Prevalence and antibiotic resistance of Mycoplasma hominis and Ureaplasma urealyticum in Chongming District, Shanghai, China from 2020 to 2023

Ureaplasma urealyticum (UU) and Mycoplasma hominis (MH) can lead to various genital and extragenital infections, with antibiotic resistance growing and varying wordwide. This study aims to investigate the prevalence and antibiotic resistance profiles of MH and UU in outpatients in Shanghai, China, from 2020 to 2023. A facility-based cross-sectional study was conducted from January 1, 2020 to December 31, 2023. Trends of MH, UU and coinfection (MH and UU coinfection), rate of antibiotic resistance during 2020 and 2023 were analyzed based on Cochran-Armitage trend test. We analyzed the prevalence and antibiotics resistance rate base on chi-square test or a single sample t-test. Our study indicated that the overall positive rate of MH, UU and coinfection were 13.47%, 32.13%, and 11.21%, respectively. For age, the trend of positive rate of UU decreased significantly (Z = -3.62, P < .001). Furthermore, the positive rate of UU increased from 31.82% in 2020 to 47.92% in 2023 (Z = 1.98, P < .05). During 2020 and 2023, Methomycin and strong bacteriocins maintained high activity against both MH and UU, with resistance rates <5%. But roxithromycin (85.48%), azithromycin (75.81%), and levofloxacin (70.97%) showed limit activity for MH, and levofloxacin (44.78%), sparfloxacin (37.36%), and azithromycin (29.40%) showed limit activity for UU. Between 2020 and 2023, the rate of antibiotic resistance to azithromycin, clarithromycin, roxithromycin, methomycin, strong bacteriocins, sparfloxacin, and levofloxacin decreased against MH. The rate of antibiotic resistance to levofloxacin decreased against UU, but increased to josamycin against UU. Josamycin, methomycin, and strong bacteriocins are promising antibiotics against MH and UU. The prevalence of MH and UU should pay more attention in China. Josamycin, methomycin, and strong bacteriocins maintained outstanding activity against MH and UU, although the resistance rate of MH to josamycin increased.