Ureaplasma urealyticum natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Fatimo Biobaku M.B.B.S [2]

Overview

The genital tract of adult men and women serve as the main reservoirs for Ureaplasma species.[1][2] Pregnancy complications such as chorioamnionitis, preterm labor, and miscarriages have been associated with Ureaplasma.[3][4][5][6][7] Neonatal complications associated with Ureaplasma include prematurity, pneumonia, pneumonitis, bronchopulmonary dysplasia, respiratory distress syndrome of the newborn and sepsis. Urogenital tract infections such as nongonococcal urethritis in men have also been associated with Ureaplasma urealyticum.[8][9]

Natural history, Complications and Prognosis

Natural History

The genital tract of adult men and women serve as the main reservoirs for Ureaplasma species.[1][2] Colonization by Ureaplasma species has been documented in sick as well as healthy infants.[10]

Complications

Infection with Ureaplasma species has been associated with the following complications:

Pregnancy complications[3][4][5][6][7]

Fetal/neonatal complications[2][10][11][12][13][14][15][16][17][18][19]

Common

Uncommon

Complications in adult men and women[1][20][21][22][23][24][25][26][27][8][9]

Prognosis

Polymicrobial infection of the amniotic fluid with Ureaplasma species and other bacteria is associated with poor perinatal prognosis in preterm labor.[28] Despite macrolide antibiotic treatment, there is a significant association between U. urealyticum infection and pulmonary morbidity and mild cerebral impairment in preterm infants.[2]

References

  1. 1.0 1.1 1.2 Deguchi T, Yoshida T, Miyazawa T, Yasuda M, Tamaki M, Ishiko H; et al. (2004). "Association of Ureaplasma urealyticum (biovar 2) with nongonococcal urethritis". Sex Transm Dis. 31 (3): 192–5. PMID 15076934.
  2. 2.0 2.1 2.2 2.3 Resch B, Gutmann C, Reiterer F, Luxner J, Urlesberger B (2016). "Neonatal Ureaplasma urealyticum colonization increases pulmonary and cerebral morbidity despite treatment with macrolide antibiotics". Infection. 44 (3): 323–7. doi:10.1007/s15010-015-0858-7. PMID 26518581.
  3. 3.0 3.1 Harada K, Tanaka H, Komori S, Tsuji Y, Nagata K, Tsutsui H; et al. (2008). "Vaginal infection with Ureaplasma urealyticum accounts for preterm delivery via induction of inflammatory responses". Microbiol Immunol. 52 (6): 297–304. doi:10.1111/j.1348-0421.2008.00039.x. PMID 18577163.
  4. 4.0 4.1 Vogel I, Thorsen P, Hogan VK, Schieve LA, Jacobsson B, Ferre CD (2006). "The joint effect of vaginal Ureaplasma urealyticum and bacterial vaginosis on adverse pregnancy outcomes". Acta Obstet Gynecol Scand. 85 (7): 778–85. doi:10.1080/00016340500442423. PMID 16817073.
  5. 5.0 5.1 Kikhney J, von Schöning D, Steding I, Schulze J, Petrich A, Hiergeist A; et al. (2017). "Is Ureaplasma spp. the leading causative agent of acute chorioamnionitis in women with preterm birth?". Clin Microbiol Infect. 23 (2): 119.e1–119.e7. doi:10.1016/j.cmi.2016.10.010. PMID 27756710.
  6. 6.0 6.1 Joste NE, Kundsin RB, Genest DR (1994). "Histology and Ureaplasma urealyticum culture in 63 cases of first trimester abortion". Am J Clin Pathol. 102 (6): 729–32. PMID 7801884.
  7. 7.0 7.1 Koucký M, Malíčková K, Cindrová-Davies T, Smíšek J, Vráblíková H, Černý A; et al. (2016). "Prolonged progesterone administration is associated with less frequent cervicovaginal colonization by Ureaplasma urealyticum during pregnancy - Results of a pilot study". J Reprod Immunol. 116: 35–41. doi:10.1016/j.jri.2016.04.285. PMID 27172838.
  8. 8.0 8.1 Esen B, Gozalan A, Sevindi DF, Demirbas A, Onde U, Erkayran U; et al. (2017). "Ureaplasma urealyticum: Presence among Sexually Transmitted Diseases". Jpn J Infect Dis. 70 (1): 75–79. doi:10.7883/yoken.JJID.2015.258. PMID 27000449.
  9. 9.0 9.1 García-de-la-Fuente C, Miñambres E, Ugalde E, Sáez A, Martinez-Martinez L, Fariñas MC (2008). "Post-operative mediastinitis, pleuritis and pericarditis due to Mycoplasma hominis and Ureaplasma urealyticum with a fatal outcome". J Med Microbiol. 57 (Pt 5): 656–7. doi:10.1099/jmm.0.47632-0. PMID 18436601.
  10. 10.0 10.1 Waites KB, Crouse DT, Cassell GH (1993). "Systemic neonatal infection due to Ureaplasma urealyticum". Clin Infect Dis. 17 Suppl 1: S131–5. PMID 8399903.
  11. Waites KB, Crouse DT, Philips JB, Canupp KC, Cassell GH (1989). "Ureaplasmal pneumonia and sepsis associated with persistent pulmonary hypertension of the newborn". Pediatrics. 83 (1): 79–85. PMID 2909979.
  12. Okogbule-Wonodi AC, Gross GW, Sun CC, Agthe AG, Xiao L, Waites KB; et al. (2011). "Necrotizing enterocolitis is associated with ureaplasma colonization in preterm infants". Pediatr Res. 69 (5 Pt 1): 442–7. doi:10.1203/PDR.0b013e3182111827. PMC 3968774. PMID 21258263.
  13. Viscardi RM, Hashmi N, Gross GW, Sun CC, Rodriguez A, Fairchild KD (2008). "Incidence of invasive ureaplasma in VLBW infants: relationship to severe intraventricular hemorrhage". J Perinatol. 28 (11): 759–65. doi:10.1038/jp.2008.98. PMC 5334544. PMID 18596706.
  14. Patterson AM, Taciak V, Lovchik J, Fox RE, Campbell AB, Viscardi RM (1998). "Ureaplasma urealyticum respiratory tract colonization is associated with an increase in interleukin 1-beta and tumor necrosis factor alpha relative to interleukin 6 in tracheal aspirates of preterm infants". Pediatr Infect Dis J. 17 (4): 321–8. PMID 9576388.
  15. Waites KB, Rudd PT, Crouse DT, Canupp KC, Nelson KG, Ramsey C; et al. (1988). "Chronic Ureaplasma urealyticum and Mycoplasma hominis infections of central nervous system in preterm infants". Lancet. 1 (8575–6): 17–21. PMID 2891889.
  16. Agarwal P, Rajadurai VS, Pradeepkumar VK, Tan KW (2000). "Ureaplasma urealyticum and its association with chronic lung disease in Asian neonates". J Paediatr Child Health. 36 (5): 487–90. PMID 11036807.
  17. Abele-Horn M, Peters J, Genzel-Boroviczény O, Wolff C, Zimmermann A, Gottschling W (1997). "Vaginal Ureaplasma urealyticum colonization: influence on pregnancy outcome and neonatal morbidity". Infection. 25 (5): 286–91. PMID 9334863.
  18. Schelonka RL, Katz B, Waites KB, Benjamin DK (2005). "Critical appraisal of the role of Ureaplasma in the development of bronchopulmonary dysplasia with metaanalytic techniques". Pediatr Infect Dis J. 24 (12): 1033–9. PMID 16371861.
  19. Wang EE, Ohlsson A, Kellner JD (1995). "Association of Ureaplasma urealyticum colonization with chronic lung disease of prematurity: results of a metaanalysis". J Pediatr. 127 (4): 640–4. PMID 7562292.
  20. Shimada Y, Ito S, Mizutani K, Sugawara T, Seike K, Tsuchiya T; et al. (2014). "Bacterial loads of Ureaplasma urealyticum contribute to development of urethritis in men". Int J STD AIDS. 25 (4): 294–8. doi:10.1177/0956462413504556. PMID 24047884.
  21. Kasprzykowska U, Elias J, Elias M, Mączyńska B, Sobieszczańska BM (2014). "Colonization of the lower urogenital tract with Ureaplasma parvum can cause asymptomatic infection of the upper reproductive system in women: a preliminary study". Arch Gynecol Obstet. 289 (5): 1129–34. doi:10.1007/s00404-013-3102-7. PMC 3984420. PMID 24318169.
  22. Povlsen K, Bjørnelius E, Lidbrink P, Lind I (2002). "Relationship of Ureaplasma urealyticum biovar 2 to nongonococcal urethritis". Eur J Clin Microbiol Infect Dis. 21 (2): 97–101. PMID 11939406.
  23. Maeda S, Deguchi T, Ishiko H, Matsumoto T, Naito S, Kumon H; et al. (2004). "Detection of Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma parvum (biovar 1) and Ureaplasma urealyticum (biovar 2) in patients with non-gonococcal urethritis using polymerase chain reaction-microtiter plate hybridization". Int J Urol. 11 (9): 750–4. doi:10.1111/j.1442-2042.2004.00887.x. PMID 15379939.
  24. Couldwell DL, Gidding HF, Freedman EV, McKechnie ML, Biggs K, Sintchenko V; et al. (2010). "Ureaplasma urealyticum is significantly associated with non-gonococcal urethritis in heterosexual Sydney men". Int J STD AIDS. 21 (5): 337–41. doi:10.1258/ijsa.2009.009499. PMID 20498103.
  25. George MD, Cardenas AM, Birnbaum BK, Gluckman SJ (2015). "Ureaplasma septic arthritis in an immunosuppressed patient with juvenile idiopathic arthritis". J Clin Rheumatol. 21 (4): 221–4. doi:10.1097/RHU.0000000000000248. PMID 26010188.
  26. Farrell JJ, Larson JA, Akeson JW, Lowery KS, Rounds MA, Sampath R; et al. (2014). "Ureaplasma parvum prosthetic joint infection detected by PCR". J Clin Microbiol. 52 (6): 2248–50. doi:10.1128/JCM.00432-14. PMC 4042745. PMID 24671783.
  27. Abdelfattah MM, Khattab RA, Mahran MH, Elborgy ES (2016). "Evaluation of patients with dry eye disease for conjunctival Chlamydia trachomatis and Ureaplasma urealyticum". Int J Ophthalmol. 9 (10): 1457–1465. doi:10.18240/ijo.2016.10.15. PMC 5075662. PMID 27803864.
  28. Yoneda N, Yoneda S, Niimi H, Ueno T, Hayashi S, Ito M; et al. (2016). "Polymicrobial Amniotic Fluid Infection with Mycoplasma/Ureaplasma and Other Bacteria Induces Severe Intra-Amniotic Inflammation Associated with Poor Perinatal Prognosis in Preterm Labor". Am J Reprod Immunol. 75 (2): 112–25. doi:10.1111/aji.12456. PMID 26668114.

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