Ureaplasma urealyticum: the Role as a Pathogen in Women’s Health, a Systematic Review

Abstract

A systematic review was performed. Searching PUBMED and EMBASE for published articles from January 2003 to September 2017 using the key word "Ureaplasma urealyticum" yielded 1835 manuscripts. These were further screened using defined inclusion criteria: (1) original peer-reviewed observational studies; (2) English language; (3) U. urealyticum was specifically isolated; (4) present "cases"/"exposed" and "controls"/"unexposed" to enable calculating an association between U. urealyticum and the outcome studied. Altogether, 32 studies were included that underwent quality scoring based on methodology, sample size, study population, and method of identification of U. urealyticum. The association of U. urealyticum and PTD was inconsistent between the studies. Eight of the ten prospective studies failed to show an association between U. urealyticum and PTD, yet four of the six case control studies found a positive association. Regarding female infertility and genital discomfort, five of the six studies for each of these topics failed to find an association. Only two studies met the inclusion criteria for cervicitis with conflicting conclusions. Unfortunately, none of the studies met the inclusion criteria for PID. It seems that U. urealyticum has a limited role as a pathogen in female infertility, cervicitis, PID, and genital discomfort. The role as a pathogen in PTD is unclear and future studies are needed to address this issue.

Prevalence of Ureaplasma urealyticum, Chlamydia trachomatis, and Neisseria gonorrhoeae in gynecological outpatients, Taizhou, China

“…In this study, UU was detected in 62.04% of the 6190 enrolled women, CT was found in 10.20% of the 11 242 enrolled women, and NG was isolated in 4.09% of the 8289 enrolled women. Compared with region‐based data on the worldwide population, the infection rate of UU (62.04%) in the present study was higher than rates reported in a meta‐analysis (1%‐62%), but was similar to the rate in Changzhou (60.11%), which is another region in China. Because of the high infection rate of UU in Taizhou area, clinicians should carry out routine testing for UU in high‐risk women, including women infected with other STI agents, symptomatic women with cervicitis, urethritis and other gynecological diseases, women planning for pregnancy, and sex workers.…”

“…Therefore, CT was significantly associated with UU and NG, whereas no association between NG and UU was found. study was higher than rates reported in a meta-analysis (1%-62%), 9 but was similar to the rate in Changzhou (60.11%), 10 women, including women infected with other STI agents, symptomatic women with cervicitis, urethritis and other gynecological diseases, women planning for pregnancy, and sex workers. However, part of women colonized with UU would not develop disease, and routine treatment in these asymptomatic women for UU might result in antimicrobial resistance; therefore, clinicians are more difficult to make therapy decision for asymptomatic women.…”

Septic arthritis of the shoulder due to Ureaplasma urealyticum after emergency caesarean section: a case report

“…U. urealyticum is frequently found in the genital tract and normally elicits a response from the humoral immune system [1,4]. Deficits in this type of response are a risk factor for septic arthritis [8].…”

“…Ureaplasma urealyticum , a short intra- and extracellular rod lacking a cell wall, frequently colonizes the genital human tract. In the genital tract of sexually active healthy women, prevalence estimates range from 38 to 75% [ 1 , 2 ]. This germ belongs to the genital mycoplasmas, containing Ureaplasma spp .…”

“…and Mycoplasma spp., seven of which are referenced in humans on mucous membranes: U. urealyticum , U. parvum , M. pneumonia , M. ferentans , M. penetrans , M. genitalium and M. hominis [ 1 , 3 ]. They colonize mucosal surfaces and are mostly non-pathogenic, except for M. pneumoniae, which causes respiratory tract infections [ 1 ]. However, they all have the potential to invade tissues and cause opportunistic infections.…”