Ureaplasma is a type of bacteria commonly found in the genitourinary tract of both men and women. There are two main species, Ureaplasma urealyticum and Ureaplasma parvum. This organism can persist in the body for extended periods, often without causing noticeable symptoms.
How Ureaplasma Can Persist Undetected
Ureaplasma often goes unnoticed because many individuals carry the bacteria without experiencing symptoms. It is a common part of the vaginal microbiome, found in 40-80% of non-symptomatic vaginal microbiomes. It is considered a “commensal” bacteria, meaning it can exist in healthy people without causing issues when in balance with other microorganisms.
Factors contributing to its persistence include its small size and unique structure. Ureaplasma belongs to a class of bacteria called Mollicutes, which lack a cell wall. This characteristic makes it difficult to study and diagnose using standard methods. Ureaplasma can also reside within cells or form biofilms, which may protect it from the immune system and make it harder to eradicate.
Long-Term Health Implications
While often asymptomatic, the long-term presence of Ureaplasma can be associated with various health concerns when it overgrows or causes an infection. It has been linked to non-gonococcal urethritis (NGU), an inflammation of the urethra not caused by gonorrhea, and cervicitis in women. In men, Ureaplasma has been identified as a cause of chronic prostatitis.
Ureaplasma can also play a role in reproductive health issues for both sexes. In women, it has been associated with pelvic inflammatory disease (PID). It is linked to infertility, potentially impacting sperm motility in men or causing tubal factor infertility in women if the bacteria reach the upper genital tract. Some studies indicate that long-lasting colonization of mucosal membranes by Ureaplasma can stimulate inflammation, contributing to reproductive system disorders.
During pregnancy, Ureaplasma can have implications such as an increased risk of preterm labor and premature rupture of membranes. Certain species, like Ureaplasma parvum, have been associated with preterm birth. Ureaplasma species can also produce urease, an enzyme that contributes to the formation of struvite calculi, a type of kidney stone, in the urinary tract.
Diagnosis and Management
Diagnosis of Ureaplasma involves nucleic acid amplification tests (NAATs), which can be performed on urine samples or swabs from the vagina, urethra, or cervix. Routine screening for Ureaplasma is not common because it is frequently asymptomatic and can be part of the normal flora. Testing is recommended when individuals present with symptoms, or when investigating other conditions like infertility or recurrent infections.
Treatment for symptomatic Ureaplasma infections involves specific antibiotics, such as macrolides (e.g., azithromycin) or tetracyclines (e.g., doxycycline). Due to the absence of a cell wall, certain antibiotics like penicillin are ineffective against Ureaplasma. While treatment can be effective, persistence of Ureaplasma after antibiotic therapy can occur, and some strains may show resistance.
In cases of symptomatic or recurrent infections, healthcare providers may recommend partner treatment to prevent reinfection. Individuals experiencing symptoms or concerns should seek proper diagnosis, as Ureaplasma can cause symptoms similar to other urinary tract infections.