Ureaplasma urealyticum: Difference between revisions
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====Neonatal infection and the role of Ureaplasma species==== | ====Neonatal infection and the role of Ureaplasma species==== | ||
* ''Ureaplasma urealyticum'' is the most common organism isolated from infected amniotic fluid and placenta, suggesting the potential role of Ureaplasma species in the development of disseminated neonatal infection.<ref name="pmid21258263">{{cite journal| author=Okogbule-Wonodi AC, Gross GW, Sun CC, Agthe AG, Xiao L, Waites KB et al.| title=Necrotizing enterocolitis is associated with ureaplasma colonization in preterm infants. | journal=Pediatr Res | year= 2011 | volume= 69 | issue= 5 Pt 1 | pages= 442-7 | pmid=21258263 | doi=10.1203/PDR.0b013e3182111827 | pmc=3968774 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21258263 }} </ref><ref name="pmid8399903">{{cite journal| author=Waites KB, Crouse DT, Cassell GH| title=Systemic neonatal infection due to Ureaplasma urealyticum. | journal=Clin Infect Dis | year= 1993 | volume= 17 Suppl 1 | issue= | pages= S131-5 | pmid=8399903 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8399903 }} </ref> | |||
* The infection is commonly acquired via vertical transmission | |||
====Colonization with Ureaplasma species and its association with urogenital infections==== | ====Colonization with Ureaplasma species and its association with urogenital infections==== | ||
Revision as of 19:57, 13 April 2017
| Ureaplasma urealyticum | ||||||||||||||
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| Ureaplasma urealyticum Shepard et al., 1974 |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Fatimo Biobaku M.B.B.S [2]
Overview
Historical Perspective
Investigations carried out in the mid 1970's by Tafari et al. described the isolation of Ureaplasma urealyticum from the lungs of stillborn infants with pneumonitis, and it is one of the earliest investigations that suggested the possible pathogenic role of U. urealyticum in neonatal disease.[1] Waites et al. reported the first case of suspected neonatal ureaplasmal pneumonia with sepsis and persistent pulmonary hypertension of the newborn in the 1980's.[2] Several case reports are now available in the literature documenting the isolation of Ureaplasma urealyticum and Ureaplasma parvum in fetal lung tissue, cord blood, pulmonary secretions, pleural fluid, lung tissue, and blood stream of neonates with pneumonia.[1]
Pathophysiology
Pathogenesis
The role of Ureaplasma infection in preterm delivery
- Ureaplasma species are considered to be of low virulence, and 40-80% of healthy women have Ureaplasma species (commonly U. urealyticum and U. parvum) in their genital tract.[3][4][1][5]
- Controversial evidence exists supporting the association between genital colonization with Ureaplasma species and complications of pregnancy such as preterm delivery.[6]
- Lactobacilli help maintain the vaginal acidity, preventing the invasion of bacteria. However, the urease activity of Ureaplasma species such as U. urealyticum increases the pH of the vagina via the hydrolysis of urea into carbon dioxide and ammonia. This increases the susceptibility to mixed infection with other pathogenic bacteria.[6]
- These pathogens induce the secretion of pro-inflammatory cytokines such as IL-1, TNF-α, IL-6, and chemokines such as IL-8, leading to the recruitment of leukocytes and production of prostaglandins. Uterine stimulation by prostaglandins result in preterm delivery.[6]
- Ureaplasmal lipoprotein also induce apoptosis, and it is possible that the apoptotic cells sustain genital tract inflammation which promote preterm delivery.[6]
- Studies have also shown a higher rate of vaginal infection with Ureaplasma species in women with preterm deliveries compared to those with full-term deliveries.[6]
Neonatal infection and the role of Ureaplasma species
- Ureaplasma urealyticum is the most common organism isolated from infected amniotic fluid and placenta, suggesting the potential role of Ureaplasma species in the development of disseminated neonatal infection.[4][1]
- The infection is commonly acquired via vertical transmission
Colonization with Ureaplasma species and its association with urogenital infections
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications, and Prognosis
Diagnosis
Treatment
Prevention
- ↑ 1.0 1.1 1.2 1.3 Waites KB, Crouse DT, Cassell GH (1993). "Systemic neonatal infection due to Ureaplasma urealyticum". Clin Infect Dis. 17 Suppl 1: S131–5. PMID 8399903.
- ↑ 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.
- ↑ 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.
- ↑ 4.0 4.1 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.
- ↑ 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.
- ↑ 6.0 6.1 6.2 6.3 6.4 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.