Ureaplasma urealyticum infection

Ureaplasma urealyticum infection

Ureaplasma urealyticum is a species in the genus Ureaplasma that can cause infection. Though most bacteria possess a cell wall, U urealyticum does not. It is found in about 70% of sexually active humans. It can be found in cultures in cases of pelvic inflammatory disease and is transmitted through sexual activity or from mother to infant during birth.[1] It is not a commensal of the healthy uterine or amniotic microbiome. Infection with U. realyticum can contribute neonatal infection and negative birth outcomes.

Clinical aspects

Men

It had also been associated with a number of diseases in humans, including nonspecific urethritis, and infertility.[2][3]

Women and infants

Infection in the newborn is accompanied by a strong immune response and is correlated with the need for prolonged mechanical ventilation.[4] Infection with U. urealyticum in pregnancy and birth can be complicated by chorioamnionitis, stillbirth, premature birth,[1] and, in the perinatal period, pneumonia, bronchopulmonary dysplasia[5] and meningitis.[6] U. urealyticum has been found to be present in amniotic fluid in women who have had a premature birth with intact fetal membranes.[7]

U. urealyticum has been noted as one of the infectious causes of sterile pyuria.[8] It increases the morbidity as a cause of neonatal infections.[4] It is associated with premature birth, preterm rupture of membranes, preterm labor, cesarean section, placental inflammation, congenital pneumonia, bacteremia, meningitis, fetal lung injury and death of infant.[3] Ureaplasma urealyticum is associated with miscarriage.[9]

Treatment

Doxycycline is the drug of choice, but azithromycin is also used as a five-day course rather than a single dose that would be used to treat Chlamydia infection;[10] streptomycin is an alternative, but is less popular because it must be injected. Penicillins are ineffective — U. urealyticum does not have a cell wall,[11] which is the drug's main target.[12][13]

References

  1. 1 2 Ljubin-Sternak, Suncanica; Mestrovic, Tomislav (2014). "Review: Clamydia trachonmatis and Genital Mycoplasmias: Pathogens with an Impact on Human Reproductive Health". Journal of Pathogens. 2014 (183167): 1–15. doi:10.1155/2014/183167. PMC 4295611. PMID 25614838.
  2. ↑ C. Huang; H.L. Zhu; K.R. Xu; S.Y. Wang; L.Q. Fan; W.B. Zhu (September 2015). "Mycoplasma and ureaplasma infection and male infertility: a systematic review and meta-analysis". Andrology. 3 (5): 809–816. doi:10.1111/andr.12078. PMID 26311339.
  3. 1 2 Medscape (2017-11-17). "Ureaplasma Infection: Background, Pathophysiology, Epidemiology".
  4. 1 2 Pryhuber, Gloria S. (2015). "Postnatal Infections and Immunology Affecting Chronic Lung Disease of Prematurity". Clinics in Perinatology. 42 (4): 697–718. doi:10.1016/j.clp.2015.08.002. ISSN 0095-5108. PMC 4660246. PMID 26593074; Access provided by the University of Pittsburgh
  5. ↑ Kafetzis DA, Skevaki CL, Skouteri V, et al. (October 2004). "Maternal genital colonization with Ureaplasma urealyticum promotes preterm delivery: association of the respiratory colonization of premature infants with chronic lung disease and increased mortality". Clin. Infect. Dis. 39 (8): 1113–22. doi:10.1086/424505. PMID 15486833.
  6. ↑ Queena, John T. .; Spong, Catherine Y; Lockwood, Charles J., editors (2012). Queenan's management of high-risk pregnancy : an evidence-based approach (6th ed.). Chichester, West Sussex: Wiley-Blackwell. ISBN 9780470655764.
  7. ↑ Payne, Matthew S.; Bayatibojakhi, Sara (2014). "Exploring Preterm Birth as a Polymicrobial Disease: An Overview of the Uterine Microbiome". Frontiers in Immunology. 5. doi:10.3389/fimmu.2014.00595. ISSN 1664-3224.
  8. ↑ Dieter RS (2000). "Sterile pyuria: a differential diagnosis". Compr Ther. 26 (3): 150–2. doi:10.1007/s12019-000-0001-1. PMID 10984817.
  9. ↑ Cunningham, F, Leveno KJ, Bloom SL, Spong CY, Dashe JS, Hoffman BL, Casey BM, Sheffield JS (2013). "Abortion". Williams Obstetrics. McGraw-Hill. p. 5.
  10. ↑ "Ureaplasma Urealyticum and Parvum Test Online". thesticlinic.com.
  11. ↑ Vancutsem E, Soetens O, Breugelmans M, Foulon W, Naessens A (2011). "Modified Real-Time PCR for Detecting, Differentiating, and Quantifying Ureaplasma urealyticum and Ureaplasma parvum". J Mol Diagn. 13 (2): 206–12. doi:10.1016/j.jmoldx.2010.10.007. PMC 3128564. PMID 21354056.
  12. ↑ "Drugs — Pencillin". elmhurst.edu.
  13. ↑ Pignanelli S, Pulcrano G, Iula VD, Zaccherini P, Testa A, Catania MR (2013). "In vitro antimicrobial profile of Ureaplasma urealyticum from genital tract of childbearing-aged women in Northern and Southern Italy". APMIS. 122 (6): 552–5. doi:10.1111/apm.12184. PMID 24106832.
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