Ureaplasma Cultures Research Articles

Association between Ureaplasma colonization and bronchopulmonary dysplasia defined by different criteria in very low birth weight infants: A retrospective cohort study.

To study the association between Ureaplasma colonization and bronchopulmonary dysplasia (BPD) with different definitions in very low birth weight (VLBW) infants. A retrospective cohort study was performed with VLBW infants admitted from January 2019 to October 2021. Neonates with a positive respiratory tract Ureaplasma culture were included in the study group. Control group infants, matched for gestational age (±1 week), birth weight (±100 g), and birth year, had a negative respiratory tract Ureaplasma culture during the same period. The primary outcomes included the incidence and severity of BPD, defined by various criteria. The study included 302 neonates (151 in the study group and 151 in the control group). After adjusting for confounders, Ureaplasma colonization was not associated with BPD as defined by the National Institutes of Health (NIH) in 2001 (adjusted odds ratio [aOR]: 0.820, 95% confidence interval [CI]: 0.362-1.860, p = .635). However, it was associated with BPD as defined by the NIH in 2018 (aOR: 2.490, 95% CI: 1.128-5.497, p = .024) and the Neonatal Research Network (NRN) in 2019 (aOR: 2.352, 95% CI: 1.077-5.134, p = .032). Additionally, VLBW infants with Ureaplasma colonization had a higher risk of moderate-severe BPD according to the NIH 2001 (aOR: 2.352, 95% CI: 1.077-5.134, p = .032), NIH 2018 (aOR: 6.339, 95% CI: 1.686-23.836, p = .006), and NRN 2019 definitions (aOR: 3.542, 95% CI: 1.267-9.904, p = .016). Ureaplasma colonization is not associated with BPD by the NIH 2001 definition, but is associated with an increased incidence by the NIH 2018 or NRN 2019 definitions.

Clinical and uterine cervix characteristics of women with Mycoplasma and Ureaplasma in genital discharge.

The objective of this study was to assess the clinical and uterine cervix characteristics of patients displaying vaginal discharge with positive results for Mycoplasma sp. and/or Ureaplasma spp. An analytical cross-sectional study involving women aged 18-45 years was conducted. Microbiological assessments included Ureaplasma and Mycoplasma cultures, as well as human papillomavirus hybrid capture using ecto and endocervix swabs. All tests were two-tailed, and significance was set at p<0.05. Among 324 women, Ureaplasma prevalence was 17.9%, and Mycoplasma prevalence was 3.1%. The Ureaplasma-positive group exhibited a higher frequency of urinary tract infections (39.1 vs. 19%, p=0.002) and human papillomavirus (39.7 vs. 12.8%, p≤0.001) compared with controls. The Mycoplasma-positive group showed a higher frequency of non-contraceptive use compared with controls (66.2 vs. 30.0%, p=0.036). Abnormal colposcopic findings were more prevalent in the Mycoplasma/Ureaplasma-positive group than in controls (positive: 65% vs. control: 35%, p=0.001). Pap smear findings did not differ between the groups. Ureaplasma spp. was associated with urinary tract infections and human papillomavirus, while the presence of Mycoplasma sp. was linked to reduced contraceptive use. When analyzing both pathogens together, a higher frequency of abnormal colposcopic findings was observed, with no difference in cytological findings in the positive group.

Ureaplasma and Mycoplasma Screening for Pregnant Individuals Who Are at High Risk for Preterm Birth.

This study aimed to examine gestational age at delivery according to Ureaplasma/Mycoplasma cervical culture results and whether pregnant individuals received antibiotics. A retrospective cohort study at a single academic institution where all pregnant individuals with risk factors for preterm birth including those with a history of preterm birth, recurrent pregnancy loss, or pregnancy requiring cervical cerclage were included. We plotted Kaplan-Meier curves to investigate the association between the gestational age at delivery and Ureaplasma culture results (negative; positive and treated; or positive but did not receive the treatment). A Cox proportional regression model was used to calculate hazard ratio (HR) with 95% confidence intervals (95% CI), controlling for confounders. The main outcome was age at delivery. Analyses were repeated for Mycoplasma culture. Of 607 individuals, 258 (42.5%) had a negative Ureaplasma culture, 308 (50.7%) had a positive Ureaplasma culture and received treatment, and 41 (6.8%) had a positive Ureaplasma culture and did not receive treatment. Compared with those who had a positive Ureaplasma culture but did not receive treatment, those who had a negative Ureaplasma culture did not have a decreased risk (HR: 1.03; 95% CI: 0.74-1.44). Compared with those who had a positive Ureaplasma culture but did not receive treatment, those who had a positive Ureaplasma culture and received treatment did not have a decreased risk (HR: 0.91; 95% CI: 0.66-1.27). The treatment failure rate of Ureaplasma after treatment was 78.6% (95% CI: 72.8-83.7%). Overall, the findings of Mycoplasma were similar. Routine ureaplasma/mycoplasma cervical culture is not recommended for pregnant individuals who are at high risk for preterm birth. · Ureaplasma/mycoplasma species are isolated in patients with preterm birth.. · High ureaplasma/mycoplasma recurrence rate despite treatment with antibiotics.. · Treatment of patient and partner did not improve gestational age at delivery..

How does gender affect ureaplasma and mycoplasma growth and antimicrobial susceptibility rates?

The aim of this study was to assess the presence of M. hominis and U. urealyticum agents, their distribution between male and female, and differences in antibiotic susceptibility in samples sent from Hisar Intercontinental Hospital's various clinics with the preliminary diagnosis of genitourinary system infection. The Mycoplasma IES test was used to identify M. hominis and U. urealyticum, and to determine antibiotic susceptibility results, in samples taken from patients. The findings of mycoplasma and ureaplasma culture testing samples requested between 2014 and 2021 were evaluated retrospectively from our records. M. hominis was found to be positive in 7.37% of the examinations, U. urealyticum was found to be positive in 34.98% of the examinations, and either of them were found to be positive in 22.01% of the examinations. The growth rate of M. hominis and/or U. urealyticum was determined to be 24.95% in females and 10.13% in males, with the growth rate in females being greater and statistically significant (p < 0.001). According to the antibiotic susceptibility test results, clarithromycin (R 17.91%) was the most susceptible antibiotic overall for both microorganisms, while clindamycin (R 90.28%) was the most resistant. Depending on the sex, clarithromycin (R 18.40%) was found to be the most susceptible antibiotic in females, and levofloxacin (R 10.87%) to be the most susceptible in males. Given the presence of M. hominis and U. urealyticum infections, especially in the presence of risky conditions such as pregnancy, laboratory tests for the diagnosis of these agents should be used in such studies since no urogenital infections were detected in the routine cultures of the patients followed up with the suspicion of urogenital infection. Gender differences should also be considered as a parameter in the preference of antibiotics.

Ureaplasma and Mycoplasma screening in women undergoing cerclage

There is conflicting data on the association between positive Ureaplasma and Mycoplasma (U & M) cervical culture and preterm birth in women undergoing cerclage. We sought to examine the association between positive U & M cervical culture and preterm delivery in women undergoing cerclage.

A novel bioreactor for the stable growth of Ureaplasma parvum and Ureaplasma urealyticum

Ureaplasma species, including Ureaplasma parvum and Ureaplasma urealyticum, are challenging to culture and maintain. Here, we describe a novel bioreactor for growing high-titer liquid Ureaplasma cultures in a stable manner.

Ureaplasma infection-mediated release of matrix metalloproteinase-9 and PGP: a novel mechanism of preterm rupture of membranes and chorioamnionitis

BackgroundPremature rupture of membranes and preterm delivery are associated with Ureaplasma infection. We hypothesized that Ureaplasma induced extracellular collagen fragmentation results in production of the tripeptide PGP (proline-glycine-proline), a neutrophil chemoattractant. PGP release from collagen requires matrix metalloproteases (MMP-8/MMP-9) along with a serine protease, prolyl endopeptidase (PE).MethodsUreaplasma culture negative amniotic fluid (indicated preterm birth, n=8; spontaneous preterm birth, n=8) and Ureaplasma positive amniotic fluid (spontaneous preterm birth, n=8) were analyzed by electro-spray ionization-liquid chromatography tandem mass spectrometry for PGP, and for MMP-9 by zymography. PE was evaluated in lysates of U. parvum serovar 3 (Up3) and U. urealyticum serovar 10 (Uu10) by western blotting and activity assay.ResultsPGP and MMP-9 were increased in amniotic fluid from spontaneous preterm birth with positive Ureaplasma cultures, but not with indicated preterm birth or spontaneous preterm birth with negative Ureaplasma cultures. Human neutrophils co-cultured with Ureaplasma strains showed increased MMP-9 activity. PE presence and activity were noted with both Ureaplasma strains.ConclusionsUreaplasma spp. carry the protease necessary for PGP release, and PGP and MMP-9 are increased in amniotic fluid during Ureaplasma infection, suggesting Ureaplasma spp. induced collagen fragmentation contributes to preterm rupture of membranes and neutrophil influx causing chorioamnionitis.

120 cases of non gonococcal urethritis mycoplasma and chlamydia infection and drug resistance status

Objective To investigate non gonococcal urethritis mycoplasma and chlamydia infection and drug sensitivity status. Methods From June 2014 to December 2014, 120 cases of non gonococcal urethritis patients in our hospital were given chlamydia trachomatis, ureaplasma, mycoplasma detection and mycoplasma culture and drug sensitivity test of mycoplasma.Mycoplasma and chlamydia test results were compared between male and female patients.Positive drug sensitivity test results of ureaplasma urealyticum(Uu) and mycoplasma hominis(Mh) were observed. Results Among the 120 patients with positive detection, the proportion of Uu was the highest, up to 41.67% (50/120); the second was Mh, accounting for 31.67% (38/120). The detection rate of Uu in women (57.14%) was significantly higher than that in males (28.13%), and the difference was statistically significant (χ2=10.35, P<0.05). The susceptibility of mycoplasma to pristinamycin susceptible rate highest, Uu and type mycoplasma reached 100.00%; followed by doxycycline, the susceptibility of Uu reached 98.00% and the susceptibility of Mh to 100.00%; sensitive rates of Uu and Mh to josamycin were 96.00% and 90.48%.The sensitive rates of Uu and Mh to tetracycline were 92.00% and 90.48% respectively. Conclusion The mycoplasma infection was mainly caused by Uu.Clinical treatment of mycoplasma infection can be based on the drug sensitivity test results to reasonably choose antibiotics, and sensitive rates of pristinamycin, doxycycline were higher. Key words: Non gonococcal urethritis; Mycoplasma; Chlamydia pneumoniae; Infection; Drug sensitivity

Presence of aerobic micro-organisms and their influence on basic semen parameters in infertile men.

Urogenital tract infections in males are one of the significant etiological factors in infertility. In this prospective study, 72 patients with abnormal semen parameters or any other symptoms of urogenital tract infection were examined. Semen analysis according to the WHO 2010 manual was performed together with microbial assessment: aerobic bacteria culture, Chlamydia antigen test, Candida culture, Ureaplasma and Mycoplasma-specific culture. In total, 69.4% of semen samples were positive for at least one micro-organism. Ureaplasma sp. was the most common micro-organism found in 33% of semen samples of infertile patients with suspected male genital tract infection. The 2nd most common micro-organisms were Enterococcus faecalis (12.5%) and Escherichia coli (12.5%), followed by Staphylococcus aureus (7%), Chlamydia trachomatis (7%) and Candida sp. (5.6%). Generally, bacteria were sensitive to at least one of the antibiotics tested. No statistically significant relationship was observed between the presence of aerobic micro-organisms in semen and basic semen parameters: volume, pH, concentration, total count, motility, vitality and morphology.

The effects of pyospermia and ureaplasma urealyticum culture positivity on semen quality in subfertile men

ObjectiveTo analyze the relationship between pyospermia, semen quality and the results of Ureaplasma urealyticum testing in subfertile men.DesignRetrospective Cohort Study.Materials and MethodsThis is a retrospective cohort study of subfertile men (n=122) visiting a single institution over a 5 year period with pyospermia and reflexive urine culture for Ureaplasma urealyticum. Study subjects had follow up semen analyses (SAs) no less than 28 days after Ureaplasma testing. The Wilcoxon rank-sum test was used to compare mean SAs before doxycycline treatment and to compare the change in mean SAs in pyospermic patients with positive (n=9) vs. negative (n=113) Ureaplasma cultures.ResultsComparison of pyospermic men after antibiotic treatment with positive vs. negative. Ureaplasma cultures revealed no statistical difference in incident semen leukocyte levels (3.73 vs. 2.59 x 106 WBC/mL, p = 0.92), volume (2.0 vs. 2.79 mL, p = 0.15), concentration (39.43 vs. 49.27 M/mL, p = 0.95), motility (44.89% vs. 50.73, p = 0.31), or strict morphology (5.0 vs. 4.97%, p = 0.40). Comparison of the change between incident and follow up semen analyses after antibiotic treatment in positive vs. negative Ureaplasma cultures did not reveal a statistically significant difference in change in semen leukocyte levels (-0.2 vs. -1.66 x 106 WBC/mL, p = 0.50), volume (-0.17 vs. -0.05 mL, p = 0.55), concentration (6.88 vs. -0.56 M/mL, p = 0.85), motility (8.56 vs. -0.11%, p = 0.16), or strict morphology (0.67 vs. -1.12%, p = 0.18).ConclusionUreaplasma culture positivity does not influence semen parameters and reflexive Ureaplasma testing in the setting of pyospermia may be of limited utility. ObjectiveTo analyze the relationship between pyospermia, semen quality and the results of Ureaplasma urealyticum testing in subfertile men. To analyze the relationship between pyospermia, semen quality and the results of Ureaplasma urealyticum testing in subfertile men. DesignRetrospective Cohort Study. Retrospective Cohort Study. Materials and MethodsThis is a retrospective cohort study of subfertile men (n=122) visiting a single institution over a 5 year period with pyospermia and reflexive urine culture for Ureaplasma urealyticum. Study subjects had follow up semen analyses (SAs) no less than 28 days after Ureaplasma testing. The Wilcoxon rank-sum test was used to compare mean SAs before doxycycline treatment and to compare the change in mean SAs in pyospermic patients with positive (n=9) vs. negative (n=113) Ureaplasma cultures. This is a retrospective cohort study of subfertile men (n=122) visiting a single institution over a 5 year period with pyospermia and reflexive urine culture for Ureaplasma urealyticum. Study subjects had follow up semen analyses (SAs) no less than 28 days after Ureaplasma testing. The Wilcoxon rank-sum test was used to compare mean SAs before doxycycline treatment and to compare the change in mean SAs in pyospermic patients with positive (n=9) vs. negative (n=113) Ureaplasma cultures. ResultsComparison of pyospermic men after antibiotic treatment with positive vs. negative. Ureaplasma cultures revealed no statistical difference in incident semen leukocyte levels (3.73 vs. 2.59 x 106 WBC/mL, p = 0.92), volume (2.0 vs. 2.79 mL, p = 0.15), concentration (39.43 vs. 49.27 M/mL, p = 0.95), motility (44.89% vs. 50.73, p = 0.31), or strict morphology (5.0 vs. 4.97%, p = 0.40). Comparison of the change between incident and follow up semen analyses after antibiotic treatment in positive vs. negative Ureaplasma cultures did not reveal a statistically significant difference in change in semen leukocyte levels (-0.2 vs. -1.66 x 106 WBC/mL, p = 0.50), volume (-0.17 vs. -0.05 mL, p = 0.55), concentration (6.88 vs. -0.56 M/mL, p = 0.85), motility (8.56 vs. -0.11%, p = 0.16), or strict morphology (0.67 vs. -1.12%, p = 0.18). Comparison of pyospermic men after antibiotic treatment with positive vs. negative. Ureaplasma cultures revealed no statistical difference in incident semen leukocyte levels (3.73 vs. 2.59 x 106 WBC/mL, p = 0.92), volume (2.0 vs. 2.79 mL, p = 0.15), concentration (39.43 vs. 49.27 M/mL, p = 0.95), motility (44.89% vs. 50.73, p = 0.31), or strict morphology (5.0 vs. 4.97%, p = 0.40). Comparison of the change between incident and follow up semen analyses after antibiotic treatment in positive vs. negative Ureaplasma cultures did not reveal a statistically significant difference in change in semen leukocyte levels (-0.2 vs. -1.66 x 106 WBC/mL, p = 0.50), volume (-0.17 vs. -0.05 mL, p = 0.55), concentration (6.88 vs. -0.56 M/mL, p = 0.85), motility (8.56 vs. -0.11%, p = 0.16), or strict morphology (0.67 vs. -1.12%, p = 0.18). ConclusionUreaplasma culture positivity does not influence semen parameters and reflexive Ureaplasma testing in the setting of pyospermia may be of limited utility. Ureaplasma culture positivity does not influence semen parameters and reflexive Ureaplasma testing in the setting of pyospermia may be of limited utility.

Ureaplasma parvum Serovar 3 Multiple Banded Antigen Size Variation after Chronic Intra-Amniotic Infection/Colonization

Ureaplasma species are the microorganisms most frequently associated with adverse pregnancy outcomes. The multiple banded antigen (MBA), a surface-exposed lipoprotein, is a key virulence factor of ureaplasmas. The MBA demonstrates size variation, which we have shown previously to be correlated with the severity of chorioamnion inflammation. We aimed to investigate U. parvum serovar 3 pathogenesis in vivo, using a sheep model, by investigating: MBA variation after long term (chronic) and short term (acute) durations of in utero ureaplasma infections, and the severity of chorioamnionitis and inflammation in other fetal tissues. Inocula of 2×107 colony-forming-units (CFU) of U. parvum serovar 3 (Up) or media controls (C) were injected intra-amniotically into pregnant ewes at one of three time points: day 55 (69d Up, n = 8; C69, n = 4); day 117 (7d Up, n = 8; C7, n = 2); and day 121 (3d Up, n = 8; C3, n = 2) of gestation (term = 145–150d). At day 124, preterm fetuses were delivered surgically. Samples of chorioamnion, fetal lung, and umbilical cord were: (i) snap frozen for subsequent ureaplasma culture, and (ii) fixed, embedded, sectioned and stained by haematoxylin and eosin stain for histological analysis. Selected fetal lung clinical ureaplasma isolates were cloned and filtered to obtain cultures from a single CFU. Passage 1 and clone 2 ureaplasma cultures were tested by western blot to demonstrate MBA variation. In acute durations of ureaplasma infection no MBA variants (3d Up) or very few MBA variants (7d Up) were present when compared to the original inoculum. However, numerous MBA size variants were generated in vivo (alike within contiguous tissues, amniotic fluid and fetal lung, but different variants were present within chorioamnion), during chronic, 69d exposure to ureaplasma infection. For the first time we have shown that the degree of ureaplasma MBA variation in vivo increased with the duration of gestation.

Rapid PCR Detection of Mycoplasma hominis, Ureaplasma urealyticum, and Ureaplasma parvum.

Objective. We compared laboratory developed real-time PCR assays for detection of Mycoplasma hominis and for detection and differentiation of Ureaplasma urealyticum and parvum to culture using genitourinary specimens submitted for M. hominis and Ureaplasma culture. Methods. 283 genitourinary specimens received in the clinical bacteriology laboratory for M. hominis and Ureaplasma species culture were evaluated. Nucleic acids were extracted using the Total Nucleic Acid Kit on the MagNA Pure 2.0. 5 μL of the extracts were combined with 15 μL of each of the two master mixes. Assays were performed on the LightCycler 480 II system. Culture was performed using routine methods. Results. M. hominis PCR detected 38/42 M. hominis culture-positive specimens, as well as 2 that were culture negative (sensitivity, 90.5%; specificity, 99.2%). Ureaplasma PCR detected 139/144 Ureaplasma culture-positive specimens, as well as 9 that were culture negative (sensitivity, 96.5%; specificity, 93.6%). Of the specimens that tested positive for Ureaplasma species, U. urealyticum alone was detected in 33, U. parvum alone in 109, and both in 6. Conclusion. The described PCR assays are rapid alternatives to culture for detection of M. hominis and Ureaplasma species, and, unlike culture, the Ureaplasma assay easily distinguishes U. urealyticum from parvum.

Tetracycline resistance genes of ureaplasmas

In the medical setting, limited information is available on antimicrobial susceptibilities and resistance development in ureaplasmas. This study addresses tetracycline and doxycycline resistance in clinical isolates of Ureaplasma parvum and Ureaplasma urealyticum. Culture, with species polymerase chain reaction (PCR) confrmatory techniques, was applied to 191 endocervical specimens, collected during the period January-March 2006. Minimum inhibitory concentration (MIC) determinations were performed by microbroth dilution, with tetracycline resistance (tetM), and int-Tn genes were characterised by PCR and sequencing. Sixty-six ureaplasma cultures (35 U. parvum, 9 U. urealyticum, 22 U. parvum and U. urealyticum) were obtained. On screening the ureaplasma cultures, tetM gene regions were demonstrated from tetracycline-susceptible and -resistant ureaplasmas. Seven isolates (six U. parvum and one U. urealyticum) were resistant to tetracycline, with dual doxycycline resistance observed in three strains. Int-Tn gene characterisation of the seven tetracycline-resistant strains revealed that three types were present, indicating that transposons from different origins had integrated into ureaplasma genomes. TetM sequences of fve tetracycline-resistant strains were seen to be highly mosaic in structure. The fnding of transposon and/or tetM regions in all ureaplasma cultures investigated, with, or without, full expression of tetracycline resistance, in conjunction with tetM and int-Tn gene mosaic or diversity, verifes that ureaplasmas undergo extensive genetic exchange of transposon or resistance genes, with concomitant genomic remodelling.

Frequency of Ureaplasma Serovars in Respiratory Secretions of Preterm Infants at Risk for Bronchopulmonary Dysplasia

Ureaplasma respiratory tract colonization is associated with bronchopulmonary dysplasia (BPD) in preterm infants. Whether the 4 Ureaplasma parvum and 10 Ureaplasma urealyticum serovars differ in virulence is unknown. This study was conducted to determine the distribution of Ureaplasma serovars in respiratory secretions of a prospective cohort of preterm infants and to assess whether any of the serovars are associated with BPD. Serial endotracheal and/or nasopharyngeal aspirates were obtained for Ureaplasma culture and PCR from 136 infants of gestational age <33 weeks. All positive samples were speciated and serovars were determined by real-time PCR. A total of 51 (37.5%) infants were Ureaplasma-positive one or more times during the first month of life. Respiratory colonization was inversely related to gestational age. Sixty-five percent of infants <26 weeks compared with 31% infants ≥ 26 weeks were culture or PCR positive. U. parvum was more common (N = 32, 63%) than U. urealyticum (N = 17, 33%); both species were present in 2 samples. Serovars 3 and 6 alone and in combination accounted for 96% U. parvum isolates. U. urealyticum isolates were commonly a mixture of multiple serovars, with serovar 11 alone or combined with other serovars (10/17, 59%) being the most common serovar. No individual species or serovars or serovar mixtures were associated with moderate-to-severe BPD. U. parvum serovars 3 and 6 and U. urealyticum serovar 11 were the most common serovars detected in respiratory samples from a prospective cohort of preterm infants.

Necrotizing Enterocolitis Is Associated With Ureaplasma Colonization in Preterm Infants

The study objective was to determine whether Ureaplasma respiratory tract colonization of preterm infants <33 wk gestation is associated with an increased risk for necrotizing enterocolitis (NEC). One or more tracheal or nasopharyngeal aspirates for Ureaplasma culture and PCR were obtained during the first week of life from 368 infants <33 wk gestation enrolled from 1999 to 2003 or from 2007 to 2009. NEC Bell stage ≥ 2 was confirmed by radiological criteria, and pathology, if available. Cord serum samples were analyzed for IL-6 and IL-1β concentrations, and placentas were reviewed for histological chorioamnionitis in the first cohort. NEC was confirmed in 29 of 368 (7.9%) of the combined cohorts. The incidence of NEC was 2.2-fold higher in Ureaplasma-positive (12.3%) than Ureaplasma-negative (5.5%) infants <33 wk (OR, 2.43; 95% CI, 1.13-5.2; p = 0.023) and 3.3-fold higher in Ureaplasma-positive (14.6%) than Ureaplasma-negative (4.4%) infants ≤ 28 wk (OR, 3.67; 95% CI, 1.36-9.93; p = 0.01). Age of onset, hematologic parameters at onset, and NEC severity were similar between Ureaplasma-positive and negative infants. Cord serum IL-6 and IL-1β concentrations were significantly higher in Ureaplasma-positive than in Ureaplasma-negative NEC-affected infants. Ureaplasma may be a factor in NEC pathogenesis in preterm infants by contributing to intestinal mucosal injury and/or altering systemic or local immune responses.

1141222744 Analysis of the relationship between ureaplasmal infection and premature delivery

Aim: Ureaplasma has recently been reported to be a pathogenic organism for sexually transmitted diseases and also for chorioamnionitis, premature delivery and neonatal pneumonia. In this study, we examined whether the ureaplasma infection is related to premature delivery.Methods: Vaginal swabs were obtained from 85 pregnant women (including 63 of normal delivery and 23 of premature delivery), and cultured in Ureaplasma culture medium. The swabs were also analyzed for bacteria flora using the conventional culture method. DNA was extracted from ureaplasma colonies grown to determine the biotype by PCR direct sequence method.Results: Ureaplasma infection was found in 51.6 and 52.6% of full‐term and preterm delivery women, respectively indicating that ureaplasma infection had no relation to premature delivery. The biotype of ureaplasma also had no relevance to preterm delivery. However, the interval between hospitalization due to threatened premature delivery and actual delivery was 8.4 days for ureaplasma‐infected patients as compared to 18 days for non‐infected patients. This result suggests that ureaplasma infection accelerates the process of premature delivery or shortens time to premature delivery.Conclusion: Our study found no association between ureaplasma infection or biotype and premature delivery. However, we found that ureaplasma‐infected patients were not as readily treatable for threatened preterm delivery as non‐infected patients.

ASSOCIATION OF UREAPLASMA UREALYTICUM WITH ABNORMAL REACTIVE OXYGEN SPECIES LEVELS AND ABSENCE OF LEUKOCYTOSPERMIA

Ureaplasma urealyticum is a commensal of the lower genitourinary tract of many sexually active adults. The organism is more common in partners of infertile than fertile marriages. We conducted a prospective study at our tertiary care center to confirm a possible association between U. urealyticum and abnormal sperm function parameters. A total of 50 consecutive male patients seeking general urology consultation for lower urinary tract symptoms characteristic of chronic prostatitis were evaluated. Urine and semen localization cultures were performed with additional semen cultures for U. urealyticum, Chlamydia trachomatis and Mycoplasma hominis. Specimens from 21 healthy men were used as controls. Specimens were analyzed by a computer assisted semen analyzer, and verified manually for concentration, percent motility and morphology. Leukocytospermia was measured by the Endtz test. Semen specimens were also analyzed for reactive oxygen species (ROS), acrosome reaction and mannose binding assay. Of the patients 17 had positive U. urealyticum cultures and the other cultures were negative. Patients with U. urealyticum had significantly higher ROS levels (log [ROS + 1] = 2.52 +/- 0.25) than those without U. urealyticum (1.49 +/- 0.20, p = 0.002) or controls (1.31 +/- 0.19, p = 0.002). Leukocytospermia was detected in only 1 of the 17 (6%) positive specimens and 4 (12%) negative specimens. Seminal ROS levels are elevated among patients with U. urealyticum. ROS induces lipid peroxidation, which reduces membrane fluidity and sperm fertilization capability, and may be the mechanism by which U. urealyticum impairs sperm function. Absence of leukocytospermia does not exclude U. urealyticum.

Efficacy of α-1 Proteinase Inhibitor (A1PI) Therapy for the Prevention of Chronic Lung Disease of Prematurity (CLD) is Supported by Supplementary Statistical Analyses † 1082

BACKGROUND: The first randomized controlled trial (RCT) of A1PI supplementation for the prevention of CLD was recently completed by our group. The incidence of CLD in survivors, defined by the requirement for supplemental oxygen at 36 weeks' corrected gestational age, was lower in the treated group but the difference did not reach statistical significance (RR=.48, CI.23-1.00). Although treatment groups were comparable with respect to demographic factors such as gestational age, birth weight and sex ratio, other variables that might influence the risk of a baby developing CLD were not considered in the original analysis. OBJECTIVE: To examine the influence of different demographic or treatment variables on the development of CLD in the cohort of premature neonates enrolled in the above trial. METHODS: Data were collected prospectively after factors potentially affecting the risk of CLD were identified. The SAS procedure LOGISTIC was used with stepwise progression on data from 94 babies with birth weights of 600-1250g. Demographic variables entered into the model were: birth weight, gestational age, sex, center, PDA, antenatal steroid exposure and ureaplasma culture. Treatment variables included: mean airway pressure x FIO2 on day 1, lowest and mean pCO2 in the first 2 days, total fluid intake, volume of packed red blood cells (PRBC), FFP or platelets transfused, amount of A1PI, amount of intravenous lipid and volume of breast milk/formula given in the first week of life. RESULTS: The model rejected all variables except the total amount of PRBC and A1PI given in the first week of life. A decreased volume of transfused PRBC's was associated with a decrease in the risk of developing CLD(OR=.91, p<.0001) while decreased volume of A1PI infused was associated with a increased risk (OR 1.28, p<.005). CONCLUSIONS: Supplementary analyses of data from a RCT of A1PI supplementation for the prevention of CLD strongly support the efficacy of this therapy. While alternative explanations should be explored, increased risk of CLD with increased PRBC transfusion is likely due to greater underlying disease severity.

The effect of positive semen bacterial and Ureaplasma cultures on in-vitro fertilization success.

A total of 342 couples planning to undergo in-vitro fertilization (IVF) were examined for the presence of bacteria in semen prior to and during the procedure. Pregnancy rates were analysed retrospectively to ascertain any adverse affects if > 10000 colony forming units (CFU)/ml bacteria were detected in the semen sample. The most common bacteria isolated from semen were Enterococcus spp. (73%). The presence of these bacteria did not affect the pregnancy rate of the patients with positive cultures prior to (32%) or during (37%) the IVF procedure compared with those patients in whom no bacteria were detected (32%). Those patients with semen cultures positive for Escherichia coli prior to the IVF procedure, but which cleared after treatment had a higher pregnancy rate (60%) compared with those patients who were positive for E.coli at the time of the attempt. The group of patients with Staphylococcus aureus in the semen at the time of IVF also demonstrated a low pregnancy rate (17%). Of the patients. 36 (11%) had positive Ureaplasma cultures from the screening test carried out on the semen and 22% became pregnant after successful treatment. None of the three patients with persistently positive cultures became pregnant. In conclusion, the presence of Enterococcus in semen does not affect pregnancy rates following IVF. E.coli, S.aureus and Ureaplasma urealyticum may have a negative effect and should be treated.

Histology and Ureaplasma urealyticum culture in 63 cases of first trimester abortion.

The association between chorioamnionitis caused by Ureaplasma urealyticum and preterm delivery has been well documented. In contrast, a pathogenic role for Ureaplasma has been postulated in early spontaneous abortions, but definitive evidence for this association has been lacking. In 42 early spontaneous abortions and 21 elective abortions (both first trimester), the chorion was cultured for Ureaplasma. Each case was evaluated histologically for four features of inflammation and one feature of degeneration. For comparison, 32 selected placentas from third trimester preterm deliveries (11 with positive Ureaplasma cultures) were examined histologically for umbilical vasculitis and acute chorioamnionitis. In abortion specimens, Ureaplasma cultures were positive in 11 of 42 early spontaneous abortions (26%) versus 0 of 21 elective abortions (EABs). None of the five histologic features correlated with positive Ureaplasma cultures in early spontaneous abortions. In contrast, in preterm placentas, umbilical vasculitis, and acute chorioamnionitis correlated strongly with positive Ureaplasma cultures. The authors conclude that in premature delivery, U urealyticum chorionic culture positivity is associated with histologic chorioamnionitis; and in abortions, Ureaplasma chorionic culture positivity correlates with early spontaneous abortions (vs elective abortions), but not with histologic inflammation. This suggests that mechanisms of Ureaplasma pathogenesis other than acute inflammation should be considered in future studies of early spontaneous abortions.