Ureaplasma urealyticum
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Introduction
The Case of...
Epidemiology
Ureaplasma can be isolated in 40-80% of cervicovaginal specimens on asymptomatic women who are sexually active.
More than 20% of liveborn infants may be colonized by Ureaplasma, and infants born preterm most likely harbor the organisms. Colonization declines after age 3 months. Less than 5% of children and 10% of adults who are not sexually active are colonized with genital mycoplasmal microorganisms.
Classification and Characteristics
A mycoplasma
Transmission and Infection
In humans, both Mycoplasma and Ureaplasma species may be transmitted by direct contact between hosts (ie, venereally through genital-to-genital or oral-to-genital contact), vertically from mother to offspring (either at birth or in utero), or by nosocomial acquisition through transplanted tissues.
Can be isolated from maternal, umbilical cord, and neonatal blood, as well as the CSF.
Delivery of infants by cesarean delivery has not prevented colonization in the lower respiratory tract because acquisition of the organisms can occur in utero by ascending infection, even through intact fetal membranes.
Clinical Manifesations
Ureaplasma species and M genitalium are causes of nonchlamydial nongonococcal urethritis in men, and may also be involved in female infection.
- Urethritis
- Pyelonephritis
- Pelvic inflammatory disease
- Endometritis or chorioamnionitis
- Infectious arthritis
- Surgical wound infections
- Neonatal pneumonia
- Neonatal meningitis
Pregnancy and early life
Can cause placental inflammation and invade the amniotic sac, causing persistent infection and problems with pregnancy, including premature birth.
Congenital pneumonia, bacteremia, meningitis, and death have occurred in infants with very low birth weight due to lower respiratory tract infection. Chronic low grade infectioncan lead to bronchopulmonary dysplasia.
Joints
Both ureaplasma and mycoplasma can cause invasive joint disease. Ureaplasma appears to be the most common nonbacterial agent of infectious arthritis in people who are hypogammaglobulineic.
Diagnosis
Ureaplasma can be detected in specialized culture within 2-5 days. PCR may be done but are not needed.
Treatment
Tetracycline has been used in the past, but resistance is now common.
Erythromycin is now commonly used
Resources and References
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