A Case of Rectal Ureaplasma Infection and Implications for Testing in Young Men Who Have Sex with Men: The P18 Cohort Study

Abstract

Ureaplasma is a significant cause of nongonococcal urethritis. This is a case of rectal Ureaplasma found on culture in a young man who has sex with men not previously reported in the literature. Nucleic acid amplification tests are now standard of care for sexually transmitted infection testing, but they do not test for Ureaplasma and, therefore, may be missing important infections. Ureaplasma could have important implications in urethritis and rectal HIV transmission among men who have sex with men engaging in condomless anal intercourse. Further study of Ureaplasma's role as a rectal pathogen may be warranted.

Anal Ureaplasma spp. positivity among HIV positive men who have sex with men may be associated with high-risk-type HPV infections

“…infections, data on the extent and the role of anal Ureaplasma spp. infections among HIV positive MSM are scarce (Abbott et al, 2017). In this study we evaluated asymptomatic anal colonization with Ureaplasma spp.…”

A case of oropharyngeal Ureaplasma urealyticum infection in a human immunodeficiency virus positive bisexual male co-infected with human papilloma virus and Treponema pallidum

“…Extragenital Ureaplasma infections have been rarely reported and, to the best of our knowledge, this is the first report of oropharyngeal Ureaplasma infection from India. There has been one recent report of rectal Ureaplasma infection found in a culture from an MSM individual [ 11 ]. Globally, there are few studies of pharyngeal infection with Ureaplasma spp.…”

Response to: Fernández-Huerta et al. Re: Abbott et al., A Case of Rectal Ureaplasma Infection and Implications for Testing in Young Men Who Have Sex with Men: The P18 Cohort Study (From: Fernández-Huerta M, Serra-Pladevall J, Esperalba J, et al. LGBT Health 2020;7:119–120; DOI: 10.1089/lgbt.2019.0211)

“…As a final point, in the case report we reference that the participant in our study was ''notified of his result and linked to outside medical treatment.'' 1 We found ourselves in the unenviable situation of having an unanticipated positive result of unclear significance without the benefit of clinical followup. The specific advice we gave the participant is that this finding was not an infection that is typically screened for and, therefore, treated; however, he should discuss the finding with a health care provider.…”