmune mechanism of inflammation (especially in chronic mycoplasmosis).

Depending on the state of the patient’s immune system, the primary infection may result in recovery or become chronic or latent. If the immune system is in a normal state, the body is cleared of mycoplasmas. In a state of immunodeficiency, mycoplasmosis becomes latent (the pathogen persists in the body for a long time). When the immune system is suppressed, mycoplasmas begin to multiply again. With significant immunodeficiency, the disease becomes chronic. Inflammatory processes can be localized at the entrance gate or provoke a wide range of diseases (rheumatoid arthritis, bronchial asthma, etc.)

Symptoms

The incubation period of mycoplasma respiratory infection ranges from 4 days to 1 month.

This type of mycoplasmosis can clinically occur as ARVI (pharyngitis, laryngopharyngitis and bronchitis) or atypical pneumonia. The symptoms of mycoplasma acute respiratory diseases do not differ from acute respiratory viral infections caused by other pathogens. Patients experience:

• moderate intoxication;
• chills, weakness;
• headache;
• sore throat and dry cough;
• runny nose;
• slight enlargement of the cervical and submandibular lymph nodes.

The temperature is normal or subfebrile (febrile is rarely observed), conjunctivitis, inflammation of the sclera, and facial hyperemia are possible. Upon examination, hyperemia of the oropharyngeal mucosa is revealed; the membrane of the posterior wall may be granular. Hard breathing and dry wheezing can be heard in the lungs. Catarrhal symptoms disappear after 7-10 days, sometimes recovery is delayed up to 2 weeks. With complications of the disease, otitis media, eustacheitis, myringitis and sinusitis may develop.

Symptoms of acute mycoplasma pneumonia are:

• chills;
• pain in muscles and joints;
• temperature rise to 38-39 °C;
• dry cough, which gradually turns into a wet cough with the separation of mucopurulent, scanty viscous sputum.

Nausea, vomiting and stool upset are sometimes observed. Polymorphic exanthema may appear around the joints.

When listening, harsh breathing, scattered dry rales (a small amount) and moist fine bubbling rales in a limited area are revealed.

When mycoplasma pneumonia ends, bronchiectasis, pneumosclerosis or deforming bronchitis often form.

In children, mycoplasmosis is accompanied by more pronounced manifestations of toxicosis. The child becomes lethargic or restless, there is a lack of appetite, nausea, and vomiting. A transient maculopapular rash may develop. Respiratory failure is mild or absent.

In young children, generalization of the infectious process is possible. In severe form, mycoplasma pneumonia occurs in patients with immunodeficiencies, sickle cell anemia, severe cardiopulmonary diseases and Down syndrome.

Mycoplasma urogenital infection does not have specific symptoms.

Mycoplasmas provoke the development of urethritis, vulvovaginitis, colpitis, cervicitis, metroendometritis, salpingo-oophoritis, epididymitis, prostatitis, and the possible development of cystitis and pyelonephritis.

Mycoplasmosis in women is manifested by scanty transparent discharge, and painful sensations when urinating are possible. When the uterus and appendages are involved in the pathological process, minor nagging pains are observed, which intensify before the onset of menstruation.

In men, mycoplasmosis is manifested in most cases by symptoms of urethritis - burning and itching in the urethra are observed, purulent discharge is possible, urine becomes cloudy, with flakes. Young men may also develop Reiter's syndrome (combined damage to the joints, eyes and urinary tract).

The effect of mycoplasmas on pregnancy

A number of researchers believe that mycoplasmosis in pregnant women is the cause of miscarriage, since in 17% of embryos (spontaneous miscarriage at 6-10 weeks), mycoplasmas were identified among other bacteria and viruses present. At the same time, the question of the significance of mycoplasma as the only cause of spontaneous miscarriages and pathology of pregnancy and fetus has not yet been fully clarified.

Mycoplasmosis during pregnancy can cause infection of the fetus (observed in 5.5-23% of newborns) and the development of generalized mycoplasmosis in the child.

Mycoplasmas can also cause the development of postpartum infectious complications (endometritis, etc.).

Diagnostics

Since the symptoms of mycoplasmosis are not specific, smears from the urethra, vagina and cervical canal are used to diagnose the disease, and a smear from the nasopharynx, sputum and blood are used to diagnose mycoplasma respiratory infection.

To identify the pathogen, use:

• ELISA, which is used to determine the presence of antibodies of classes A, M, G (the accuracy of the method is from 50 to 80%).
• PCR (qualitative and quantitative), which allows the detection of mycoplasma DNA in biological material (99% accuracy).
• A cultural method (inoculation on IST medium), which makes it possible to isolate and identify mycoplasma in clinical material, as well as give a quantitative assessment (100% accuracy). The diagnostic value is a concentration of mycoplasmas of more than 104 CFU per ml, since mycoplasmas can also be present in healthy people.

Since M. genitalium is difficult to culture, diagnosis is usually done by PCR.

Treatment

Treatment is based on the use of antibiotics and antimicrobials. For acute uncomplicated urogenital mycoplasmosis, which:

• Caused by mycoplasma M. hominis, metronidazole and clindamycin are used. Treatment may be local.
• Caused by mycoplasma M. Genitalium, tetracycline drugs (doxycycline) or macrolides (azithromycin) are used.

Treatment of chronic mycoplasmosis requires long-term antibiotic therapy, and several antibiotics are often used. Physiotherapy, immunotherapy, and urethral instillation are also prescribed.

Simultaneous treatment of the sexual partner is also necessary.

Mycoplasmosis in pregnant women is treated with antibiotics only in the third trimester when the active phase of the disease is detected (high titer of mycoplasma).

Treatment of respiratory mycoplasmosis is based on the use of macrolides; in persons over 8 years of age, the use of tetracyclines is possible.

Prevention

Prevention consists of avoiding close contact with patients and using personal protective equipment. There is no specific prevention.