Ureaplasma parvum and Ureaplasma urealyticum detected with the same frequency among women with and without symptoms of urogenital tract infection

Abstract

There is mounting evidence stating that Ureaplasma urealyticum causes non-gonococcal urethritis in males, whereas Ureaplasma parvum does not seem to be of clinical significance. However, the clinical role of U. parvum and U. urealyticum in lower urogenital tract infections in females remains unclear. The aim of the study was to determine the frequency of U. parvum and U. urealyticum among 145 Ureaplasma spp. culture-positive women with symptoms of lower urogenital tract infection (n = 75) and those without (n = 70), and to determine possible associations between the detection of U. parvum and U. urealyticum with selected characteristics. Endocervical, urethral, and vaginal swabs, and first voided urine were obtained. Polymerase chain reaction (PCR) was performed to differentiate ureaplasmas. No significant association between the detection of U. parvum or U. urealyticum and symptom status was found. Significantly more women aged 25 years and younger were infected with U. urealyticum (23.4 %) compared to those aged above 25 years (9.2 %) [odds ratio (OR) 3.0 (1.1; 8.1); p = 0.03] and significantly less women aged 25 years and younger (83.5 %) were infected with U. parvum compared to those aged above 25 years (95.5 %) [OR 0.2 (0.1; 0.9); p = 0.03]. The detection of Chlamydia trachomatis was significantly associated to both U. parvum and U. urealyticum (p = 0.021), and to U. parvum alone with borderline significance (p = 0.063). Although neither U. parvum nor U. urealyticum seem to cause symptoms in females, their role in the female urogenital tract remains unknown, taking into account their ubiquity, possible augmentation of the urogenital microenvironment, and ascending capability to the sterile upper reproductive tract.

Should we be testing for urogenital Mycoplasma hominis, Ureaplasma parvum and Ureaplasma urealyticum in men and women? – a position statement from the European STI Guidelines Editorial Board

“…There are no case–control studies or other appropriate evidence that M. hominis , U. parvum or U. urealyticum causes an inflammatory vulvovaginitis . The number of leucocytes in vaginal smears are also not increased in women positive for only ureaplasmas …”

“…The prevalence of M. hominis , U. urealyticum and U. parvum in non‐pregnant sexually active symptomatic and asymptomatic women, measured by molecular tests including species differentiation, has ranged between 3.1–15% #bib5.2–20% and 20–89%, respectively . The large variation in prevalence probably reflects both methodological and true population differences, in particular in the prevalence of BV, the most important confounder.…”

“…C. trachomatis and M. genitalium , and/or BV . The bacterial load of particularly M. hominis and to a lesser extent U. parvum and U. urealyticum can be significantly increased in the dysbiosis of BV . However, despite the association between particularly M. hominis and BV, M. hominis cannot be detected in approximately one‐third of women with BV and, accordingly, it is neither a sufficiently sensitive nor specific bacterial marker for diagnosis of BV .…”

The Human Ureaplasma Species as Causative Agents of Chorioamnionitis

“…U. parvum is isolated more frequently from the lower genital tract of females than U. urealyticum (158,159,(164)(165)(166), and serovar 3 is the most common serovar isolated from females in the United States and Australia (116,158,163). Ureaplasma colonization of the female lower genital tract has been associated with numerous factors, including ethnicity (particularly African-American, Central/West African, and Indigenous Australian women) (123,167,168), age (most prevalent in the 14-to 25-year age group; carriage declines with increasing age) (165,167), the number of recent sexual partners (123,168), the use of nonbarrier contraceptives (123), level of education (167), age of first sexual intercourse (123), and intrauterine devices (167,169). Ureaplasma spp.…”

“…Ureaplasma spp. are considered to be commensal organisms within the female lower genital tract due to (i) their high prevalence and (ii) studies demonstrating no differences in the rates of endocervical Ureaplasma colonization between women of reproductive age with and those without symptoms of genital infection (165,166). However, others have reported that Ureaplasma spp.…”