BackgroundInformation on Mycoplasma hominis resistance is currently limited in Japan. Therefore, this study investigated the antimicrobial susceptibility of M. hominis in clinical samples, along with the prevalence of M. hominis and Ureaplasma spp. in vaginal samples.MethodsVaginal samples from pregnant Japanese women were analyzed for the presence of M. hominis, U. parvum, and U. urealyticum using conventional polymerase chain reaction. The susceptibility profile of 35 M. hominis strains stored at the Hiroshima University Hospital was evaluated using the MYCOFAST RevolutioN ATB+ kit, E-test, Eiken dry plates with urea-arginine LYO2 broth named the LYO2 broth method.ResultsOut of 160 total vaginal samples, the prevalence of M. hominis, U. parvum and U. urealyticum was 4.4%, 28%, and 10%, respectively. Antimicrobial susceptibility testing using the MYCOFAST RevolutioN ATB+ kit revealed resistance rates of 17%, 11%, 0%, and 2.9% for levofloxacin, moxifloxacin, tetracycline, and clindamycin, respectively. Antimicrobial susceptibility testing results using the LYO2 broth method were consistent with the MYCOFAST RevolutioN ATB+ kit for levofloxacin, moxifloxacin, minocycline, and clindamycin. In addition, the minimum inhibitory concentrations (MIC) determined using E-test were similar to those of the MYCOFAST RevolutioN ATB+ kit.ConclusionM. hominis, which is resistant to fluoroquinolones and clindamycin, was detected in clinical samples in Japan. In addition, we found that the LYO2 broth method was comparable to the MYCOFAST RevolutioN ATB+ kit in determining MICs. Therefore, the LYO2 broth method may be a reliable and convenient tool for determining the MICs of M. hominis in Japanese clinical settings.DisclosuresAll Authors: No reported disclosures

Infection and inflammation of the seminal tract: A review of its relationship to male fertility.

Infection after cesarean delivery: diagnosis, pathophysiology, management, and prevention.

Objectives To explore the lived experiences and current clinical needs of women of reproductive age with Ureaplasma Urealyticum (UU) infection in the reproductive tract. Materials and methods A descriptive qualitative study was conducted using purposive sampling. Sixteen women of reproductive age with UU infection of the reproductive tract were included in the study. Data collection was based on in-depth interviews and on-site records of the researchers. Inductive thematic analysis was conducted. Results Five themes emerged: (a)physiological impact, (b)psychological impact, (c)social impact, (d)economic impact, and (e)clinical health care needs. The impact is diverse, radiating to various aspects of their physiology, psychology, society, and economy. The clinical needs of the relevant population mainly include information, psychological, and support needs. Conclusions Our findings indicate the need to strengthen intervention plan development; emphasize knowledge dissemination, psychological intervention, and social support for relevant populations; and provide assistance in disease treatment and management.

Respiratory tract colonization with Ureaplasma species has been repeatedly associated with the development of acute and long-term pulmonary morbidity in preterm infants. However, despite strong evidence from observational studies and animal models, apart from inflammation, underlying mechanisms of Ureaplasma-driven lung disease, such as potential functional impairments, are mainly unknown. Knowledge of Ureaplasma-lung interaction and Ureaplasma virulence factors is scarce. The present investigation is the first to examine the influence of perinatal Ureaplasma infection on critical mechanisms of alveolar fluid clearance (AFC) in immature lung cells, which drive perinatal transition from fluid-filled lungs before birth to alveolar fluid absorption, enabling lung breathing. Disruption or impairment of these mechanisms could worsen respiratory distress in preterm infants and contribute to acute lung injury. Moreover, the present study addressed Ureaplasma-derived ammonia and the accompanying pH shift as potential virulence factors driving Ureaplasma-host interactions. Both have long been discussed as virulence factors, but remain unexamined, so far. We report that viable Ureaplasma isolates induced a 30–90% decrease in epithelial Na+ transport of primary rat fetal distal lung epithelial (FDLE) cells upon 24 hours of infection. Moreover, the decrease was linked to a significant inhibition of the epithelial Na+ channel (ENaC) and Na,K-ATPase activities, both mediating the essential AFC. It was observed that acute Ureaplasma infection induced phosphorylation of Erk1/2 – a well-known inhibitor of ENaC activity. Notably, exposure of FDLE cells to Ureaplasma-driven NH3 – in contrast to the hydrolysis-driven pH shift – fully mimicked Ureaplasma-driven effects and inhibited the epithelial Na+ transport. Co-incubation with the urease inhibitor flurofamide entirely restored Na+ transport in Ureaplasma-infected FDLE cells. Ureaplasma infection differentially modulated ENaC subunit and surfactant protein mRNA expression. In summary, the present study revealed a functional impairment of fetal pulmonary epithelial cells upon acute Ureaplasma infection and identified NH3 as a Ureaplasma virulence factor in this context. Co-incubation with flurofamide restored Na+ transport. This study describes a novel mechanism of Ureaplasma-driven early preterm lung disease, which might be of great significance for a deeper understanding of Ureaplasma-host interactions. Notably, the present findings offer a potential therapeutic role for urease inhibitors in Ureaplasma-colonized preterm infants.

The diagnosis rate of chronic endometritis (CE), closely associated with infertility, recurrent pregnancy loss, and recurrent implantation failure, remains low in clinical practice. The monocyte percentage (MP) has been identified as a biomarker predicting prognosis in various severe diseases. Although monocytes have been linked to clinical endometritis in animals, their associations with CE in infertile patients remains unclear. This cross-sectional study included patients pathologically diagnosed with CE at a single center in 2021. Demographic data, history of abortion, causes of infertility, Ureaplasma urealyticum infection history, laboratory findings, and histological information were recorded. The correlation between MP and CE was investigated using logistic regression analysis, and subgroup analyses were conducted based on age, gravidity, parity, and follicular phase. The cohort consisted of 631 individuals, including 494 patients with CE, corresponding to a CE prevalence of 78%. Univariate logistic regression analysis revealed an inverse correlation between MP and CE risk (odds ratio [OR] = 0.85; 95% confidence interval [CL], 0.76–0.96; P < 0.01). Multivariate regression after adjusting for all covariates yielded an OR of 0.82 (95% CI 0.71–0.95). Furthermore, the stratified and subgroup analyses yielded consistent results. Sensitivity analyses excluding participants with pathological endometrial changes (OR = 0.83; 95% CI 0.71–0.96), those in the non-follicular phase (OR = 0.78; 95% CI 0.66–0.92), and those with both endometrial abnormality and non-follicular phase status (OR = 0.82; 95% CI 0.7–0.95) further confirmed the correlation between MP and CE risk. MP was significantly associated with CE in infertile participants in models adjusted for all covariates, suggesting that MP may be a valuable parameter for early CE prediction.

Ureaplasma species are associated with various reproductive health issues, while human papillomavirus (HPV) is associated with cervical, vaginal and vulvar cancers. Data on the association between Ureaplasma species and HPV are limited in South Africa. This study investigated the prevalence of Ureaplasma urealyticum (U. urealyticum), Ureaplasma parvum (U. parvum), and HPV coinfection and their associated factors, among adolescent girls and young women (AGYW) in the Eastern Cape Province, South Africa. A total of 214 participants were retrospectively recruited, and secondary data on HPV, U. urealyticum, U. parvum, demographics, and sexual behavior were used. HPV was detected using the Roche Linear Array HPV Genotyping Test, while U. urealyticum and U. parvum were detected using Allplex™ sexually transmitted infection (STI) essential Assay. Statistical analyses were performed using GraphPad Prism Version 8.0.1.244. The prevalence of U. urealyticum was 43.9% (94/214) and increased significantly with age (p = 0.036, R2 = 0.8497); while U. parvum prevalence was 68.7% (147/214) and was not influenced by age. Having four to six lifetime sexual partners (PR: 1.77, 95% CI: 1.04–3.00, p = 0.043) was associated with increased risk of U. urealyticum. A proportion of 36.3% (77/212) had HPV-U. urealyticum coinfection and its risk was increased among those with 3–6 lifetime sexual partners (PR: 1.59, 95% CI: 1.10–2.53, p = 0.017), 2–4 new partners past three months (PR: 2.14, 95% CI: 1.19–2.42, p = 0.021); vaginal sexual intercourse frequency past 1-month (2–3 vaginal intercourse: PR: 1.54, 95% CI: 1.06–2.53, p = 0.037; 4–10 vaginal intercourse: PR: 1.91, 95% CI: 1.83–1.91, p = 0.005) and alcohol consumption (PR: 1.85, 95% CI: 1.20–3.28, p = 0.004). U. urealyticum positives had a significantly higher risk of HPV types targeted by Cervarix® HPV vaccine than negatives (PR: 2.56, 95% CI: 1.23–5.37, p = 0.013), Gardasil®4 (PR: 2.16, 95% CI: 1.25–3.75, p = 0.006) and Gardasil®9 (PR: 1.70, 95% CI: 1.25–2.32, p = 0.001). AGYW of Eastern Cape Province, South Africa had high prevalence of U. urealyticum-HPV and U. parvum-HPV coinfections. Ureaplasma species coinfection was associated with HPV prevalence and distribution of genotypes. The U. urealyticum prevalence and its coinfection with HPV were associated with sexual behavior. Data from this study could contribute to the design of sexual health and STI interventions and could serve as a baseline for future epidemiological studies, which include ongoing surveillance of HPV genotype prevalence to evaluate the impact and effectiveness of HPV vaccination programs in the population.

Background and Objectives: Despite the development of medicine, there is no clearly established scheme for the prediction of intra-amniotic infection (IAI). In this study, evaluation of some predictors of IAI confirmed in histopathological examination was performed. Materials and Methods: The study population included 70 patients all giving birth by cesarean section divided into two groups: study (n = 34) consisting of patients with histologically confirmed IAI and control (n = 36) without IAI. Biological material included the mother’s venous blood to determine C-reactive protein (CRP), interleukin-6 (IL-6) and procalcitonin (PCT) concentrations; vaginal discharge to determine IL-6; cervical canal swabs to perform cultures for bacteria and fungi and polymerase chain reaction (PCR) for Ureaplasma urealyticum, Mycoplasma hominis, and Chlamydia trachomatis; amniotic fluid to perform cultures for aerobic and anaerobic bacteria and PCR for atypical pathogens, and to determine glucose, IL-6, and PCT concentrations; umbilical cord blood to determine PCT, CRP, Il-6 and blood culture. A fragment of the placenta and fetal membranes was taken for histopathological assessment of the inflammatory infiltrate. Results: Mothers’ serum CRP assessments as well as serum PCT assessments are of poor diagnostic value in the prediction of IAI confirmed in histopathological examination. Conclusions: The best predictive values of IAI confirmed in histopathological examination were amniotic fluid glucose and vaginal fluid IL-6 determinations.

Head trauma complicated with multi-site infections of Ureaplasma urealyticum and Mycoplasma hominis: a case report.

Integrated placental and neonatal urinary detection of Ureaplasma urealyticum: A translational approach to predicting adverse neonatal outcomes.

Background: Placental infections caused by Schistosoma spp. and sexually transmitted microorganisms can adversely impact pregnancy outcomes. However, the association between molecular detection of these pathogens in placental tissue and corresponding histopathological inflammation remains unclear, particularly in sub-Saharan African populations. Methods: In this cross-sectional study, placental parenchyma specimens with limited membrane sampling were collected from 103 Ivorian and Ghanaian mothers without known pregnancy or birth complications. Tissue pieces adjacent to PCR-tested samples were analyzed by real-time PCR targeting Chlamydia trachomatis, Mycoplasma hominis, Neisseria gonorrhoeae, Schistosoma spp., Streptococcus agalactiae, Trichomonas vaginalis, Ureaplasma parvum and Ureaplasma urealyticum. Corresponding adjacent tissues were examined by routine histopathology, supplemented with immunohistochemistry when higher pathogen DNA quantities were detected, to assess inflammatory changes. Results: Real-time PCR detected U. urealyticum in 15 out of 103 cases (14.6%, ±0.7%), U. parvum in 13 (12.6%, ±0.6%), S. agalactiae in 11 (10.7%, ±0.5%), the S. haematobium complex in four (3.9%, ±0.2%), M. hominis in four (3.9%, ±0.2%), confirmed N. gonorrhoeae in two (1.9%, ±0.1%) and non-confirmed N. gonorrhoeae in one (1.0%, ±0.1%), T. vaginalis in two (1.9%, ±0.1%), and C. trachomatis (non-lymphogranuloma venereum serovar) in one (1.0%, ±0.1%). Overall, pathogen DNA levels were low, with only four positive PCR results yielding cycle threshold (Ct) values below 30 and none below 25. Histopathological examination revealed no relevant inflammatory changes in any samples. Conclusions: Placental parenchyma tissues with limited membrane sampling testing positive for Schistosoma spp. or sexually transmitted pathogens by molecular methods demonstrated no corresponding histopathological inflammation. These findings warrant confirmatory studies to better characterize potential region-specific placental infection phenotypes and their clinical significance.

Ureaplasma urealyticum, a commensal organism, is potentially pathogenic. In solid organ transplant recipients, non-genitourinary U. urealyticum infection is associated with an increased risk of graft failure or death. We reported a case of mediastinitis caused by U. urealyticum in a heart transplant recipient and reviewed 13 other cases previously described. Among the 14 patients, 3 were female and 11 were male, with a median age of 61 years. The median time to symptom onset was 9 days after surgery. Among the 10 documented cases with reported symptoms, altered mental status and hyperammonemia syndrome occurred in 9 cases, whereas our patient manifested persistent fever. Both culture and molecular diagnostics were employed in the reviewed cases, with molecular methods predominating. U. urealyticum was difficult to cover with initial empirical antibiotic therapy; the patient in this study improved after omadacycline antimicrobial therapy and was successfully discharged following subsequent management. Regarding clinical outcomes, four patients died or withdrew from treatment, while targeted therapy duration among surviving patients ranged from 9 days to 4 weeks. There is a possibility of severe U. urealyticum infection in patients with immunodeficiency after organ transplantation. Monitoring ammonia levels, utilizing rapid diagnostics, and initiating prompt treatment are all crucial to improving prognosis and reducing severe nerve damage, organ dysfunction, and mortality. Not applicable.

Ureaplasma urealyticum (UU), Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and herpes simplex virus types 1 and 2 (HSV-1 and HSV-2) are common etiologic agents of reproductive tract infections (RTIs) with high global prevalence and the potential to cause adverse genital outcomes. This study assessed the positivity rates and co-infection patterns of UU, CT, NG, and HSV among women in Xihu District, Hangzhou, Zhejiang Province, China. We analyzed 5,577 female genital tract specimens collected from January 2018 to December 2024 at Tongde Hospital of Zhejiang Province. Pathogen DNA was detected using real-time PCR. UU susceptibility testing was performed with the Mycoplasma Identification and Susceptibility Test Kit. Among 5,577 specimens, positivity rates were 49.11% for UU, 7.48% for CT, 1.88% for NG, and 10.52% for HSV. A total of 118 mixed infections involving two or more pathogens were identified; the most frequent combination was UU + CT, accounting for 73.73% of mixed infections. UU was the most common organism in co-infections, present in more than 96% of mixed-infection cases. Significant associations were observed between UU and CT (p < 0.001) and between UU and NG (p < 0.05). The overall pathogen positivity rate increased over the seven-year period (p < 0.01). Younger women (≤ 19 years) had the highest positivity for UU, CT, NG, and HSV-1, whereas older women (> 60 years) had the highest HSV-2 positivity. More than 95% of UU isolates were susceptible to doxycycline, minocycline, and josamycin. This study characterizes the epidemiology of UU, CT, NG, and HSV in real-world obstetrics and gynecology outpatient settings in Xihu District, Hangzhou. Given the elevated positivity among younger women, targeted health education and management strategies are warranted.

Background and Objectives: Preterm birth (PTB) imposes a substantial medical and economic burden on perinatal care. Recent advances in 16S rRNA gene sequencing help detailed microbiota analysis. Understanding microbiota’s contribution may help in understanding PTB pathogenesis. We aim to investigate the microbiota profiles of the oral, vaginal, and placental microbiota in pregnant Japanese women hospitalized for care of preterm labor and examine the association between them and perinatal outcomes. Materials and Methods: This cross-sectional study included 20 pregnant Japanese women admitted to a single perinatal center for preterm labor between 2022 and 2023. Oral, vaginal, and placental samples were collected aseptically during hospitalization. The patients were retrospectively categorized into: term birth (TB, n = 10), chronic abruption-oligohydramnios sequence (CAOS, n = 3), and PTB without CAOS (PTB, n = 7) perinatal outcomes. Microbiota profiles were analyzed using 16S rRNA gene sequencing, and group comparisons were performed using univariate statistical methods. Results: Alpha or beta diversity of the oral and vaginal microbiota among the three groups did not differ significantly. CAOS and PTB groups showed a trend toward altered vaginal microbial composition, but not the TB group. In the placental microbiota, beta diversity differed significantly among the TB, PTB, and CAOS groups. Ureaplasma urealyticum was more abundant in the PTB group, whereas Ureaplasma parvum was more abundant in the CAOS group. Conclusions: A potential shift in the vaginal microbiota and alterations in the placental microbiota, observed in PTB, including CAOS, suggested a possible microbial contribution.

Existing studies yielded conflicting evidence regarding the associations between genital tract microbial and funisitis, chorioamnionitis and adverse pregnancy outcomes. This study aims to provide additional evidence for their association through systematic investigation. A total of 98 FFPE umbilical cord specimens confirmed as funisitis and chorioamnionitis through histopathological examination were tested for seven genital tract microorganisms using quantitative polymerase chain reaction (qPCR). Electronic medical records of mothers and neonates were retrieved to analyze the risk associations between microorganism-positive cases and chorioamnionitis as well as adverse pregnancy outcomes. The umbilical cord samples with Ureaplasma parvum positive had been sequenced for serovars analysis. Ureaplasma parvum (UP), Ureaplasma urealyticum (UU), Group B Streptococcus (GBS) and Mycoplasma homini s (MH) were all detected in the study with prevalence of 36.5 %, 7.9 %, 18.6 %, and 5.8 %, respectively, while Mycoplasma genitalium (MG), Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) were not detected. Ureaplasma spp. were identified as the predominant microorganisms detected in 98 umbilical cord cases by using qPCR, demonstrating concordance with clinical vaginal swab findings from pregnant women. Genital microorganisms infection was associated with high stage chorioamnionitis (p = 0.0254) and adverse pregnant outcomes (p = 0.0053). In addition, the prevalence of U.parvum demonstrated a strong significant association with neonatal pneumonia (p = 0.0037). Umbilical cord specimens tested positive for U.parvum demonstrated a significant association with adverse perinatal outcomes and neonatal pneumonia. Additional studies are warranted to investigate the determinants enabling commensal U.parvum in the genital tract to ascend and induce intrauterine infection, thereby leading to adverse clinical outcomes.

Septic abortion is one the leading causes of maternal morbidity and mortality, due to severe complications including pelvic inflammatory disease and sepsis. Preterm premature rupture of the membranes may initiate intrauterine infection which may spread further, to cause an intra-peritoneal abscess which, without adequate treatment, leads to life-threatening consequences of septic shock. The case report presents a 27-years-old woman, in 19th week of first gestation, who presented to the emergency department due to fever and lower abdominal pain. Upon admission to gynecology department gynecological examination, transvaginal ultrasound, cervical and urine bacterial cultures and blood tests were conducted, and empirical intravenous antibiotics were administered immediately. Cervical swab revealed Ureaplasma urealyticum infection, no urine infection was detected, C-reactive protein and procalcitonin were highly elevated. Upon elevation inflammatory markers, non-reactive of the antibiotic's treatment, a further gynecological examination revealed preterm premature rupture of the membranes and due to high risk of sepsis, abortion was pharmacologically induced following patients' informed consent. As transvaginal ultrasonography revealed incomplete abortion, dilation and curettage was performed. The antibiotics treatment was continued, yet due to further increase of abdominal pain and elevation of inflammatory markers, computer tomography revealed an intra-peritoneal abscess, measuring 68 x 90 x 90 millimeters. Multidisciplinary cooperation with surgery and interventional radiology lead to percutaneous drainage of the abscess and patient's full recovery. Preterm premature rupture of the membranes and septic abortion is a rare cause of intra-peritoneal abscesses, yet, upon persevering symptoms, and no evident transvaginal ultrasound findings, computer tomography may prove effective in the diagnostic process.

Ureaplasma urealyticum (UU) and Mycoplasma hominis (MH) can lead to various genital and extragenital infections, with antibiotic resistance growing and varying wordwide. This study aims to investigate the prevalence and antibiotic resistance profiles of MH and UU in outpatients in Shanghai, China, from 2020 to 2023. A facility-based cross-sectional study was conducted from January 1, 2020 to December 31, 2023. Trends of MH, UU and coinfection (MH and UU coinfection), rate of antibiotic resistance during 2020 and 2023 were analyzed based on Cochran–Armitage trend test. We analyzed the prevalence and antibiotics resistance rate base on chi-square test or a single sample t-test. Our study indicated that the overall positive rate of MH, UU and coinfection were 13.47%, 32.13%, and 11.21%, respectively. For age, the trend of positive rate of UU decreased significantly (Z = −3.62, P < .001). Furthermore, the positive rate of UU increased from 31.82% in 2020 to 47.92% in 2023 (Z = 1.98, P < .05). During 2020 and 2023, Methomycin and strong bacteriocins maintained high activity against both MH and UU, with resistance rates <5%. But roxithromycin (85.48%), azithromycin (75.81%), and levofloxacin (70.97%) showed limit activity for MH, and levofloxacin (44.78%), sparfloxacin (37.36%), and azithromycin (29.40%) showed limit activity for UU. Between 2020 and 2023, the rate of antibiotic resistance to azithromycin, clarithromycin, roxithromycin, methomycin, strong bacteriocins, sparfloxacin, and levofloxacin decreased against MH. The rate of antibiotic resistance to levofloxacin decreased against UU, but increased to josamycin against UU. Josamycin, methomycin, and strong bacteriocins are promising antibiotics against MH and UU. The prevalence of MH and UU should pay more attention in China. Josamycin, methomycin, and strong bacteriocins maintained outstanding activity against MH and UU, although the resistance rate of MH to josamycin increased.

BackgroundThe aim of this study was to analyze the prevalence of common sexually transmitted infections, including Ureaplasma urealyticum (UU), Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and herpes simplex virus (HSV), in Hangzhou, China.MethodsAn analysis was conducted on 12,505 patients who visited the outpatient department of Tongde Hospital of Zhejiang Province from 2018 to 2024. Urinary and reproductive swabs were collected, and the deoxyribonucleic acid (DNA) contents of UU, CT, NG, and HSV 1/2 were detected via real-time polymerase chain reaction (PCR).ResultsAmong 12,505 outpatients, the age-adjusted prevalence was 30.93% for UU, 10.33% for CT, 11.51% for NG, and 10.64% for HSV. UU infection is prevalent among individuals aged 20 to 59, whereas CT and NG infections are most commonly observed in the 15 to 19 age group. UU and HSV infections primarily affected women, whereas CT and NG infections were more prevalent among men. The prevalence of HSV-2 infection was significantly positively correlated with age. Additionally, co-infection with UU and CT (16.61‰) was the most prevalent. UU was positively associated with CT, CT was positively associated with NG, while UU was negatively associated with NG. The age-adjusted prevalence of CT and NG, as well as the age-adjusted prevalence of UU in women, declined significantly in 2020 and then gradually increased thereafter.ConclusionsThis study furthers understanding of the epidemiological characteristics of UU, NG, CT, and HSV among outpatients in Hangzhou, providing a scientific basis for optimizing regional screening strategies and formulating effective prevention and control plans.Clinical trialNot applicable.

The present study aimed to investigate the effects of Ureaplasma urealyticum (U. urealyticum, UU) infection on sperm DNA, semen parameters and sperm quality in male patients for interpreting the proposed mechanisms of male infertility. The morphology of sperm was observed under the standard bright-field microscope at 1000× magnification after the hematoxylin-eosin (HE) staining. All the experiments of semen biochemical parameters of seminal plasma zinc, fructose, citric acid, neutral α-glucosidase, elastase, and sperm acrosin activity were performed on the SK6000 Fully Automated Biochemical Analyzer. The values of DNA fragmentation index (DFI) and high DNA stainability (HDS) in semen were tested by using the sperm chromatin structure assay (SCSA). The seminal plasma elastase level increased (p = 0.0006) and sperm morphology abnormality increased in UU-positive group (p < 0.0001). There was no significant difference in each of other semen parameters including semen volume, leukocyte concentration, seminal plasma zinc, fructose, citric acid, neutral α-glucosidase, and sperm acrosin activity (p > 0.05 for each). The values of DFI in the UU-positive group were higher than those in the UU-negative group (p < 0.01), but there was no significant difference in HDS between UU-positive group and UU-negative group (p > 0.05). UU infection in male genital tract can not only significantly increase the seminal plasma elastase levels and sperm morphological abnormalities, but also markedly elevate sperm DNA fragmentation levels and decrease sperm DNA integrity. It may represent an important pathway contributing to male infertility.

IntroductionGardnerella vaginalis, traditionally linked to bacterial vaginosis (BV) in women, is increasingly detected in men with urethral symptoms. Its clinical relevance and co-infection patterns remain poorly defined. This study assessed the prevalence, quantitative load, and co-infections of G. vaginalis, and other urogenital pathogens in symptomatic men.MethodsWe retrospectively analyzed 418 symptomatic male patients using multiplex polymerase chain reaction (PCR), targeting 21 pathogens. Pathogen loads were reported as qualitative or quantitative (<10⁴ or ≥10⁴ copies/mL).ResultsAt least one pathogen was detected in 239 (57.2%) patients (95% CI: 52.4-61.9). G. vaginalis was most frequently identified: 90 (21.5%), followed by Chlamydia trachomatis: 63 (15.1%), Mycoplasma genitalium: 45 (10.8%), and Ureaplasma urealyticum: 38 (9.1%). Quantitative analysis showed 105 patients with G. vaginalis <10⁴ copies/mL and 90 with ≥10⁴ copies/mL. Polymicrobial infections occurred in 81 (19.5%) patients, most often involving G. vaginalis with U. urealyticum (n = 13) or U. parvum (n = 11).ConclusionsG. vaginalis was the leading pathogen in symptomatic men, frequently present at clinically significant loads and in co-infections. These findings support its inclusion in routine male sexually transmitted infection (STI) diagnostic panels.