Ureaplasma

An infection caused by the bacteria Ureaplasma urealyticum or Ureaplasma parvum

Illustration of polymorphic bacterial cells representing a Ureaplasma infection

Another emerging disease that is even more poorly understood than Mycoplasma genitalium

What is a Ureaplasma infection?

Similar to Mycoplasma genitalium, a Ureaplasma infection is a bacterial infection that we don’t know enough about. What we do know is that it can be transmitted during intercourse or from mother to infant during childbirth, is often asymptomatic, and is difficult to diagnose [1]. 

How common is it?

Ureaplasma species are pretty common bacteria, but the resulting infection is difficult to diagnose and a large percentage of cases are asymptomatic. As a result, we don’t really know how many people carry Ureaplasma.

What causes a Ureaplasma infection and who is at risk?

Ureaplasma species are complex yet commonly found bacteria. There are two species of Ureaplasma commonly found in humans, U. urealyticum and U. parvum. Various studies have reported one species to be more disruptive than the other, but these are conflicting [2]. Both species have the potential to be neutral or disruptive.

Ureaplasma falls into the same category as Mycoplasma and is likewise characterized by a lack of cell walls which makes it notoriously difficult to diagnose and treat [3]. 

We don’t know why the bacteria become infectious, but we do know that sexually active men and women as well as pregnant women are at a higher risk of infection since the bacteria can be transferred during childbirth or intercourse [1]. Having unprotected sex, or having sex with new or multiple partners puts you at a higher risk of infection. Ureaplasma is often found in cases of pelvic inflammatory disease (PID), urinary tract infections and neonatal infections [4].

What are the symptoms?

Symptomatic cases can result in vaginal bleeding as well as vaginal pain while urinating or during intercourse [5]. Even though most cases of Ureaplasma infection seem to not cause any symptoms at all, the potential complications of an untreated infection range from moderate to severe.

How is it diagnosed?

It is possible to diagnose a Ureaplasma infection using a culture test, but other methods like a PCR test are more common. It can also be detected through Next Generation Sequencing (NGS). 

What are the treatment options?

Common antibiotics like penicillin which work by attacking the cell walls of a bacteria are not effective against Ureaplasma species since they don't have any walls to attack [1]. As a result, only a small handful of antibiotics like Azithromycin can be used to treat a Ureaplasma infection. It is important to note that Azithromycin is also one of the most commonly used antibiotics. As a result of its widespread use, Azithromycin resistance seems to be on the rise. Therefore, it is important to consult your doctor before re-starting any treatment course [1].

Can Ureaplasma infection lead to other complications?

A Ureaplasma infection can lead to frequent UTIs and potentially pelvic inflammatory disease (PID). Research also suggests that Ureaplasma infections are correlated with male infertility [5].

For pregnant women, Ureaplasma is linked to some dangerous pregnancy-related outcomes including stillbirths and chorioamnionitis, an inflammation of fetal membranes which can lead to preterm birth [1]. The infection can also be transferred to the newborn, potentially causing birth abnormalities. 

What can be done to prevent a Ureaplasma infection?

To reduce your chances of exposure to Ureaplasma, practice safe sex by always discussing sexual health with your partner, using barrier protection correctly (such as a condom or dental dam), and getting tested regularly. To protect yourself against infections, avoid disrupting the balance of protective bacteria in the vaginal microbiome by limiting the use of douches as well as the use of scented soaps, tampons or pads.

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References

1. Long S, Pickering L, Prober C.Principles and practice of pediatric infectious diseases. Edinburgh:Elsevier/Saunders; 2012.

2. Boujemaa, S., Mlik, B., Ben Allaya, A. et al. Spread of multidrug resistance among Ureaplasma serovars, Tunisia. Antimicrob Resist Infect Control 9, 19 (2020).

3. Stillbirth - Causes [Internet].nhs.uk. 2020 [cited 17 September 2020]. Available from:https://www.nhs.uk/conditions/stillbirth/causes/

4. Vaginal bleeding Causes [Internet].Mayo Clinic. 2020 [cited 17 September 2020]. Available from:https://www.mayoclinic.org/symptoms/vaginal-bleeding/basics/causes/sym-20050756

5. OchsendorfF. Sexually transmitted infections: impact on male fertility. Andrologia.2008;40(2):72-75.

Written by Aisha Ommaya, science comms officer with Juno Bio

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