Ureaplasma is a group of small bacteria often present in the genitourinary tract of sexually active individuals, frequently without causing noticeable symptoms. While it often exists harmlessly, an overgrowth can sometimes lead to infection and health complications. Questions commonly arise about its potential to cause illness and the various ways it can spread, including the possibility of oral transmission. Understanding the nature of this organism and its transmission routes is important for sexual and reproductive health.
What is Ureaplasma
Ureaplasma belongs to the Mollicutes class of bacteria, part of the Mycoplasma family. These organisms are distinguished by their extremely small size and lack a rigid cell wall. This absence makes Ureaplasma naturally resistant to many common antibiotics, such as penicillin, which target cell wall synthesis.
The bacteria typically reside on mucosal surfaces, particularly within the lower urogenital tract. Two primary species, Ureaplasma urealyticum and Ureaplasma parvum, are most often found in humans. For many healthy, sexually active adults, Ureaplasma is considered a commensal organism that lives in the body without causing disease.
How Ureaplasma Spreads
Ureaplasma is primarily acquired through sexual activity, classifying it as a sexually transmitted organism. Transmission occurs through the exchange of genital secretions during unprotected vaginal, anal, or oral sex. The bacteria commonly colonize the urethra and vagina, but they can also take hold in the throat following oral contact.
Oral transmission is possible when the bacteria pass from the genital area to the pharynx through oral-genital contact. However, genital-to-genital contact remains the most frequent route for establishing a urogenital tract infection. The likelihood of transmission is increased in individuals with multiple sexual partners.
Ureaplasma can also be transmitted from a mother to her infant (perinatal transmission), either in utero or during delivery through the birth canal.
Health Effects of Ureaplasma Infection
While often asymptomatic, an overgrowth of Ureaplasma can act as an opportunistic pathogen, leading to various health issues in the genitourinary system.
Effects in Men
In men, the infection is recognized as a possible cause of non-gonococcal urethritis (NGU), which involves inflammation of the urethra. Symptoms of urethritis can include a discharge from the penis, a burning sensation during urination, and general urethral discomfort.
Effects in Women
For women, Ureaplasma infection may be associated with gynecological conditions, including cervicitis and bacterial vaginosis (BV). Untreated infections can potentially ascend into the upper reproductive tract, increasing the risk for pelvic inflammatory disease (PID). PID can cause lower abdominal pain and may lead to long-term complications such as infertility or ectopic pregnancy due to scarring.
Pregnancy and Neonatal Risks
Ureaplasma is also linked to adverse outcomes during pregnancy. The bacteria have been associated with an increased risk of preterm labor, preterm premature rupture of membranes, and chorioamnionitis (inflammation of the fetal membranes). When transmitted to an infant during birth, the organism can potentially cause serious neonatal infections, including pneumonia and meningitis, particularly in premature babies.
Testing and Treatment Methods
Testing Methods
Diagnosis is typically reserved for symptomatic individuals or those facing adverse reproductive or pregnancy outcomes. The most common diagnostic approach is Polymerase Chain Reaction (PCR) testing, which detects the organism’s DNA. Samples are collected from the affected site, such as a first-void urine sample for men or a vaginal or cervical swab for women. If oral colonization is suspected, a throat swab can also be submitted for PCR analysis.
Treatment
Treatment for Ureaplasma infection involves antibiotics, but selection is restricted because the bacteria lack a cell wall. Standard cell wall-targeting antibiotics like penicillin are ineffective. Treatment typically involves drugs that penetrate the bacterial cell, such as tetracyclines (doxycycline) or macrolides (azithromycin).
For non-pregnant adults, doxycycline is often the initial medication, usually taken twice daily for seven days. Alternative regimens are selected for pregnant patients or in cases of macrolide resistance. Sexual partners of an infected individual should also be evaluated and treated to prevent reinfection.