Mycoplasma hominis: what is it, what to treat?

The intracellular microorganism - mycoplasma hominis - does not always cause the disease, but sometimes provokes the development of a pathology such as mycoplasmosis. Pathogenic microbes often act as causative agents of infections and inflammatory reactions in which healthy cells are damaged, both by the microbes themselves and by toxic products of their vital activity.

Mycoplasma hominis can develop outside the cell, because of this, the immune defense becomes difficult to detect. The microorganism has a three-layer membrane, has DNA, RNA, has a pronounced effect on immunity, causing diseases of the respiratory and urogenital tracts.

[1], [2], [3], [4]

Pathogenesis

Microorganism mycoplasma hominis refers to conditionally pathogenic microbes that can live in the body of even healthy people, and this is considered absolutely normal. That is, a person throughout his life may not suspect that his body has mycoplasma, and no harm in the norm of the microbe does not bring.

If within the body certain conditions are created, under which the development and reproduction of mycoplasma accelerates, then in this situation one can already talk about a deviation from the norm - namely, the development of the disease. For this to happen, it is necessary to create certain conditions that are promoted by such risk factors:

• weakening of immunity;
• change in hormonal balance;
• chronic alcohol intoxication;
• chronic dysbiosis;
• postinfection and postoperative conditions, exhaustion of the body.

Among other reasons for increasing the pathogenicity of mycoplasma, we can distinguish:

• unsatisfactory social and living conditions of residence, non-observance of sanitary and hygienic standards;
• unprotected sexual intimacy with a patient with mycoplasmosis;
• frequent or chronic diseases of the urogenital system;
• promiscuous sexual intercourse;
• early sexual life.

Mycoplasma hominis in women often appears:

• with a disorderly sexual life;
• with long-term use of hormonal or immunosuppressive drugs, antibiotics;
• after abortions, pregnancies;
• as a result of the weakening of immune defense under stress;
• after chemo and radiation treatment.

The microorganism of mycoplasma hominis has a small size, it is surrounded by a cytoplasmic membrane.

Mycoplasma does not have a clear cell wall, but there is a tendency to polymorphism. Such features determine the relative resistance of the microbe to antibiotic therapy.

With a combination of certain optimal conditions for mycoplasma, the microbe begins to multiply rapidly, which leads to the development of an infectious reaction. The number of mycoplasmas can reach 10 thousand / ml, or even more. In such a situation, male patients develop prostatitis, urethritis, epididymitis, and in women - inflammatory processes in the reproductive and urinary system.

Mycoplasmas settle on eukaryotic membranes, which in the case of pathology leads to the development of a local inflammatory reaction. Microbes "suck" to the cells of the epithelium with the help of receptors, change the functionality of cells and stimulate autoimmune reactions. As a result, hemostasis is disrupted, the vascular endothelium is affected, platelets are glued together, and the DIC syndrome develops.

How is mycoplasma hominis transmitted?

Mycoplasma hominis can be transmitted in several ways:

• Sexual mechanism of transmission is possible with random unprotected sex. In some cases, the patient may not know that he is the carrier of the infection - but this does not exclude the possibility of infection.
• A child can get infected from the mother during childbirth if the mother is a carrier of mycoplasma.
• The household transfer mechanism implies the use of common personal hygiene items: for example, if several people use one towel, including the carrier of the infection.

In this case, the most common way of transmission of mycoplasma is the sexual way.

[5], [6], [7], [8], [9],

Epidemiology

Mycoplasma hominis has a wide distribution in the natural environment: the microbe constantly resides within living organisms. Mycoplasma hominis and genitalia live and develop in the genitourinary system, and when combined certain conditions cause the appearance of a urogenital disease.

As of today, mycoplasma is diagnosed in 30-70% of women on the background of inflammatory urinary diseases, and in 20-40% of men.

The most common method of infection is unprotected sex.

[10], [11], [12], [13], [14], [15], [16], [17], [18], [19]

Symptoms

Mycoplasma can cause an infectious disease with all the relevant symptoms, or for a long time to remain in a "dormant" state, without manifesting itself. Explicit first signs of the disease are found only when the number of pathogens reaches 104-106 cfu / ml or more.

The incubation period of infection caused by mycoplasma may be different. It depends on such factors:

• from the number of microbes inside the body;
• from the degree of lowering of immunity, the general state of the organism;
• from the localization of the lesion - for example, with respiratory mycoplasmosis, the incubation period can be as several days and a month, and with lesion of the genito-urinary organs - from two to three weeks.

The first signs of mycoplasma involvement in the respiratory system are manifested by the development of pharyngitis, rhinopharyngitis, laryngopharyngitis, bronchitis - while the clinical picture corresponds to the listed pathologies. Common signs of intoxication are usually mild. It can be a slight fever, weakness, pain in the head, a feeling of aches. Additional symptoms are dry cough, rhinitis. Visually, you can pay attention to conjunctivitis, submandibular and cervical lymphadenopathy, reddening of the oropharynx. Auscultatory in the lungs there are wheezing and hard breathing.

The clinical picture with urogenital mycoplasmosis should be considered separately for patients of different sexes.

Mycoplasma hominis in women manifests itself as signs of vaginitis, vaginosis, salpingo-oophoritis, thrush, endometritis, etc. Infection reveals itself as a crotch itch, the presence of massive discharge with an unpleasant odor, a burning sensation at the end of urination or sexual contact, suprapubic pain. As secondary manifestations may occur adhesive processes, ectopic pregnancy, difficulties with conception, etc.

Mycoplasma hominis in men affects the mucous tissues of the prostate gland, urethra, kidneys. Characteristic signs may be:

• colorless small discharge in the morning;
• burning sensation in the urethra;
• Pulling pain in the groin;
• edema;
• problems with potency.

If you do not pay attention to the problem in time, then mycoplasma can lead to such diseases as prostatitis, urethritis, as well as male infertility caused by a disorder of spermatogenesis.

Secondary symptoms of mycoplasmosis may be unmotivated seizures of nausea and vomiting, a slight increase in temperature.

Mycoplasma hominis in pregnant women

The increased multiplication of mycoplasma hominis in the female body during pregnancy can become a provoking factor in the development of premature labor, spontaneous abortion, uterine bleeding, and early placental abruption. Such troubles are related to the intrauterine inflammatory process.

If a newborn baby gets infected during labor, then it increases the risk of developing meningitis or mycoplasmosis pneumonia. In neglected cases, the child may even die.

There is evidence that mycoplasma, which causes an acute inflammatory process during pregnancy, can cause disorders in the intrauterine development of the child - primarily due to intoxication and impaired blood circulation in the fetus.

Mycoplasma hominis in children

Babies become infected with mycoplasma mainly during labor, if the mother is sick or carries the infection. Mycoplasma hominis is often the primary cause of the appearance of chorioamnionitis, postpartum infectious disease, pyelonephritis - after all, during birth microbes fall not only on the skin, but also on mucous membranes, respiratory organs and even in the stomach of the newborn.

The consequence of infection to the baby can be:

• inflammation of the walls of the ventricles of the ventriculitis;
• inflammation of the membranes of the brain - meningitis;
• abscesses (as an external abscess, and with a lesion of the brain);
• lymphadenitis, general intoxication of the body.

The degree of survival in these babies is considered extremely low, and it largely depends on the state of the immune system of the baby. If there are chances of recovery, then, as a rule, it proceeds slowly, against a background of severe and prolonged treatment.

Mycoplasma hominis and gardnerella

Often the difficulty in treating mycoplasmosis lies in the fact that the infection in most cases is not present in isolation. In many patients mycoplasma coexists simultaneously with ureaplasma, chlamydia, Trichomonas, Gardnerella. That is why the diagnosis of infectious inflammation should be maximally voluminous, so that the prescribed treatment was adequate and did not lead to a new wave of the disease with a co-infection.

Gardnerella among inflammatory pathologies of the urogenital system occupies one of the leading places and often becomes the cause of inflammatory processes in the genitals and urinary tract. Mycoplasma in combination with gardnerella is difficult to cure and shows a tendency to repeat episodes of the disease.

Complications and consequences

Mycoplasma often leads to the onset of an infectious inflammatory reaction of the urogenital organs. Some of the undesirable consequences are:

• difficulties with conceiving a child, both in men and women;
• adhesions, chronic inflammatory processes;
• violations during pregnancy;
• abnormalities of fetal development;
• serious illness in a newborn baby, death;
• periodic febrile conditions.

[20], [21], [22], [23], [24],

Diagnostics

Since there are no specific symptoms of mycoplasma infection, this makes the diagnosis somewhat difficult. Laboratory studies, collection of epidemiological history are mandatory. However, not all diagnostic techniques for mycoplasma are informative. For example, light microscopy will not help to detect mycoplasma, since this microorganism does not have a membrane.

When suspected for mycoplasma, such diagnostic procedures and tests are preferred:

• Seeding on mycoplasma hominis: for it take a swab from the vaginal walls, or discharge from the cervical canal or urethra. This method determines only mycoplasma hominis in the smear, but not mycoplasma genitalia. The disadvantages of this method are the following: for a quality cultivation it is not easy to choose the right nutrient medium, and the growing period can be quite long.
• Immunological analysis on mycoplasma hominis allows to identify antibodies to microbes in the blood. The analysis of a blood take since morning on an empty stomach. Minus this method: it is not always informative. For example, with weakened antigenicity and a significant immunodeficiency state, the indicators may become erroneous.
• The method of polymerase chain reaction is considered the most informative in terms of determining the presence of mycoplasma. The method allows to detect such structures as mycoplasma hominis DNA - both in the blood and in the smear. The main difference between the method and other varieties of research is that the indicators are not distorted even after antibiotic therapy. Minus this method: there is a possibility of confusion between the detected DNA of the dead microbes and the DNA of active microorganisms.

When carrying out an enzyme immunoassay, a negative or norm of mycoplasma hominis is considered when two IgG and IgM antibodies are indicated under the minus sign. If the value of Mycoplasma hominis IgG is positive and IgM is negative, it should be understood that the patient has already formed his own immune response to the infection.

With positive both values, it is necessary to treat mycoplasmosis.

About full recovery is said when a blood test shows that mycoplasma hominis IgA, IgG and IgM are absent.

Mycoplasma hominis IgG is detected in the blood 2-3 weeks after the onset of the disease: it can be detected also for 1-2 years after clinical treatment. IgM antibodies are detected somewhat earlier. Thus, titers of antibodies to mycoplasma hominis of IgG class increase about a week later than IgM antibodies, however they remain elevated for a longer time.

The quantitative analysis for mycoplasma hominis is determined by such referential values:

• IgG:
  • less than 0.8 - result (-);
  • from 0,8 to 1,1 - the result is doubtful;
  • from 1,1 and above - result (+).
• IgM:
  • less than 0.8 - result (-);
  • from 0,8 to 1,1 - the result is doubtful;
  • from 1,1 and above - result (+).
• Age:
  • less than 0.8 - result (-);
  • from 0,8 to 1,1 - the result is doubtful;
  • from 1,1 and above - result (+).

Instrumental diagnostics, as a rule, is limited to the listed types of research. Additional diagnostic procedures can be prescribed only if other diseases are suspected or complications are attached.

Differential diagnosis of mycoplasma damage is often very difficult, due to the lack of typical symptoms for this infection. Therefore, the main diagnostic method should be laboratory tests. As a rule, differentiate mycoplasmosis with gonorrhea, vaginal candidiasis, etc.

The results of the tests often cause a lot of questions in patients. For example, mycoplasma hominis and genitalium: what's the difference?

Mycoplasma hominis is a conditionally pathogenic microbe, which can be present in the body, both in norm and in pathology, a difference only in the amount of this microorganism.

Mycoplasma genitalia is considered to be a pathogenic microbe, possessing a high degree of pathogenicity and contagiousness (infectiousness). Fortunately, mycoplasma genitalia is less common, however, differential diagnosis between these two types of mycoplasma is mandatory.

[25], [26], [27]

Treatment

Therapy in cases of mycoplasma involvement with hominis must necessarily be complex and include the use of antibiotics, antifungal agents, immunomodulators. For antibiotic therapy, the most commonly used drugs are a macrolide group - Clarithromycin, Sumamed, Fromilide, etc. The tetracyclines also have a similar effect. The duration of therapy with mycoplasma is usually 1-3 weeks. However, the doctor can make his own adjustments depending on the course of the disease, on the degree of weakness of immunity, on the age and general health of a person.

Enzyme therapy is used mainly in the chronic course of mycoplasmosis, and only against the background of the main antibiotic therapy.

Complex treatment can also include physiotherapy and the use of external drugs (for irrigation, irrigation, suppositories, douching).

Do I need to treat mycoplasma hominis?

Mycoplasma hominis is considered a microbe, which can be present in the normal flora of a healthy person, including in pregnant women, without causing any troubles and diseases. Under normal conditions, if mycoplasma does not lead to the appearance of painful symptoms, it is not necessary to treat it. Treatment is prescribed only if there are complaints from the patient or patient. Important difference: if the analysis indicates the presence of mycoplasma genitalia, then treatment must be carried out necessarily.

The treatment regimen of mycoplasma hominis is always formed to provide a complex effect. Typically, such drugs are used:

• Antibiotics of a broad spectrum of antimicrobial activity:
  • tetracyclines - doxycycline;
  • macrolides - azithromycin, clarithromycin;
  • fluoroquinolones - Ciprofloxacin, Cyphran.
• Antiprotozoal preparations - Trichopol.
• External antibacterial and antiseptic agents - suppositories Metronidazole, ointment Oflokain, suppositories Geksikon.
• Antifungal drugs that are mandatory for antibiotic prescribing - Nystatin, Fluconazole, Clotrimazole, and also the Livarol suppository or others.
• Probiotics that support the balance of the flora - Vaginorm, Lactonorm.
• Immunostimulating drugs - Immunal, Immunorix.
• Painkillers with severe pain, non-steroidal anti-inflammatory drugs.
• Vitamins of complex composition - Vitrum, Undevit, Alphabet.
• Douching, irrigation with decoctions of medicinal herbs, Miramistin.

[28], [29], [30],

Antibiotics for mycoplasma hominis

	Dosage and route of administration	Side effects	Special instructions
Sumamed	Take 1 g of the drug once a day, between meals.	Pain in the head, temporary visual impairment, nausea, abdominal pain.	Sumamed in capsules can not be prescribed to children weighing less than 45 kg.
Clarithromycin	Take 500 mg twice a day, for 3-4 weeks.	Pain in the abdomen, diarrhea, nausea, changes in taste.	Clarithromycin is not used to treat children under 12 years old.
Cifran	Applied as injections in severe mycoplasmosis, in individually selected dosages.	Rash on the body, nausea, diarrhea, transient increase in transaminase activity.	Tsifran is not recommended for use during pregnancy, lactation, and pediatrics.
Oflokain cream	Applied for the treatment of men with mycoplasmosis of the external genitalia. Apply to the skin 2 times a day.	Itching, redness of the skin, rash, swelling.	With mycoplasma, Oflocaine is used only for the treatment of men. It is appropriate for women to use suppositories.
Doxycycline	Capsules of 100 mg twice a day, not less than a week.	Hypersensitive reactions, tinnitus, digestive disorders.	Doxycycline is contraindicated in pregnancy. Children are used from the age of 12.

[31], [32], [33], [34],

Physiotherapeutic treatment

Physiotherapeutic procedures are prescribed only with confirmed mycoplasmosis, as an auxiliary type of treatment. Such procedures will help to stop the development of the inflammatory process, to prevent the formation of adhesions.

Usually used:

• Electrotherapy (improves blood flow in tissues, relieves pain);
• Magnetic-laser treatment (enhances the effect of drugs);
• Therapy by ultrasound (improves blood circulation, relieves pain).

As part of the overall treatment scheme, ozonotherapy can be used, which reduces the duration of the treatment course by increasing the effect of antibiotics and the antibacterial effect of ozone.

Alternative treatment

To successfully cure of mycoplasmosis, it is necessary to apply a comprehensive approach, with mandatory passage of antibiotic therapy. Doctors unanimously state that it will not be possible to get rid of mycoplasma only with the help of alternative prescriptions. However, alternative drugs will actually help to eliminate the unpleasant symptoms of mycoplasmosis, and also effectively complement the traditional conservative treatment prescribed by the doctor.

Fresh garlic with mycoplasma hominis is recommended to eat every day, for several teeth (at least 2 pieces). You can make garlic salad dressing, and then add it not only to salads, but also to water them other dishes. When preparing the sauce, mix the minced garlic, lemon juice, a little vegetable oil and salt.

Mycoplasma will quickly leave the body, if daily three times a day to drink tea, brewed on the basis of grass blue cornflower. To make such a tea, you need to pour boiling water (250 ml) with two tablespoons of dry herb and keep under the lid for 50-60 minutes.

A good effect of mycoplasma is shown by the St. John's wort and the color of the mimic. Two full tablespoons of an equilibrium mixture of these plants are poured with a liter of water and boiled on low heat for 8-10 minutes, then insisted under the lid for another 2 hours. Next, the medicine is filtered and drunk in a glass three times a day, about a quarter of an hour before a meal.

As a supplement, it is recommended to enrich the diet with vitamins in order to properly maintain immunity. It is necessary to include in the menu plant products, as well as broths of dog rose, currant, chamomile.

[35], [36], [37], [38], [39]

Herbal Treatment

When the mycoplasma affects the female sex system, it is recommended that the douches be douched with the following infusion: take one tablespoon of the grass of the hog queen and two tablespoons of the crushed oak bark, pour 400 ml of boiling water, insist 40 minutes. The resulting infusion is cooled, filtered well through gauze and used for douching, in the morning and at night.

Treatment with herbs for mycoplasma also includes the use of herbal teas enriched with vitamins, which allows to strengthen and support immune defense. As a basis for tea, you can apply rose hips, cranberry berries, needles - ingredients in the amount of 2 tablespoons pour 0.5 liters of boiling water and allow to infuse for six hours. The received medicine should be drunk every day for 1-2 glasses (it is possible with honey).

In the daily menu it is recommended to include a lot of greenery (dill, stalks of celery, coriander), seasonal vegetables and citrus.

Homeopathy

Homeopathic preparations with mycoplasma involvement hominis can be used only as an auxiliary kind of therapy, since these medications can not remove the infection from the body. However, they are able to stop the inflammatory process and eliminate the unpleasant signs of the disease.

In acute inflammatory process, such homeopathic remedies can be useful:

• Aconite;
• Belladonna;
• Colon;
• Staphysiria;
• Mercury corrodes.
• In subacute disease often appointed:
• Acidum benzoicum;
• The Equisetum;
• Acidum nitrikum.

With frequent relapses of the disease will help:

• Tue
• Likopodium;
• Calcium carbonate.

At the beginning of treatment it is recommended to use low dilutions (potency) of homeopathic medicines. In the future, you can adjust the dosage depending on how effective the drug is.

Surgery

Surgical intervention to treat lesions of mycoplasma hominis is not practiced.

Prevention of the mycoplasma hominis

In order to prevent respiratory infection, mycoplasma should be given special attention to personal hygiene. It is inadmissible to use someone else's dishes for eating, to put on other people's things, to wipe themselves with other people's towels.

In order not to interfere with urogenital mycoplasmosis, it is necessary to carefully select sexual partners, not to allow promiscuous sexual intercourse. Sex with an unfamiliar person must necessarily be protected.

It is worth noting that the defeat of mycoplasma, diagnosed in the initial stage, has every chance of a complete cure.

Immunity in relation to mycoplasma in humans is not formed, so there are no special vaccinations against mycoplasmosis: the responsibility for prevention lies entirely with each specific person.

[40], [41], [42], [43]

Forecast

If the approach to the treatment of mycoplasmosis was literate, and the probability of a relapse of infection was reduced to zero, then several medication courses usually lead to a cure. Independently, without the help of a doctor, the disease can not be cured.

In addition, for a complete cure it is necessary to be examined for the presence of other infectious diseases that may be present in the body along with mycoplasma hominis. If mycoplasma hominis is not the only causative agent of the disease, the treatment may be longer, but it also completely cures.

[44], [45]