A 19-Year Audit of Genital Mycoplasma Species in Blood Cultures From Women Attending a Tertiary Maternity Hospital.

backgroundThe genital mycoplasmas, Ureaplasma parvum, Ureaplasma urealyticum and Mycoplasma hominis commonly colonise the female genital tract and occasionally cause invasive infection. Our microbiology laboratory, which services a specialist maternity referral hospital, is unique in manufacturing specialised in-house blood culture media for detecting mycoplasma bacteraemia. This audit aimed to review the proportion of patients with a positive blood culture for a genital mycoplasma species over a 19-year period and to describe clinical management and outcomes for these patients.

methodsData was extracted from the laboratory information system to identify all mycoplasma blood culture bottles collected from 2000 to 2018 for women > 18 years at the Royal Women's Hospital in Victoria, Australia. Clinical and demographic data for women with a blood culture positive for a genital mycoplasma species over the period 2008-2018 were extracted from the hospital medical records.

resultsThe average annual blood culture positivity rate for a genital mycoplasma was 0.56%. Thirty-eight women had a blood culture positive for Ureaplasma spp. (n = 28) or Mycoplasma hominis (n = 13); three women had both organisms isolated from a single blood culture. Most women had a genital mycoplasma isolated in the early post-partum period (66%) or associated with early pregnancy loss (23%). 57% of women received antibiotics which would be expected to have activity against mycoplasmas. No adverse outcomes were recorded within 30 days, regardless of whether mycoplasma-active antibiotics were prescribed.

conclusionGenital mycoplasma bacteraemia may occur in the early post-partum period or be associated with early pregnancy loss. It is unclear whether this represents transient bacteraemia or whether women benefit from directed antimicrobial therapy.