Objective To analyze the epidemiological characteristics and drug resistance patterns of urogenital mycoplasma infections in patient specimens from non-gynecologic departmentsat West China Hospital, Sichuan University between 2020 and 2024, and to provide evidence for clinical diagnosis, treatment, and antimicrobial stewardship of mycoplasma infections in non-gynecologic patients.

Methods A total of 856 Mycoplasma culture specimens were retrospectively analyzed in the study. All specimens were submitted for lab analysis by urology, dermatovenereology, and other relevant departments (excluding gynecology) of our hospital between 2020 and 2024. Mycoplasma culture, identification, and antimicrobial susceptibility testing were performed using the bioMérieux colorimetric kit (France). The detection rate, species distribution, demographic characteristics, and antimicrobial resistance profiles of mycoplasma infections were analyzed accordingly.

Results The overall positivity rate was 14.02% (120/856), with urethral secretions constituting the predominant specimen type (48.33%). Ureaplasma spp. infections accounted for 89.17% (107/120), Mycoplasma hominis infections for 4.17% (5/120), and co-infections for 6.66% (8/120). Among patients with non-gynecologic urogenital mycoplasma infections, the positive rate in women (24.67%) was higher than that in men (8.27%) (P < 0.05), with women exhibiting a 2.98-fold higher risk of infection (risk ratio RR = 2.98, 95% CI: 2.12-4.19) compared to men. The peak incidence occurred in the 30-39 age group (50.00%). High resistance to quinolones was prevalent, with resistance rates exceeding 80% for both ofloxacin and ciprofloxacin. Among macrolides, josamycin exhibited the highest susceptibility rate (93.33%). Among tetracycline-class antibiotics, all isolates were 100% susceptible to doxycycline.

Conclusion Urogenital mycoplasma infections are predominantly caused by Ureaplasma spp. infection, with higher incidence among women and individuals aged 30-39 years. When clear clinical indications are present, tetracycline-class antibiotics, such as doxycycline, should be considered preferential therapeutic options. Special attention should also be given to the high rates of macrolide resistance of Mycoplasma hominis infections and co-infections.