Overlooked Urogenital Pathogens: Clinical Importance of Mycoplasma hominis and Ureaplasma urealyticum in Urine Samples

Introduction: Mycoplasma hominis and Ureaplasma urealyticum are uropathogens, especially in patients with genitourinary system disorders, but no urine culture growth.This study aimed to evaluate the presence of M. hominis and/or U. urealyticum in urine samples, antibiotic susceptibilities, and concurrent routine urine culture and urinalysis results. Materials and Methods:The results of 3042 patients were analyzed.Mycoplasma-IES (AutobioDiagnostics, China) kit was used to determine the culture and antibiotic-susceptibilities of M. hominis-U.urealyticum.Concomitant routine urine culture-urinalysis results were compared with M. hominis-U.urealyticum culture results. Results:The study evaluated 6084 results.M. hominis and/or U. urealyticum growth was detected in 17.1% of patients.The frequency of U. urealyticum was found to be higher.When antimicrobial resistance rates were analyzed, josamycin resistance was found to be significantly higher in individuals over 65 years of age with M. hominis and/or U. urealyticum positivity.Additionally, resistance to ciprofloxacin, levofloxacin, ofloxacin, clindamycin, and clarithromycin was significantly higher in females with U. urealyticum positivity.A significant difference was observed between M. hominis positivity and no growth in routine urine cultures compared to the presence of growth.A significant correlation was found between U. urealyticum positivity and the absence of growth in routine urine cultures, as well as negative findings on urinalysis.Conclusion: Although M. hominis and U. urealyticum are common commensal flora of the genitourinary system, it is clinically important to evaluate their presence on a case-by-case basis, considering their pathogenic potential.