Emerging antimicrobial resistance and high prevalence of genital Mycoplasma hominis and Ureaplasma urealyticum infections among infertile women in Algeria : Implications for reproductive health.

Abstract

Background: Genital infections caused by Mycoplasma hominis and Ureaplasma urealyticum are increasingly linked to female infertility, yet their epidemiology and resistance patterns remain poorly characterized in low-resource settings.

Objective: This study aimed to determine the prevalence, antimicrobial resistance (AMR) profiles, and risk factors of M. hominis and U. urealyticum infections among infertile women in Akbou, Algeria.

Methods: In this cross-sectional analysis (February-July 2024), cervicovaginal swabs from 79 infertile women were tested using the MYCOFAST® RevolutioN 2 system. Demographic, clinical, and reproductive data were collected via structured questionnaires. Statistical analyses included χ²-testsand logistic regression.

Results: The overall infection prevalence was 37.9% (n = 30), with U. urealyticum (17.7%), M. hominis (13.9%), and co-infections (6.3%) predominating. Infections peaked in women aged 31-35 years (63.3%). Resistance to tetracycline was high (U. urealyticum: 71.4%; M. hominis: 54.5%), while doxycycline and clindamycin retained full efficacy. Significant risk factors included prior abortion (adjusted odds ratio, OR = 4.2, p < 0.001), STI history (OR = 3.8, p < 0.001), and artificial insemination (OR = 2.9, p = 0.018).

Conclusion: The high prevalence of genital Mycoplasma infections and emerging AMR in Algeria underscores the need for routine screening, updated treatment guidelines, and targeted antimicrobial stewardship programs to safeguard reproductive health.