Ureaplasma parvum

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Ureaplasma parvum
Scientific classification OOjs UI icon edit-ltr.svg
Domain: Bacteria
Phylum: Mycoplasmatota
Class: Mollicutes
Order: Mycoplasmatales
Family: Mycoplasmataceae
Genus: Ureaplasma
Species:
U. parvum
Binomial name
Ureaplasma parvum
Robertson et al. 2002

Ureaplasma parvum is a species of Ureaplasma , a genus of bacteria belonging to the family Mycoplasmataceae. [1]

Ureaplasma parvum was formerly known as Ureaplasma urealyticum biovar 1. [2] Ureaplasma parvum has been identified as being a commensal in the uterus as part of the microbiome in healthy women of reproductive age. [3] [4]

In addition, this pathogen may latently infect the chorionic villi tissues of pregnant women, thereby impacting pregnancy outcome. [5]

Classification

Ureaplasma spp. are one of the smallest known clonal bacteria. They are closely related to mycoplasmas as they lack a peptidoglycan cell wall, metabolize cholesterol, and require urea for ATP synthesis. [6] The Ureaplasma genus has 14 serotypes that are classified based on the 16S rRNA gene, the urease gene, and the multiple-banded antigen (MBA) gene. [7] U. parvum has four serotypes (-1, -3, -6, -14) that were differentiated by variations in the MBA gene, a Ureaplasma surface antigen protein. [8] Although U. parvum is known to be a commensal microorganism within healthy humans, its ability to become pathogenic may be due to its ability to easily acquire new genes via horizontal gene transfer (HGT). [9] Sequencing of U. parvum samples isolated from clinical patients reveals a much more diverse set of strains (at least 19), suggesting that further methods of classifying U. parvum should be investigated. [9]

Clinical relevance

The clinical implications concerning the pathogenicity of U. parvum have yet to be determined because of its recent establishment as a separate species from U. urealyticum. Due to the species heterogeneity in Ureaplasma spp. not being noted in clinical studies prior to their distinction from each other, it is possible that U. urealyticum is disproportionately overrepresented compared to U. parvum. [6] As a consequence, interpreting data on Ureaplasma parvum can be difficult since there are currently few studies that differentiate between the Ureaplasma spp. Therefore, there is little substantial evidence that U. parvum causes any of the diseases that have been associated with U. urealyticum, specifically inflammatory vulvovaginitis, male infertility and non-gonococcal urethritis (NGU), female urethritis and urethral pain syndrome, pelvic inflammatory disease, cervicitis, ectopic pregnancy, and female infertility. [10] It is important for future studies to accurately differentiate between U. urealyticum and U. parvum, as this will aid in the etiological analysis of NGU and other diseases.

Ureaplasma spp. lack a cell wall and are therefore resistant to antimicrobials that specifically attack the cell wall. For this reason, Ureaplasma spp. are particularly difficult to diagnose and eradicate, and unnecessary treatment can further encourage antimicrobial resistance. [11] As a result, extensive testing and treatment of the Ureaplasma spp. is not always recommended. [11] Ureaplasma parvum is usually part of the normal genital flora. Rarely can it cause invasive infections such as genitourinary infections, septic arthritis, or meningitis.

Commensalism

Ureaplasma parvum is commensal in both males and females, where it attaches itself to the mucosal lining of the urogenital tract. Damage to mucosal linings results in the relocation of Ureaplasma spp. to other physiological areas of the body, which can lead to infection and disease. [12] U. parvum has been investigated as an opportunistic pathogen, however current studies question its contribution to urogenital infections. [13] For example, a study conducted by Rumyantseva et al. [14] showed that in female patients with varying vaginal microflora, U. parvum was the most prevalent mycoplasma. In normal vaginal microflora, 43.5% of samples were U. parvum positive. Bacterial vaginosis and aerobic vaginitis samples were 59.9% and 23.9% U. parvum positive, respectively. This study supports the symbiotic considerations between vaginal microflora (primarily normal and bacterial vaginosis) and mycoplasma such as U. parvum.

Current studies: Ureaplasma parvum in males

Ureaplasma parvum (and U. urealyticum) have been linked to nongonococcal urethritis (NGU), but the Ureaplasma spp. have also been found in many healthy men, allowing for considerable skepticism that the two are correlated. Similarly, links to prostatitis and infertility are difficult to establish due to its presence in control groups. [15] In andrology studies, the presence of U. parvum in semen has been found to be significant. Various Ureaplasma spp. isolates have been detected in semen via polymerase chain reaction (PCR) and immunofluorescent antibody assay. In 36.6% of washed samples, U. parvum was present. [16] Andrology studies surrounding U. parvum demonstrated that the bacteria can remain on the spermatozoa even after washing.

Current studies: Ureaplasma parvum in females

Current research indicates that U. parvum infections can cause pregnancy complications. In pregnant women with an intra-amniotic infection, U. parvum is the most common bacterium found. Ureaplasma spp. generally causes a more severe inflammatory response than other microbial infections. These infections can lead to preterm birth, maternal and fetal inflammation, placental inflammation (chorioamnionitis), and neonatal mortality. [17] One study [18] found that amniotic inoculation with a clinically isolated U. parvum serovar 14 causes preterm birth in animal models, while serovar 3 causes a low rate of preterm birth but a higher rate of neonatal mortality. Studies are ongoing.

Related Research Articles

<span class="mw-page-title-main">Mycoplasma genitalium</span> Species of bacterium

Mycoplasma genitalium is a sexually transmitted, small and pathogenic bacterium that lives on the mucous epithelial cells of the urinary and genital tracts in humans. Medical reports published in 2007 and 2015 state that Mgen is becoming increasingly common. Resistance to multiple antibiotics, including the macrolide azithromycin, which until recently was the most reliable treatment, is becoming prevalent. The bacteria was first isolated from the urogenital tract of humans in 1981, and was eventually identified as a new species of Mycoplasma in 1983. It can cause negative health effects in men and women. It also increases the risk factor for HIV spread with higher occurrences in those previously treated with the azithromycin antibiotics.

<span class="mw-page-title-main">Pelvic inflammatory disease</span> Infection of uterus, fallopian tubes, ovaries or the inner surface of pelvis

Pelvic inflammatory disease, also known as pelvic inflammatory disorder (PID), is an infection of the upper part of the female reproductive system, namely the uterus, fallopian tubes, and ovaries, and inside of the pelvis. Often, there may be no symptoms. Signs and symptoms, when present, may include lower abdominal pain, vaginal discharge, fever, burning with urination, pain with sex, bleeding after sex, or irregular menstruation. Untreated PID can result in long-term complications including infertility, ectopic pregnancy, chronic pelvic pain, and cancer.

Urethritis is the inflammation of the urethra. The most common symptoms include painful or difficult urination and urethral discharge. It is a commonly treatable condition usually caused by infection with bacteria. This bacterial infection is often sexually transmitted, but not in every instance; it can be idiopathic, for example. Some incidence of urethritis can appear asymptomatic as well.

<span class="mw-page-title-main">Trichomoniasis</span> Medical condition

Trichomoniasis (trich) is an infectious disease caused by the parasite Trichomonas vaginalis. About 70% of affected people do not have symptoms when infected. When symptoms occur, they typically begin 5 to 28 days after exposure. Symptoms can include itching in the genital area, a bad smelling thin vaginal discharge, burning with urination, and pain with sex. Having trichomoniasis increases the risk of getting HIV/AIDS. It may also cause complications during pregnancy.

<i>Mycoplasma</i> Genus of bacteria

Mycoplasma is a genus of bacteria that, like the other members of the class Mollicutes, lack a cell wall around their cell membranes. Peptidoglycan (murein) is absent. This characteristic makes them naturally resistant to antibiotics that target cell wall synthesis. They can be parasitic or saprotrophic. Several species are pathogenic in humans, including M. pneumoniae, which is an important cause of "walking" pneumonia and other respiratory disorders, and M. genitalium, which is believed to be involved in pelvic inflammatory diseases. Mycoplasma species are among the smallest organisms yet discovered, can survive without oxygen, and come in various shapes. For example, M. genitalium is flask-shaped, while M. pneumoniae is more elongated, many Mycoplasma species are coccoid. Hundreds of Mycoplasma species infect animals.

Nongonococcal urethritis (NGU) is inflammation of the urethra that is not caused by gonorrheal infection.

<i>Trichomonas vaginalis</i> Species of parasite that causes sexually transmitted infections

Trichomonas vaginalis is an anaerobic, flagellated protozoan parasite and the causative agent of a sexually transmitted disease called trichomoniasis. It is the most common pathogenic protozoan that infects humans in industrialized countries. Infection rates in men and women are similar but women are usually symptomatic, while infections in men are usually asymptomatic. Transmission usually occurs via direct, skin-to-skin contact with an infected individual, most often through vaginal intercourse. The WHO has estimated that 160 million cases of infection are acquired annually worldwide. The estimates for North America alone are between 5 and 8 million new infections each year, with an estimated rate of asymptomatic cases as high as 50%. Usually treatment consists of metronidazole and tinidazole.

Mycoplasma hominis is a species of bacteria in the genus Mycoplasma. M. hominis has the ability to penetrate the interior of human cells. Along with ureaplasmas, mycoplasmas are the smallest free-living organisms known.

<i>Ureaplasma urealyticum</i> Species of bacterium

Ureaplasma urealyticum is a bacterium belonging to the genus Ureaplasma and the family Mycoplasmataceae in the order Mycoplasmatales. This family consists of the genera Mycoplasma and Ureaplasma. Its type strain is T960. There are two known biovars of this species; T960 and 27. These strains of bacteria are commonly found as commensals in the urogenital tracts of human beings, but overgrowth can lead to infections that cause the patient discomfort. Unlike most bacteria, Ureaplasma urealyticum lacks a cell wall making it unique in physiology and medical treatment.

<span class="mw-page-title-main">Mycoplasmataceae</span> Family of bacteria

Mycoplasmataceae is a family of bacteria in the order Mycoplasmatales. This family consists of the genera Mycoplasma and Ureaplasma.

<span class="mw-page-title-main">Reactive arthritis</span> Medical condition

Reactive arthritis, also known as Reiter's syndrome, is a form of inflammatory arthritis that develops in response to an infection in another part of the body (cross-reactivity). Coming into contact with bacteria and developing an infection can trigger the disease. By the time the patient presents with symptoms, often the "trigger" infection has been cured or is in remission in chronic cases, thus making determination of the initial cause difficult.

<span class="mw-page-title-main">Chorioamnionitis</span> Medical condition

Chorioamnionitis, also known as intra-amniotic infection (IAI), is inflammation of the fetal membranes, usually due to bacterial infection. In 2015, a National Institute of Child Health and Human Development Workshop expert panel recommended use of the term "triple I" to address the heterogeneity of this disorder. The term triple I refers to intrauterine infection or inflammation or both and is defined by strict diagnostic criteria, but this terminology has not been commonly adopted although the criteria are used.

<span class="mw-page-title-main">Grepafloxacin</span> Chemical compound

Grepafloxacin was an oral broad-spectrum fluoroquinolone antibacterial agent used to treat bacterial infections. Grepafloxacin was withdrawn worldwide from markets in 1999, due to its side effect of lengthening the QT interval on the electrocardiogram, leading to cardiac events and sudden death.

<span class="mw-page-title-main">Vaginal flora</span> Microorganisms present in the vagina

Vaginal flora, vaginal microbiota or vaginal microbiome are the microorganisms that colonize the vagina. They were discovered by the German gynecologist Albert Döderlein in 1892 and are part of the overall human flora. The amount and type of bacteria present have significant implications for an individual's overall health. The primary colonizing bacteria of a healthy individual are of the genus Lactobacillus, such as L. crispatus, and the lactic acid they produce is thought to protect against infection by pathogenic species.

<i>Salmonella enterica <span style="font-style:normal;">subsp.</span> enterica</i> Subspecies of bacterium

Salmonella enterica subsp. enterica is a subspecies of Salmonella enterica, the rod-shaped, flagellated, aerobic, Gram-negative bacterium. Many of the pathogenic serovars of the S. enterica species are in this subspecies, including that responsible for typhoid.

Mycoplasma orale is a small bacterium found in the class Mollicutes. It belongs to the genus Mycoplasma, a well-known group of bacterial parasites that inhabit humans. It also is known to be an opportunistic pathogen in immunocompromised humans. As with other Mycoplasma species, M. orale is not readily treated with many antibiotics due to its lack of a peptidoglycan cell wall. Therefore, this species is relevant to the medical field as physicians face the task of treating patients infected with this microbe. It is characterized by a small physical size, a small genome size, and a limited metabolism. It is also known to frequently contaminate laboratory experiments. This bacteria is very similar physiologically and morphologically to its sister species within the genus Mycoplasma; however, its recent discovery leaves many questions still unanswered about this microbe.

The vaginal flora in pregnancy, or vaginal microbiota in pregnancy, is different from the vaginal flora before sexual maturity, during reproductive years, and after menopause. A description of the vaginal flora of pregnant women who are immunocompromised is not covered in this article. The composition of the vaginal flora significantly differs in pregnancy. Bacteria or viruses that are infectious most often have no symptoms.

The exact role of Mycoplasma hominis in regards to a number of conditions related to pregnant women and their (unborn) offspring is controversial. This is mainly because many healthy adults have genitourinary colonization with Mycoplasma, published studies on pathogenicity have important design limitations and the organisms are very difficult to detect. The likelihood of colonization with M. hominis appears directly linked to the number of lifetime sexual partners Neonatal colonization does occur, but only through normal vaginal delivery. Caesarean section appears protective against colonization and is much less common. Neonatal colonization is transient.

<span class="mw-page-title-main">Uterine microbiome</span>

The uterine microbiome is the commensal, nonpathogenic, bacteria, viruses, yeasts/fungi present in a healthy uterus, amniotic fluid and endometrium and the specific environment which they inhabit. It has been only recently confirmed that the uterus and its tissues are not sterile. Due to improved 16S rRNA gene sequencing techniques, detection of bacteria that are present in low numbers is possible. Using this procedure that allows the detection of bacteria that cannot be cultured outside the body, studies of microbiota present in the uterus are expected to increase.

References

  1. ↑ Oshima K, Nishida H (May 2008). "Detection of the genes evolving under Ureaplasma-specific selection". Journal of Molecular Evolution. 66 (5): 529–32. Bibcode:2008JMolE..66..529O. doi:10.1007/s00239-008-9106-4. PMID   18414924. S2CID   25734066.
  2. ↑ Kong F, Ma Z, James G, Gordon S, Gilbert GL (March 2000). "Species identification and subtyping of Ureaplasma parvum and Ureaplasma urealyticum using PCR-based assays". Journal of Clinical Microbiology. 38 (3): 1175–9. doi:10.1128/JCM.38.3.1175-1179.2000. PMC   86368 . PMID   10699016.
  3. ↑ Yarbrough VL, Winkle S, Herbst-Kralovetz MM (2014). "Antimicrobial peptides in the female reproductive tract: a critical component of the mucosal immune barrier with physiological and clinical implications". Human Reproduction Update. 21 (3): 353–77. doi: 10.1093/humupd/dmu065 . PMID   25547201.
  4. ↑ Mor G, Kwon JY (October 2015). "Trophoblast-microbiome interaction: a new paradigm on immune regulation". American Journal of Obstetrics and Gynecology. 213 (4 Suppl): S131-7. doi: 10.1016/j.ajog.2015.06.039 . PMC   6800181 . PMID   26428492.
  5. ↑ Contini C, Rotondo JC, Magagnoli F, Maritati M, Seraceni S, Graziano A, et al. (January 2018). "Investigation on silent bacterial infections in specimens from pregnant women affected by spontaneous miscarriage". Journal of Cellular Physiology. 234 (1): 100–107. doi: 10.1002/jcp.26952 . hdl: 11392/2393176 . PMID   30078192.
  6. 1 2 Beeton ML, Payne MS, Jones L (September 2019). "The Role of Ureaplasma spp. in the Development of Nongonococcal Urethritis and Infertility among Men". Clinical Microbiology Reviews. 32 (4). doi:10.1128/CMR.00137-18. PMC   6750135 . PMID   31270127.
  7. ↑ Kim MS, Lee DH, Kim TJ, Oh JJ, Rhee SR, Park DS, Yu YD (January 2021). "The role of Ureaplasma parvum serovar-3 or serovar-14 infection in female patients with chronic micturition urethral pain and recurrent microscopic hematuria". Translational Andrology and Urology. 10 (1): 96–108. doi: 10.21037/tau-20-920 . PMC   7844479 . PMID   33532300.
  8. ↑ Kong F, Ma Z, James G, Gordon S, Gilbert GL (September 2000). "Molecular genotyping of human Ureaplasma species based on multiple-banded antigen (MBA) gene sequences". International Journal of Systematic and Evolutionary Microbiology. 50 Pt 5 (5): 1921–1929. doi: 10.1099/00207713-50-5-1921 . PMID   11034506.
  9. 1 2 Paralanov V, Lu J, Duffy LB, Crabb DM, Shrivastava S, Methé BA, et al. (May 2012). "Comparative genome analysis of 19 Ureaplasma urealyticum and Ureaplasma parvum strains". BMC Microbiology. 12 (1): 88. doi: 10.1186/1471-2180-12-88 . PMC   3511179 . PMID   22646228.
  10. ↑ Taylor-Robinson D (November 2017). "Mollicutes in vaginal microbiology: Mycoplasma hominis, Ureaplasma urealyticum, Ureaplasma parvum and Mycoplasma genitalium". Research in Microbiology. 168 (9–10): 875–881. doi: 10.1016/j.resmic.2017.02.009 . PMID   28263902.
  11. 1 2 Horner P, Donders G, Cusini M, Gomberg M, Jensen JS, Unemo M (November 2018). "Should we be testing for urogenital Mycoplasma hominis, Ureaplasma parvum and Ureaplasma urealyticum in men and women? - a position statement from the European STI Guidelines Editorial Board". Journal of the European Academy of Dermatology and Venereology. 32 (11): 1845–1851. doi:10.1111/jdv.15146. hdl: 10067/1554670151162165141 . PMID   29924422. S2CID   49313037.
  12. ↑ Gupta A (2019-06-20). "Mycoplasma and Ureaplasma – The big conundrum". Walk In Gyn Care. Retrieved 2021-04-19.
  13. ↑ Zimmerman CU, Stiedl T, Rosengarten R, Spergser J (March 2009). "Alternate phase variation in expression of two major surface membrane proteins (MBA and UU376) of Ureaplasma parvum serovar 3". FEMS Microbiology Letters. 292 (2): 187–93. doi: 10.1111/j.1574-6968.2009.01505.x . PMID   19220471.
  14. ↑ Rumyantseva T, Khayrullina G, Guschin A, Donders G (March 2019). "Prevalence of Ureaplasma spp. and Mycoplasma hominis in healthy women and patients with flora alterations". Diagnostic Microbiology and Infectious Disease. 93 (3): 227–231. doi:10.1016/j.diagmicrobio.2018.10.001. hdl: 10067/1585870151162165141 . PMID   30344067. S2CID   53041181.
  15. ↑ Beeton ML, Payne MS, Jones L (September 2019). "The Role of Ureaplasma spp. in the Development of Nongonococcal Urethritis and Infertility among Men". Clinical Microbiology Reviews. 32 (4): e00137–18, /cmr/32/4/CMR.00137–18.atom. doi:10.1128/CMR.00137-18. PMC   6750135 . PMID   31270127.
  16. ↑ Knox CL, Allan JA, Allan JM, Edirisinghe WR, Stenzel D, Lawrence FA, et al. (October 2003). "Ureaplasma parvum and Ureaplasma urealyticum are detected in semen after washing before assisted reproductive technology procedures". Fertility and Sterility. 80 (4): 921–9. doi: 10.1016/S0015-0282(03)01125-7 . PMID   14556813.
  17. ↑ von Chamier M, Allam A, Brown MB, Reinhard MK, Reyes L (2012-08-29). Kanellopoulos-Langevin C (ed.). "Host genetic background impacts disease outcome during intrauterine infection with Ureaplasma parvum". PLOS ONE. 7 (8): e44047. Bibcode:2012PLoSO...744047V. doi: 10.1371/journal.pone.0044047 . PMC   3430619 . PMID   22952869.
  18. ↑ Motomura K, Romero R, Xu Y, Theis KR, Galaz J, Winters AD, et al. (June 2020). Ballard JD (ed.). "Intra-Amniotic Infection with Ureaplasma parvum Causes Preterm Birth and Neonatal Mortality That Are Prevented by Treatment with Clarithromycin". mBio. 11 (3): e00797–20, /mbio/11/3/mBio.00797–20.atom. doi:10.1128/mBio.00797-20. PMC   7315120 . PMID   32576673.
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