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

BACKGROUND: The 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.

METHODS: Data 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.

RESULTS: The 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.

CONCLUSION: Genital 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.