Mycoplasma hominis chorioamnionitis associated with preterm delivery: A case report

Abstract

This case report highlights a Mycoplasma hominis infection associated with chorioamnionitis following preterm premature rupture of membranes (PPROM) in a 43-year-old pregnant woman at 30 weeks gestation. The patient presented with a mild fever and increased white cell count, leading to the diagnosis of chorioamnionitis. Empiric antibiotic treatment with ampicillin and gentamicin was initiated, later switched to ceftriaxone. Mycoplasma hominis was identified through routine placental cultures on CDC Anaerobic Blood Agar, and confirmed by whole-genome sequencing (WGS) using the Illumina HiSeq platform. The WGS revealed no resistance mutations to macrolides, quinolones, or tetracyclines, and predicted susceptibility to these antimicrobials. The isolate exhibited a high number of SNP differences (5471–8074) compared to publicly available M. hominis genomes. No specific anti-Mycoplasma treatment was administered, and both mother and newborn had favourable outcomes. This case underscores the importance of considering Mycoplasma infections in pregnancy complications and the need for specialized testing, as routine cultures may fail to detect these organisms. WGS offers a comprehensive approach to pathogen identification and drug resistance profiling, though the clinical impact of targeted antimicrobial therapy for Mycoplasma infections in such cases remains uncertain.