The Role of
            <i>Ureaplasma</i>
            spp. in the Development of Nongonococcal Urethritis and Infertility among Men

Beeton, Michael L.; Payne, Matthew S.; Jones, Lucy C.

doi:10.1128/cmr.00137-18

Cited by 50 publications

(39 citation statements)

References 66 publications

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“…This is consistent with current understanding of NGU that neither C. trachomatis nor M. genitalium is detectable in 30–80% of NGU cases [2]. In men with NGU, the role of testing for and treating additional organisms such as Ureaplasma urealyticum remains an area of controversy and further research [2, 27].…”

Section: Discussionsupporting

confidence: 82%

Men at risk of gonococcal urethritis: a case-control study in a Darwin sexual health clinic

Chen¹,

Connor²,

Gunathilake

2019

BMC Infect Dis

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BackgroundMale urethritis is primary sexually transmitted. Northern Territory (NT) has the highest rates of gonococcal infection in Australia and local guidelines recommend empiric treatment with azithromycin and ceftriaxone for all men presenting with urethritis. As gonococcal drug resistance is a growing concern, this study aims to improve empiric use of ceftriaxone through examining local patterns of male urethritis, comparing cases of gonococcal urethritis (GU) to controls with non-gonococcal urethritis (NGU).MethodsA retrospective study was undertaken of all men with symptomatic urethritis presenting to Darwin sexual health clinic from July 2015 to July 2016 and aetiology of urethritis in this population was described. Demographic, risk profile, and clinical features of GU cases were compared to NGU controls.ResultsAmong n = 145 men, the most common organisms identified were Chlamydia trachomatis (23.4%, SE 3.5%) and Neisseria gonorrhoeae (17.2%, SE 3.1%). The main predictors of GU were any abnormalities on genital examination (aOR 10.4, 95% CI 2.1 to 50.8) and a history of urethral discharge (aOR 5.7, 95% CI 1.4 to 22.6). Aboriginal patients (aOR 3.0, 95% CI 0.9 to 9.6) and those over 30 years of age (aOR 1.4, 95% CI 0.3 to 7.0) were more likely to have GU in the unadjusted analysis, but not in the adjusted model.ConclusionThis is the first study looking at patterns of male urethritis in urban NT and the results support a move towards adopting national guidelines to use ceftriaxone for empiric management of syndromic urethritis only in high-risk patients. In addition to traditional demographic risk factors, clinical features remain an important component of risk stratification.

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Section: Discussionsupporting

confidence: 82%

Men at risk of gonococcal urethritis: a case-control study in a Darwin sexual health clinic

Chen¹,

Connor²,

Gunathilake

2019

BMC Infect Dis

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“…Although the role of Ureaplasma species was controversially discussed in the past (Kjaergaard et al, 1997;Potts, Sharma, et al, 2000), there is mounting evidence that these pathogens, particularly Ureaplasma urealyticum, play a significant role in genital tract infections under specific conditions (Beeton, Payne, & Jones, 2019).…”

Section: Ureaplasma Urealyticummentioning

confidence: 99%

The role of infections and leukocytes in male infertility

2020

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Oxidative stress is preempted by an adequate level of antioxidants, which scavenge oxidants when they are produced in excess by different sources, including leukocytes and immature spermatozoa. Enzymatic antioxidants, such as superoxide dismutase, catalase and glutathione peroxidase, and several nonenzymatic antioxidants (pro teins, vitamins and minerals), working as oxidant scavengers and cofactors of en zymatic antioxidants have been identified in seminal plasma. The total antioxidant capacity (TAC) is a diagnostic test that can be utilised in the male infertility workup. TAC measures the amount of total antioxidants in seminal plasma. Therefore, it pro vides an assessment of the reductive potential in seminal plasma. Several studies have investigated the diagnostic application of TAC in various andrology conditions. There is substantial evidence in the literature to show that infertile patients have lower seminal TAC in comparison with fertile men. Moreover, there is a positive cor relation between TAC and seminal parameters, such as sperm concentration, motility and morphology. Evaluation of TAC together with reactive oxygen species (ROS) and sperm DNA fragmentation index (DFI) may be beneficial in the diagnosis of male infertility.

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“…Adults are mainly infected through sexual contact, with the cervix being the main site of colonization in women. U. urealyticum colonization is associated with many diseases, including brain abscess, prostatitis, rheumatoid arthritis ( 3 , 4 ), non-gonococcal urethritis, and hyperglycemia ( 5 , 6 ). Maternal-fetal transmission seems to occur frequently, and intra-amniotic U. urealyticum infection may contribute to chorioamnionitis and preterm birth ( 7 , 8 ).…”

Section: Introductionmentioning

confidence: 99%

“…Maternal-fetal transmission seems to occur frequently, and intra-amniotic U. urealyticum infection may contribute to chorioamnionitis and preterm birth ( 7 , 8 ). Individuals respond differently to U. urealyticum ( 6 , 9 , 10 ), with some able to clear an infection (as a result of a Th1/IFN-γ response), while others develop a chronic infection, and still others are susceptible to repeat infections. In particular, chronically asymptomatic infections can be frequent in women and may cause pelvic inflammation and sterility.…”

Section: Introductionmentioning

confidence: 99%

“…In particular, chronically asymptomatic infections can be frequent in women and may cause pelvic inflammation and sterility. Although U. urealyticum infections are often be cured by antibiotics, they can also be chronic, persistent, and antibiotic resistant ( 6 , 11 , 12 ). Therefore, the availability of a safe and effective vaccine would represent a much-needed and powerful means of protection from U. urealyticum infection and transmission.…”

Section: Introductionmentioning

confidence: 99%

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GrpE Immunization Protects Against Ureaplasma urealyticum Infection in BALB/C Mice

et al. 2020

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Nucleotide exchange factor (GrpE), a highly conserved antigen, is rapidly expressed and upregulated when Ureaplasma urealyticum infects a host, which could act as a candidative vaccine if it can induce an anti-U. urealyticum immune reaction. Here, we evaluated the vaccine potential of recombinant GrpE protein adjuvanted by Freund's adjuvant (FA), to protect against U. urealyticum genital tract infection in a mouse model. After booster immunization in mice with FA, the GrpE can induced both humoral and cellular immune response after intramuscular injection into BALB/c mice. A strong humoral immune response was detected in the GrpE-immunized mice characterized by production of high titers of antigen-specific serum IgG (IgG1, IgG2a, and IgG3) antibodies. At the same time, the GrpE also induced a Th1-biased cytokine spectrum with high levels of IFN-γ and TNF-α after re-stimulation with immunogen GrpE in vitro, suggesting that GrpE could trigger the Th1 response when used for vaccination in the presence of FA. Although GrpE vaccination in the presence of a Th1-type adjuvant-induced had readily detectable Th1 responses, there wasn't increase inflammation in response to the infection. More importantly, the robust immune responses in mice after immunization with GrpE showed a significantly reduced U. urealyticum burden in cervical tissues. Histopathological analysis confirmed that tissues of GrpE-immunized BALB/c mice were protected against the pathological effects of U. urealyticum infection. In conclusion, this study preliminarily reveals GrpE protein as a promising new candidate vaccine for preventing U. urealyticum reproductive tract infection.

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The Role of Ureaplasma spp. in the Development of Nongonococcal Urethritis and Infertility among Men

Cited by 50 publications

References 66 publications

Men at risk of gonococcal urethritis: a case-control study in a Darwin sexual health clinic

Men at risk of gonococcal urethritis: a case-control study in a Darwin sexual health clinic

The role of infections and leukocytes in male infertility

GrpE Immunization Protects Against Ureaplasma urealyticum Infection in BALB/C Mice

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