Ureaplasma Urealyticum Research Articles

P-2091. Potential Impact of Targeted Sequencing on Central Line-associated Bloodstream Infection (CLABSI) at Stanford Health Care, 2015–2024

Abstract Background Central line-associated bloodstream infection (CLABSI) remains a key quality measure. However, the CLABSI surveillance definition attributes bloodstream infections in patients with central venous access devices to the central line if no other sources are found, potentially overestimating true line-related cases. Incorporating non-culture based microbiologic testing, such as next-generation sequencing, into the CLABSI surveillance definition may further skew these estimates. We aimed to review the organisms identified in 16S rRNA sequencing tests from blood samples to determine if they were typically associated with CLABSI. Methods We retrieved all 16S rRNA sequencing orders from Stanford Hospitals & Clinics from May 2015– May 2024. We identified orders obtained from blood specimens and categorized those patients with and without central venous access devices. We compared the identified organisms with those included in the NSHN CLABSI definition (https://www.cdc.gov/nhsn/pdfs/pscmanual/17pscnosinfdef_current.pdf). Results Of the 3,830 16S rRNA tests ordered, 225 were from blood specimens. Among these, 40% (65/225) had a central venous access device at some point during admission. Eight tests were positive: two from patients with a device during collection, identifying Bartonella quintana and Ureaplasma urealyticum—both not excluded from the NHSN definition. Other positives included two cases of Borrelia hermsii, Paracoccus spp., Leptospira spp., Legionella spp., and coagulase-negative Staphylococcus, with only the latter typically associated with central venous access device infection. Only organisms from the genera Blastomyces, Histoplasma, Coccidioides, Paracoccidioides, Cryptococcus, and Pneumocystis are excluded from the NHSN CLABSI definition. Conclusion The increasing use of next-generation sequencing tests, such as 16S rRNA targeted sequencing, introduces unique scenarios where non-culturable organisms can be detected in blood specimens. There may be some risk of unfairly penalizing institutions for reporting organisms not associated with CLABSI. The list of organisms included in the NHSN CLABSI surveillance definition should be continuously updated to reflect the adoption of new non-culture-based testing methods. Disclosures All Authors: No reported disclosures

P-647. Comparative efficacy of antibiotic regimens against Ureaplasma species with varying antibiotic resistance profiles in a mouse model of lung infection

Abstract Background Lung transplant recipients (LTRs) can experience hyperammonemia syndrome (HS) correlated with lung infection by ammonia-producing Ureaplasma species. HS in LTRs can be managed by Ureaplasma-directed antibiotic therapy; however, Ureaplasma species lack a cell wall, limiting treatment options. Precise guidelines for Ureaplasma-directed antibiotic therapy in LTRs is lacking, and antibiotic resistance may complicate treatment. Here, levofloxacin (LEV), azithromycin (AZM), and doxycycline (DOX) were tested against isolates of U. urealyticum and U. parvum with varying antibiotic resistance profiles, and efficacies compared.Fig 1.Antibiotic prophylaxis of murine infection by antibiotic resistant Ureaplasma isolates. Mice were prophylaxed with levofloxacin (LEV; 100 mg/kg SQ), azithromycin (AZM; 100 mg/kg PO), or doxycycline (DOX; 100 mg/kg IP) 12 hours prior to infection with isolates of Ureaplasma parvum or Ureaplasma urealyticum resistant to one or none of the antibiotics. 18 hours after infection, mice were sacrificed and lungs harvested, with resulting Ureaplasma loads quantified (color changing units: CCU). Control animals (CTRL) were given no antibiotics. Significance between groups was determined via Kruskal-Wallis tests with Dunn’s multiple comparison tests. * p ≤0.05, **p ≤0.01, ***p ≤0.001. Methods Mice were immunosuppressed using a combination of tacrolimus (1.2 mg/kg daily), mycophenolate mofetil (40 mg/kg daily), and methylprednisolone (20 mg/kg weekly) to mimic immunosuppression given to LTRs. Prophylactic antibiotics were given 12 hours prior to infection, including either LEV (100 mg/kg subcutaneously), AZM (100 mg/kg orally), or DOX (100 mg/kg intraperitoneally). Mice were then infected with Ureaplasma isolates resistant to one or none of the antibiotics, including U. parvum IDRL-10774 (fully susceptible), U parvum IDRL-10774R (IDLR-10774 with evolved AZM resistance; serial passage in sub-MIC AZM), U. parvum IDRL-11160 (LEV resistant), and U. urealyticum ATCC-33175 (DOX resistant). Mice were euthanized 18 hours post-infection, and lung bacterial loads (color changing units; CCU/gram) quantified. Results The effect of various antibiotic treatments against mouse lung infections with the four Ureaplasma isolates is displayed in Fig 1. Infection with IDRL-10774 (fully susceptible) and IDRL-11160 (LEV resistant) was only prevented by doxycycline (p=0.09 and p=0.01, respectively). For IDRL-10774, insignificant mean reductions (possibly due to a high standard deviation in the controls) were observed for both LEV (-106.9 CCU/g) and AZM (-105.25 CCU/g). IDRL-10774R (evolved AZM resistance) showed a complete loss of susceptibility to AZM compared to unevolved IDRL-10774. ATCC-33175 (DOX resistant) was not reduced by any antibiotics tested. Conclusion DOX was the most effective antibiotic tested, preventing lung infection by all isolates, except a DOX resistant isolate. Disclosures Robin Patel, MD, a patent on Bordetella pertussis/parapertussis PCR issued, a patent on a device/method for sonication with royalties paid by Samsung to Mayo Clinic, a: See above|MicuRx Pharmaceuticals and BIOFIRE: Grant/Research Support|PhAST, Day Zero Diagnostics, Abbott Laboratories, Sysmex, DEEPULL DIAGNOSTICS, S.L., Netflix, Oxford Nanopore Technologies and CARB-X: Advisor/Consultant|Up-to-Date and the Infectious Diseases Board Review Course.: Honoraria

Prevalence and Antimicrobial Susceptibility of Mycoplasma hominis and Ureaplasma Species among Women in Dakar

Introduction: Genital mycoplasmas, which cause infections of the lower reproductive tract in women, are a major cause of morbidity and complications. The aim of this study was to determine the prevalence of mycoplasma infections and the antibiotic susceptibility profile among women in Dakar. Material and methods: We conducted a retrospective descriptive study over a four-year period, from 02 January 2018 to 31 December 2021. The study population consisted of women referred to the microbiology laboratory at Military Hospital of Ouakam for genital mycoplasma testing. The Mycoplasma IES kit was used for mycoplasma testing and susceptibility testing in accordance with the manufacturer's recommendations. Results: A total of 1431 patients were enrolled during the study period. The mean age was 32.6 ± 8.5 years. The overall prevalence of mycoplasma infection was 55.8% (798/1431). Of the 798 positive cultures, 52.8% were infected with Ureaplasma urealyticum (UU) and 17.9% with Mycoplasma hominis (MH). UU+MH co-infection was 31.08%. Analysis of the sensitivity profiles showed that UU was sensitive to most of the antibiotics used, while M. hominis strains showed low levels of resistance to tetracyclines (TET DOX, MIN), quinolones (OFX, LEV, SPA) and JOS. This resistance was much higher with macrolides (ERY, ROX, AZT), certain quinolones (ASP, CIP) and aminoglycosides (SPE). However, M. hominis strains were much more resistant to these molecules than U. urealitycum isolates. Conclusion: Our study revealed a high rate of genital mycoplasma infection among women in Dakar. The high rates of resistance to certain molecules underline the importance of surveillance to prevent transmission of resistant strains and rational use of antibiotics.

The possible pathogenic mechanisms of microorganisms in infertility: a narrative review.

Infertility can harm a patient in physical, psychological, spiritual, and medical ways. This illness is unusual because it affects the patient's companion and the patient individually. Infertility is a multifactorial disease, and various etiological factors like infection are known to develop this disorder. Recently published studies reported that different bacteria, such as Chlamydia trachomatis, Mycoplasma spp., Ureaplasma urealyticum, Escherichia coli, Staphylococcus aureus, and Pseudomonas aeruginosa, can lead to infertility by immunopathological effects, oxidative stress, and adverse effects on sperm concentration, motility, morphology, and DNA condensation. Among viruses, Human papillomavirus and Herpes simplex virus reduce sperm progressive motility and sperm concentration. The viruses can lead to the atrophy of the germinal epithelium and degenerative changes in the testes. Candida albicans also harm sperm quality, motility, and chromatin integrity and induce apoptosis in sperm cells. Finally, Trichomonas vaginalis leads to distorted heads, broken necks, and acrosomes exocytosis in sperms. This parasite decreases sperm viability and functional integrity. Noteworthy, oxidative stress could have a role in many pathological changes in the reproductive system. Recent findings show that microorganisms can increase reactive oxygen species concentration inside the host cells, leading to oxidative stress and sperm distress and dysfunction. Therefore, this article explores the potential significance of critical bacteria linked to infertility and their pathogenic mechanisms that can affect sperm function and the female reproductive system.

A simple and colorimetric method utilizing cell-free toehold switch sensors for the detection of Chlamydia trachomatis, Ureaplasma urealyticum and Neisseria gonorrhoeae.

Sexually transmitted infections (STIs) rank among the most prevalent acute infectious conditions and remain a major global public health concern. Notable STI pathogens include Chlamydia trachomatis (CT), Ureaplasma urealyticum (UU), and Neisseria gonorrhoeae (NG). Early detection and diagnosis are crucial for controlling the spread of STIs. In this study, we utilized toehold switches integrated with a cell-free system to develop a simple, colorimetric, sensitive, specific and rapid method for the parallel detection of CT, UU, and NG. Target DNA and sensor DNA were transcribed into target trigger RNA and toehold switch sensor RNA respectively, within a cell-free transcription system. The binding of target RNA to the toehold switch RNA activated the switch, subsequently initiating the translation of the downstream lacZ gene. The expressed LacZ protein hydrolyzed the substrate chlorophenol red-β-d-galactopyranoside (CPRG), resulting in a color change from yellow to purple, which provided a visible colorimetric output. The three screened sensors exhibited excellent orthogonality without any observed cross-reactivity. By enhancing sensitivity with recombinase polymerase amplification (RPA), we reliably detected NG in clinical samples using this method, with no interference from other pathogens. Moreover, we selected high-performance toehold switch sensor for paper-based detection, further enhancing portability. In summary, this technique enables the simple snd sensitive parallel detection of CT, UU, and NG, generating visible colorimetric results without the need for specialized personnel or sophisticated equipment. Given these advantages, this method holds significant potential as a simple and portable diagnostic tool in resource-limited settings or point-of-care testing (POCT) scenarios.

Development of a droplet digital PCR method for the detection of Ureaplasma urealyticum.

Human infection with Ureaplasma urealyticum(UU) is mainly manifested as non-gonococcal urethritis, where it can lead to cervicitis, premature rupture of membranes and abortion in women, as well as infertility in males, which becomes a major problem in clinical diagnosis and treatment. At present, real-time fluorescence quantitative PCR and culture are the two main methods for detecting UU. The real-time fluorescence quantitative PCR method is cumbersome and cannot accomplish absolute quantification on nucleic acids, while the cultivation method has limitations such as low sensitivity and being time-consuming. The aim of this study is to establish a more rapid and accurate droplet digital PCR(ddPCR) method for the detection of UU. Primers were designed for the ParC gene of UU. Nucleic acids from a standard strain of UU were extracted. Specificity, sensitivity, and repeatability detection was performed using ddPCR, and the detection performance of ddPCR was evaluated. The detection process could be completed in 92min. It has a high sensitivity of up to 3.8pg/μL. With a high specificity, no positive microdrop were detected in eight negative control pathogens in this experiment. In addition, ddPCR detection of UU has good repeatability, and the calculated CV is 2.1%. Our data indicated that ddPCR detection technology has the characteristics of absolute quantification, high stability, high specificity and high sensitivity of UU. It can promote the accurate detection of UU, providing a more scientific basis for clinical diagnosis and treatment.

A study of the risk factors for Ureaplasma urealyticum infection and the predictive role of immunoinflammation.

Despite increasing awareness on the prevention of Ureaplasma urealyticum (Uu) infection, the high-risk factors responsible for infection in female patients in China are yet to be determined. The study included 3043 Chinese women. Cervical secretion samples were collected for Uu identification. Higher age groups (25-30, 30-35, 35-40, and >40 years) had a higher risk of Uu infection (OR = 1.46; OR = 1.51; OR = 1.71; OR = 2.49, respectively). Being literate, and use of intrauterine device (IUD), or other contraceptive methods could reduce the risk of Uu infection (OR = 0.64; OR = 0.79; OR = 0.76, respectively). Women with low level of cleanliness or promiscuous behavior had a higher risk of Uu infection (OR = 1.42; OR = 1.41, respectively). Among the Uu-positive patients, 66.84%, 24.81%, and 8.35% were infected with biovars 1, 2, and coinfection. The predominant subtypes were S6 serotypes (28.91%) in biovar 1 and S2` subtypes (62.73%) in biovar 2. The possibility of S1 + S6 infection was lower than that in S1 patients (OR = 0.529). C-reactive protein (CRP) and systemic immune inflammation index (SII) could be used to predict Uu infection (area under curve, AUC = 0.55; AUC = 0.68, respectively). Uu-positive patients were infected with two biovars and multiple subtypes. Age, method of contraception, cleanliness, education level, promiscuity, and subtypes of Uu were factors influencing Uu infection. CRP and SII provide a new strategy for clinical diagnosis of Uu infection.

Could APTIMA mRNA Assay Contribute to Predicting Cervical Bacterial Sexually Transmitted Co-Infections? A Colposcopy Population Study.

In addition to chronic hrHPV anogenital infection, continuing inflammatory cervical changes are intrinsic in the development of precancerous lesions. In younger women, much of this inflammatory background parallels the progressive maturation of squamous metaplasia, often rendering treatment interventions redundant; however, patients with persistent cervical precancer, as well as those harboring invasive bacterial pathogens, might benefit from controlling the active inflammatory process by shortening the HPV natural cycle and avoiding subsequent cervical surgery. In a colposcopy population of 336 predominantly young asymptomatic individuals, we explored the impact of molecularly detected bacterial STIs on HPV DNA and APTIMA positivity rates using validated assays. In the multivariable analysis, several largely anticipated epidemiological factors were related to STI positivity. In this cohort, the HPV DNA test illustrated better performance for the prediction of STI positivity than the corresponding APTIMA test (sensitivity 52.94% vs. 33.82%), while inversely, the APTIMA test was more indicative of bacterial STI negativity than the HPV DNA test (specificity 77% vs. 60%). In addition, no significant differences between these two molecular assays were documented in terms of PPV, NPV, and overall accuracy. Despite the high Ureaplasma urealyticum and low Chlamydia trachomatis prevalence recorded in this study's population, which is among the first assessing the co-variation of bacterial STI expression with established HPV biomarkers, the APTIMA assay did not predict concurrent bacterial STIs superiorly compared with an established HPV DNA assay.

Bioalkylation Strategies to Synthesize Allylated Tetrahydroisoquinolines by Using Norcoclaurine Synthase and O‐Methyltransferases

AbstractO‐Methyltransferase (O‐MT)‐mediated alkylations are of growing interest for the regioselective modification of bioactive motifs, although there are still few examples of applications with more structurally complex compounds. In this work, we have used O‐MTs for the allylation of various catechol and tetrahydroisoquinoline substrates via a biocatalytic cascade involving additionally methionine adenosyltransferases (MATs) and a methylthioadenosine nucleosidase (MTAN). Furthermore, we have integrated norcoclaurine synthase into this cascade to stereoselectively generate (S)‐THIQs in situ as both intermediates and products in the allylation cascade. Notably, a variation in the order in which NCS and MAT‐MT‐MTAN are added can significantly affect the regioselective outcome, enabling exquisite control of both stereochemistry and regiochemistry in the products. We also identified Ureaplasma urealyticum MAT as an effective enzyme for the formation of the S‐adenosyl‐S‐allyl‐L‐homocysteine required as the cofactor for the O‐MTs and established that the racemate rather than the single isomer of S‐allyl‐homocysteine can effectively be used in the cascades with MATs.

Genomic Identification of Genital Ureaplasma urealyticum and Ureaplasma parvum Infection by Duplex Polymerase Chain Reaction in Symptomatic Women Attending a Tertiary Care Hospital: A Cross-sectional Study

Introduction: Ureaplasma urealyticum (U. urealyticum) and Ureaplasma parvum (U. parvum) are the two causative agents for Sexually Transmittable Diseases (STDs), they are often accompanied by Pelvic Inflammatory Disease (PID), vaginitis, endometriosis, etc. Aim: To detect the prevalent genotypes/biovars of Ureaplasma species by using Duplex Polymerase Chain Reaction (PCR) in symptomatic women attending the Obstetrics and Gynaecology clinic of a tertiary care hospital. Materials and Methods: This was a cross-sectional study, comprised of 200 symptomatic women aged from 18 to 45 years. This study was carried out in the Department of Microbiology, School of Allied Health Sciences, Department of Obstetrics and Gynaecology, Mahatma Gandhi Medical College and Research Institute, and Mahatma Gandhi Medical Advanced Research Institute, Sri Balaji Vidyapeeth, Puducherry, India for the period of January 2021 to January 2024. Duplex PCR was performed for the presence of U. urealyticum and U. parvum in endocervical samples. Amplified PCR products were analysed and the positive PCR products were sent for sequencing and the sequenced results were compared with GenBank and phylogenetic analysis was constructed. Data was analysed using Chi-square tests to test level of significance between the two groups (p-value≤0.05). Results: The overall results found that 48 (24%) of symptomatic women were positive for Ureaplasma species. In Duplex PCR, 24 (12.0%) were positive for both urease and upv genes; followed by 15 (7.5%) for urease and 9 (4.5%) for upv genes only. The phylogenetic tree concluded that the genetic sequences of Ureaplasma species are closely related to various isolates within a species. Conclusion: The study concludes that U. parvum is the most common pathogen in symptomatic women with predominant age of 26-35-year-old. The duplex PCR, increase the sensitivity and specificity by the application of two different genes in a single amplification reaction. Since the research will focus on different gene targets of Ureaplasma species by the application of multiplex in future study.

Mpox outbreak among men who have sex with men in Kraków, Poland; June-November 2022.

Mpox is a zoonotic disease caused by mpox virus. Sporadic cases reported before 2022 were almost universally linked to a direct contact with animals or travel to endemic regions of Africa. However, in 2022, a significant shift occurred in human‑to‑human transmission, leading to a global outbreak in 117 countries. In Poland, 217 cases of mpox were reported. The aim of this study was to evaluate the epidemiology, clinical presentation, laboratory findings, and coinfections with sexually transmitted pathogens among patients with mpox. We retrospectively analyzed all mpox cases diagnosed at the University Hospital in Kraków between June 2022 and November 2022. Forty‑five patients at a median (interquartile range) age of 34 (19-48) years were diagnosed with mpox. Most of them (n = 44; 98%) were men, 42 (93%) identified themselves as men who have sex with men (MSM). Twenty‑two of the patients (49%) had previously been diagnosed with HIV. Together with mpox diagnosis, new cases of sexually transmitted infections (STIs) were identified. Specifically, 4 patients (9%) were newly diagnosed with HIV, 5 with syphilis, 4 with Chlamydia trachomatis infection, 3 with Neisseria gonorrhoeae infection, and 2 with Ureaplasma urealyticum infection; in this group, 4 patients (33%) had more than 1 sexually transmitted coinfection. The 2022 mpox outbreak in Kraków primarily affected MSM and was transmitted through sexual contact. Health care professionals should be aware of emerging STIs. Educational initiatives should emphasize the importance of vaccinations, safe sexual practices, and regular testing.

Sexually transmitted pathogens in asymptomatic women at Rethabile clinic, Limpopo, South Africa.

Health care for sexually transmitted infections (STIs) is often inadequate, especially for women, because of the asymptomatic nature of many STIs, which can lead to a false sense of health. Thus, there is limited data on the prevalence of STIs in pregnant women in low and middle-income countries. The study aimed to determine the prevalence of STIs in asymptomatic pregnant women attending antenatal Rethabile Community Health Centre, Limpopo, South Africa. A cross-sectional analysis of asymptomatic pregnant women at Rethabile Community Health Centre between March 2023 and November 2023 was conducted to determine the prevalence of seven STIs, detected from self-collected vaginal swab specimens using HAIN fluoroType STI-multiplex Polymerase Chain Reaction (PCR) test for nine targets covering seven major STIs. The study found that Ureaplasma urealyticum was the most prevalent pathogen (43%) followed by Chlamydia trachomatis (41%), and Trichomonas vaginalis (10%). The less common pathogens detected were Mycoplasma Genitalium (5%) and Neisseria gonorrhoeae (2%). High STI prevalence among asymptomatic pregnant women at Rethabile Community Health Centre necessitates diagnostic screening over syndromic management because of a lack of reporting for symptoms. The paper examines the epidemiology of STIs in Limpopo, South Africa, focusing on healthy, asymptomatic populations. It emphasises the need for laboratory screening, particularly in pregnant women, over empiric treatment because of high chances of missing infections.

Neonatal central nervous system infection by Ureaplasma species is rare, but relevant: results from a multicenter nationwide surveillance study.

Ureaplasma species (spp.) are relevant contributors to preterm birth but may also cause invasive infections particularly in very immature preterm infants. This study aimed to assess the incidence of neonatal Ureaplasma infections of the central nervous system (CNS). A nationwide epidemiological study on Ureaplasma CNS infection in preterm and term neonates and infants below 12 months of age was conducted between 10/2019 and 09/2022, using the German Pediatric Surveillance Unit (ESPED). Over a period of three years, five infants with Ureaplasma meningitis were reported, amended by three cases treated in our own hospital. All infants had a history of extreme preterm birth. Clinical presentation varied and included non-specific neurological symptoms, such as developmental delay, in some cases, and acute, sepsis-like conditions in others, with increased apneas, irritability, and seizures. As the most consistent finding, internal hydrocephalus was reported, paralleled by pathological cerebrospinal fluid assessment characterized by mild pleocytosis, persistently elevated protein levels, and remarkably low or undetectable glucose levels, prompting further diagnostics. Treatment protocols varied and included off-label regimens. Ureaplasma eradication was verified by negative CSF-PCR and/or culture in most cases. Despite successful eradication, long-term neurological impairment was present in all infants. Although seemingly rare, Ureaplasma-driven neuroinflammation relevantly contributes to long-term morbidity of affected preterm infants.

Method for Identification and Bacterial Count Quantification in a Case of Ureaplasma Meningitis.

Intrauterine Ureaplasma infection is associated with chorioamnionitis and preterm birth. The difficulty of detecting Ureaplasma species by conventional culture methods makes definitive diagnosis of clinical infection challenging. Thus far, quantitative tests for Ureaplasma have been performed using adult cervical samples, amniotic fluid, and pediatric bronchial secretions, but quantification of bacterial count in central nervous system infections caused by Ureaplasma species has not been unreported. We report a case of culture-negative Ureaplasma meningitis in a preterm infant in whom novel techniques to identify this pathogen and quantify bacterial count were effective. We suspected meningitis based on a sustained reduction in cerebrospinal fluid (CSF) glucose levels. Multiple CSF cultures were sterile. We confirmed infection by Ureaplasma species using the melting temperature mapping method. Treatment with erythromycin and ciprofloxacin resulted in a gradual decrease in the bacterial count in the CSF to 0. Our study highlights the potential utility of the melting temperature mapping method as a new diagnostic tool for culture-negative Ureaplasma meningitis and establishes the utility of serial quantification of bacterial count to monitor response to therapy.

Microbiological Profile of Vaginal Swabs from Infertile Women in the Cities of Ngaoundere and Garoua, Cameroon

Genital infections are a real public health problem in developed countries. They have serious consequences such as ectopic pregnancy (EP), chronic pelvic pain, premature delivery, miscarriage, cervical cancer and even infertility. The objective of this study was to determine the epidemiological and microbiological profile of genital infections among infertile women in the cities of Ngaoundéré and Garoua. This descriptive study was carried out in the Protestant and regional hospitals, as well as the military and regional hospitals serving the cities of Ngaoundéré and Garoua, over a period of five months, from August 2020 to January 2021. Women of reproductive age (15 to 45 years) who met the inclusion criteria, gave their informed consent, and had at least one consultation in the gynecology department of the aforementioned hospitals for infertility made up our population. Thus, the study included 100 women, or 50 women per city. A pre-tested questionnaire was employed to get data from the subjects. Blood samples were taken for chlamydia testing, and cervical-vaginal samples were taken for microbiological analysis (PCV+ATB and mycoplasma testing). The gathered information. SphinxPlus. V5 was the program used to analyze the data that were collected. Ninety-six percent of the 100 women who participated in this study had a vaginal infection. The infertile women's modal age range was 26–35 years old, with a mean age of 29. Of the women, 54% were housewives, 33% had completed their elementary; education, and 55 were in monogamous marriages. At 65%, secondary infertility was the most prevalent type. 5.15 years was the average length of infertility. Abortions accounted for 41% of the patients' histories, whereas genital infections made up 69%. When the infertile women's vaginal pH was analyzed, the majority (69%) had a pH > 4.5. Chlamydia trachomatis (28.41%), Ureaplasma urealyticum (22.63%), Candidas albicans (20.58%), Gardnerella vaginalis (14.40%), Mycoplasma hominis (9.46%), Candidas spp (1.65%), Staphylococcus (1.64%), Trichomonas vaginalis (0.82%), and Neisseria gonorrhoeae (0.41%) were among the microbiological analyses of the samples. The etiological identification of genital infections and infertility of infectious or tubal origin, which can be avoided with early intervention, is greatly aided by microbiology.

Impact of Ureaplasma urealyticum infection on semen parameters and in vitro fertilization outcomes in infertile men.

Ureaplasma urealyticum (UU) is a common pathogen associated with genital tract infections in infertile males. However, its impact on semen quality, embryo development, and in vitro fertilization (IVF) outcomes remains underexplored. This study aims to evaluate the effect of male UU infection on semen parameters, embryo development, pregnancy outcomes, and neonatal health in infertile couples. A retrospective analysis was conducted on 1,215 infertile couples at the First Hospital of USTC. Participants were divided into two groups based on the male partner's UU infection status: UU-positive (n=249) and UU-negative (n=966). Semen parameters (sperm concentration, motility, morphology, anti-sperm antibodies, DNA stainability) were assessed. Embryo development was evaluated through fertilization rates and blastocyst formation rates. Pregnancy outcomes (clinical pregnancy, live birth rates, miscarriage rate) and neonatal health (gestational age, birth weight, Apgar scores, preterm delivery) were also compared. Semen parameters, including sperm concentration, motility, and morphology, were similar between the UU-positive and UU-negative groups. However, the UU-positive group had significantly higher levels of anti-sperm antibodies (ASA) (p=0.020) and higher DNA stainability (HDS) (p=0.014). Despite these differences, embryo quality, as measured by fertilization rates and blastocyst formation rates, was not significantly different between the two groups. Pregnancy outcomes, including clinical pregnancy and live birth rates, were also comparable. While the UU-positive group had a slightly higher miscarriage rate, this difference was not statistically significant. Neonatal outcomes, including gestational age, birth weight, Apgar scores, and preterm delivery rate, did not differ significantly between the two groups. The study suggests that while male UU infection may adversely affect certain semen parameters, its impact on IVF outcomes-such as embryo quality, pregnancy rates, and neonatal health-appears to be minimal. These findings support the continued use of IVF as a viable and safe option for infertile couples with male UU infection, as it does not significantly influence reproductive or neonatal outcomes.

Prior immunity to Ureaplasma urealyticum protects against respiratory infection in immunosuppressed mice.

Ureaplasma species can cause systemic infections in immunocompromised hosts, including lung transplant recipients. Here, we investigated the impact of prior exposure to Ureaplasma urealyticum on the risk of U. urealyticum and Ureaplasma parvum infection in mice subjected to an immunosuppression regimen similar to that administered to solid organ transplant recipients. Mice were immunized with three intramuscular injections of U. urealyticum, with control mice injected with adjuvant only. Following immunization, mice received tacrolimus, mycophenolate mofetil, and methylprednisolone, and then were challenged with U. urealyticum or U. parvum intraperitoneally and intratracheally over 6 days. Relative U. urealyticum antibody levels in plasma were assessed over time, and lungs were harvested at sacrifice for bacterial load quantification, assessed using a color-changing unit assay. U. urealyticum antibody levels were higher in immunized compared with control animals (P < 0.0001), even when animals were immunosuppressed. U. urealyticum and U. parvum lung burden was reduced in immunized compared with control mice (~6 log10 reduction for U. urealyticum and <1 log10 reduction for U. parvum; P = 0.008 and 0.046, respectively). In summary, this study shows that prior exposure to live U. urealyticum provides some protection against infection with U. urealyticum.IMPORTANCEUreaplasma-induced hyperammonemia syndrome is a rare but potentially deadly complication of solid organ transplantation, especially lung transplantation. The pathophysiology of this relatively recently recognized condition is poorly understood, and it is unclear what factors may influence patient susceptibility. This study investigates the possible protective effects of prior exposure to Ureaplasma urealyticum in a mouse model subjected to an immunosuppression regimen similar to that given to lung transplant recipients. The findings show that prior exposure could provide protection against Ureaplasma lung infection.

Molecular Exploration of Mycoplasma fermentans and Mycoplasma genitalium in Mexican Women with Cervicitis.

Genital Mycoplasmas are implicated in adverse pregnancy outcomes and the development of infertility. However, the role of Mycoplasma fermentans in these outcomes has not been adequately studied; therefore, its participation in these sufferings requires further investigation. This study aimed to evaluate the prevalence of M. fermentans in pregnant and non-pregnant women. End-point PCR was used to analyze two hundred and twenty-eight endocervical samples for M. hominis, M. genitalium, M. fermentans, M. pirum, Ureaplasma urealyticum, and U. parvum diagnoses. The prevalence of Mycoplasma spp. was as follows: U. parvum was found in 83 samples (36.4%), U. urealyticum in 39 instances (17.1%), M. hominis in 36 (15.7%), M. fermentans in 32 (14%), M. genitalium in 15 (6.6%), and M. pirum in 0 samples. No association was found between the Mycoplasma spp. and some infertility conditions or adverse pregnancy. However, M. fermentans and M. hominis were found to be associated with bacterial vaginosis (RR = 3.4 CI 95% 1.85-6.3, p < 0.005). In conclusion, M. fermentans and M. hominis were isolated more often in women with bacterial vaginosis, which suggests that these bacteria could contribute to the development of this pathology.

INFLUENCE OF UROGENEITRAL INFECTION IN PREGNANT WOMEN ON THE UTERINE – FETOPLACENTARY COMPLEX

As reported by the World Health Organization (WHO), approximately 20 % of pregnant women globally are aff ected by an infection of the lower genital tract. Urogenital infection can result in complications during the onset and progression of pregnancy, as well as the postpartum period. These complications include placental dysfunction, premature birth, low birth weight, premature rupture of the fetal membranes, and postpartum endometritis. A marker of normal placental function is α2-fertility microglobulin (AFMG), the determination of which will refl ect the presence or absence of a uterine- fetoplacental complex violation during urogenital infection in pregnant women.The aim of the study is to reveal the infl uence of urogenital infection on the dysfunction of the uterine – fetoplacental complex in pregnant women.Materials and methods. A total of 75 pregnant women were examined, divided into two groups: the main group (MG) and the comparison group (CG). The MG consisted of 55 pregnant women, of whom 35 underwent local sanitation of the urogenital infection according to the identifi ed pathogen (Subgroup A) and 20 refused this procedure (Subgroup B). The CG consisted of 20 pregnant women without urogenital infection, as determined by bacterioscopic, bacteriological, and polymerase chain reaction (PCR) examinations. All pregnant women underwent determination of AFMG in blood serum via immunoenzymatic methodology. The statistical analysis was conducted using the MedStat software (serial number MS00019). The study was performed in accordance with the provisions of the Declaration of Helsinki. The study protocol was approved by the Local Ethics Committee of PFMU for all women who participated in this study. Statistical processing was performed using the MedStat program (serial number MS00019). The work is a part of the initiative research work of the Department of Obstetrics and Gynecology No. 1 of Poltava State Medical University «Pathogenetic role of endothelial dysfunction and genetic features in pathology during pregnancy and gynecological diseases» (state registration No. 0117U005253, term of implementation 2017-2023).Research results. The results of the study demonstrated that pregnant women with a urogenital infection had a history of chronic pyelonephritis 5.5 times more frequently (p = 0.03) and salpingo- oophoritis 10.2 times more frequently (p &lt; 0.001), which may be a source of latent infection. The most prevalent infectious agents among pregnant women were: The most prevalent microorganisms were Ureaplasma urealyticum (21.4 %), Candida fungi (19.04 %), Gardnerella vaginalis (11.9 %), and Toxoplasma gondii (11.9 %). The level of AFMG in pregnant women with urogenital infection was observed to be 4.3 times lower than in pregnant women with CG (p &lt; 0.001). The remediation of an infection of the lower genital tract during pregnancy has been observed to increase AFMG production by a factor of four (p &lt; 0.001). The level of AFMG in pregnant women of CG was 2.2 times higher than in pregnant womenof Subgroup A (p &lt; 0.004).Conclusions. It was demonstrated that urogenital infection in pregnant women has a considerable impact on the dysfunction of the utero- fetoplacental complex. It was also shown that local sanitation of the lower genital tract in these women, based on the identified pathogen, has a benefi cial eff ect on the placenta’s functioning. However, this approach does not fully address the issue of protein synthesis impairment.

Associations of Ureaplasma urealyticum infection with male infertility and intrauterine insemination outcomes.

Ureaplasma urealyticum (UU) is one of the most commonly occurring pathogens associated with genital tract infections in infertile males, but the impact of seminal UU infection in semen on intrauterine insemination (IUI) outcomes is poorly understood. We collected data from 245 infertile couples who underwent IUI at The First Affiliated Hospital of USTC (Hefei, China) between January 2021 and January 2023. The subjects were classified into two groups according to their UU infection status: the UU-positive group and the UU-negative group. We compared semen parameters, pregnancy outcomes, and neonatal birth outcomes to investigate the impact of UU infection on IUI outcomes. There were no significantly statistical differences in various semen parameters, including semen volume, sperm concentration, total and progressive motility, sperm morphology, leukocyte count, the presence of anti-sperm antibody, and sperm DNA fragmentation index (DFI), between the UU-positive and UU-negative groups of male infertile patients (all P > 0.05). However, the high DNA stainability (HDS) status of sperm differed between the UU-positive and UU-negative groups, suggesting that seminal UU infection may affect sperm nuclear maturation (P = 0.04). Additionally, there were no significant differences in pregnancy or neonatal birth outcomes between the two groups (all P > 0.05). These results suggest that IUI remains a viable and cost-effective option for infertile couples with UU infection who are facing infertility issues.