Ureaplasma is a microscopic bacterium often found in the human urogenital tract. It belongs to the Mycoplasmataceae family, a group of bacteria unique for lacking a rigid cell wall. While often present without causing any issues, Ureaplasma can, under certain conditions, contribute to various health concerns.
What is Ureaplasma
Ureaplasma is a genus of bacteria containing several species, with Ureaplasma urealyticum and Ureaplasma parvum being the most frequently encountered in humans. These microorganisms are exceptionally small, among the tiniest known free-living bacteria. A defining characteristic is the absence of a cell wall, which differentiates them from many other bacteria. This structural peculiarity means they are naturally unaffected by antibiotics that specifically target cell wall synthesis.
Ureaplasma species commonly exist as commensal organisms, residing in the urogenital tracts of many healthy individuals, particularly sexually active adults, without causing adverse effects. However, under specific conditions, these bacteria can transition from a harmless presence to an opportunistic pathogen. When their numbers increase or the body’s immune system is compromised, they can lead to infections. Ureaplasma primarily colonizes the mucosal linings of the genital and urinary tracts, including the urethra, vagina, and cervix. It can also be found in other areas like the throat and rectum, though less commonly associated with symptoms there.
How Ureaplasma Spreads
Ureaplasma is primarily transmitted through sexual contact, establishing it as a sexually transmitted infection. This includes vaginal, anal, and oral sexual activity. Transmission can occur even without the exchange of bodily fluids like semen, as direct mucosal contact is sufficient for the bacteria to spread.
Another significant route of transmission is perinatal, where a mother colonized with Ureaplasma can pass the bacteria to her baby. This typically happens during childbirth as the infant passes through the birth canal, but it can also occur in utero. The rate of vertical transmission from mother to infant can range from 18% to 55% in full-term infants and 29% to 55% in preterm infants. Ureaplasma is not typically spread through casual contact, such as sharing toilets or swimming pools.
Identifying Ureaplasma
Many individuals carrying Ureaplasma experience no symptoms. When symptoms do manifest, they can vary between sexes. In women, potential signs include unusual or watery vaginal discharge, pelvic discomfort, painful urination, and a fishy odor. Men might experience urethral discharge, painful or burning urination, and occasionally testicular pain. These symptoms can sometimes be mistaken for other common urogenital infections.
For newborns who acquire the bacteria during birth, Ureaplasma can cause more severe manifestations. These may include respiratory problems like pneumonia or chronic lung disease, low birth weight, and in some cases, meningitis. Testing for Ureaplasma is recommended when individuals present with persistent urogenital symptoms that do not respond to initial treatments, or in cases of unexplained infertility or pregnancy complications.
Diagnosis involves collecting specific samples, depending on the suspected site of infection. These samples can include urine, urethral, vaginal, or cervical swabs. In cases involving pregnancy complications, amniotic fluid may also be collected. Laboratory detection primarily relies on molecular tests like Polymerase Chain Reaction (PCR), which identifies the bacteria’s genetic material. PCR is preferred due to its higher accuracy and faster turnaround time compared to traditional culture methods. Culture, while also used, requires specialized media and can take several days for results.
Addressing Ureaplasma
Management of Ureaplasma infections typically involves a course of antibiotics. Common medications include doxycycline, azithromycin, and sometimes moxifloxacin, chosen based on individual factors like pregnancy status. It is important to complete the entire prescribed course of antibiotics to ensure effective eradication of the bacteria and prevent recurrence. Treating all sexual partners concurrently is also necessary to prevent reinfection and interrupt the cycle of transmission. Follow-up testing may be recommended if symptoms persist after treatment.
If Ureaplasma infections are left unaddressed, they can lead to various health implications. In women, this can include pelvic inflammatory disease (PID), which may contribute to infertility by causing scarring in the fallopian tubes. For men, untreated infection might lead to urethritis, epididymitis, and a potential decrease in sperm quality or motility, impacting fertility.
During pregnancy, Ureaplasma has been associated with adverse outcomes such as preterm birth, miscarriage, premature rupture of membranes, and inflammation of the amniotic sac (chorioamnionitis). Less commonly, Ureaplasma has been linked to the formation of kidney stones. Consulting a healthcare professional for accurate diagnosis and appropriate treatment is important to mitigate these potential risks.