Ureaplasma urealyticum epidemiology and demographics

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Fatimo Biobaku M.B.B.S [2]

Overview

Genital tract colonization by Ureaplasma occur in over 40% of healthy women.[1][2][3][4] Ureaplasma species are the most common pathogen identified in VLBW infants.[4] Respiratory tract colonization by Ureaplasma is more common in preterm VLBW infants compared to term infants.[5][6] 20-45% of VLBW infants have Ureaplasma colonization of the respiratory tract.[2]

Epidemiology and Demographics

Prevalence

Ureaplasma species are commensal organisms in the female genital tract, colonizing 40-80% of the genital tract of healthy women.[1] [2][3][4] The prevalence of vaginal colonization with U. urealyticum in pregnant women is 29-42%.[7] Ureaplasma species are the most common pathogen identified in VLBW infants.[4] Ureaplasma colonization of the respiratory tract is more common in preterm VLBW infants compared to term infants.[5][6] 20-45% of VLBW infants have Ureaplasma colonization of the respiratory tract.[2] The incidence of Ureaplasma species in cord blood cultures of VLBW neonates was found to be 17%.[8] Ureaplasma species have also been shown to invade the bloodstream and cross the blood–brain barrier in 23% of VLBW infants in another study.[4] The prevalence of Ureaplasma positive CSF culture from preterm infants investigated for suspected meningitis was 8%.[9]

Age

Colonization by Ureaplasma species can be seen in both the pediatric and adult population. Genital tract of adult men and women are the main reservoirs of Ureaplasma species.[2][10] However, symptomatic Ureaplasma infection is seen more often in preterm neonates.[4] Colonization of neonates by U. urealyticum increases with decreasing gestational age and birth weight.[11]

Gender

There is no known gender predilection for Ureaplasma infection.

Race

A study conducted in the United States in the 1980's in 13,747 women of low socioeconomic status from four different ethnic groups revealed that women of black ethnicity were more likely to have genital tract colonization with potentially pathogenic organisms such as U. urealyticum [12] Another study was carried out by Doh et al. in healthy pregnant women from different ethnic groups, and it revealed no racial predilection for Ureaplasma colonization.[13]

References

  1. 1.0 1.1 Waites KB, Crouse DT, Cassell GH (1993). "Systemic neonatal infection due to Ureaplasma urealyticum". Clin Infect Dis. 17 Suppl 1: S131–5. PMID 8399903.
  2. 2.0 2.1 2.2 2.3 2.4 Resch B, Gutmann C, Reiterer F, Luxner J, Urlesberger B (2016). "Neonatal Ureaplasma urealyticum colonization increases pulmonary and cerebral morbidity despite treatment with macrolide antibiotics". Infection. 44 (3): 323–7. doi:10.1007/s15010-015-0858-7. PMID 26518581.
  3. 3.0 3.1 Okogbule-Wonodi AC, Gross GW, Sun CC, Agthe AG, Xiao L, Waites KB; et al. (2011). "Necrotizing enterocolitis is associated with ureaplasma colonization in preterm infants". Pediatr Res. 69 (5 Pt 1): 442–7. doi:10.1203/PDR.0b013e3182111827. PMC 3968774. PMID 21258263.
  4. 4.0 4.1 4.2 4.3 4.4 4.5 Viscardi RM, Hashmi N, Gross GW, Sun CC, Rodriguez A, Fairchild KD (2008). "Incidence of invasive ureaplasma in VLBW infants: relationship to severe intraventricular hemorrhage". J Perinatol. 28 (11): 759–65. doi:10.1038/jp.2008.98. PMC 5334544. PMID 18596706.
  5. 5.0 5.1 Waites KB, Katz B, Schelonka RL (2005). "Mycoplasmas and ureaplasmas as neonatal pathogens". Clin Microbiol Rev. 18 (4): 757–89. doi:10.1128/CMR.18.4.757-789.2005. PMC 1265909. PMID 16223956.
  6. 6.0 6.1 Patterson AM, Taciak V, Lovchik J, Fox RE, Campbell AB, Viscardi RM (1998). "Ureaplasma urealyticum respiratory tract colonization is associated with an increase in interleukin 1-beta and tumor necrosis factor alpha relative to interleukin 6 in tracheal aspirates of preterm infants". Pediatr Infect Dis J. 17 (4): 321–8. PMID 9576388.
  7. Vogel I, Thorsen P, Hogan VK, Schieve LA, Jacobsson B, Ferre CD (2006). "The joint effect of vaginal Ureaplasma urealyticum and bacterial vaginosis on adverse pregnancy outcomes". Acta Obstet Gynecol Scand. 85 (7): 778–85. doi:10.1080/00016340500442423. PMID 16817073.
  8. Goldenberg RL, Andrews WW, Goepfert AR, Faye-Petersen O, Cliver SP, Carlo WA; et al. (2008). "The Alabama Preterm Birth Study: umbilical cord blood Ureaplasma urealyticum and Mycoplasma hominis cultures in very preterm newborn infants". Am J Obstet Gynecol. 198 (1): 43.e1–5. doi:10.1016/j.ajog.2007.07.033. PMC 2278008. PMID 18166302.
  9. Waites KB, Rudd PT, Crouse DT, Canupp KC, Nelson KG, Ramsey C; et al. (1988). "Chronic Ureaplasma urealyticum and Mycoplasma hominis infections of central nervous system in preterm infants". Lancet. 1 (8575–6): 17–21. PMID 2891889.
  10. Deguchi T, Yoshida T, Miyazawa T, Yasuda M, Tamaki M, Ishiko H; et al. (2004). "Association of Ureaplasma urealyticum (biovar 2) with nongonococcal urethritis". Sex Transm Dis. 31 (3): 192–5. PMID 15076934.
  11. Agarwal P, Rajadurai VS, Pradeepkumar VK, Tan KW (2000). "Ureaplasma urealyticum and its association with chronic lung disease in Asian neonates". J Paediatr Child Health. 36 (5): 487–90. PMID 11036807.
  12. Goldenberg RL, Klebanoff MA, Nugent R, Krohn MA, Hillier S, Andrews WW; et al. (1996). "Bacterial colonization of the vagina during pregnancy in four ethnic groups". Am J Obstet Gynecol. 174 (5): 1618–1621. doi:10.1016/S0002-9378(96)70617-8. PMID 28140029.
  13. Doh K, Barton PT, Korneeva I, Perni SC, Bongiovanni AM, Tuttle SL; et al. (2004). "Differential vaginal expression of interleukin-1 system cytokines in the presence of Mycoplasma hominis and Ureaplasma urealyticum in pregnant women". Infect Dis Obstet Gynecol. 12 (2): 79–85. doi:10.1080/10647440400003667. PMC 1784593. PMID 15739821.

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