Ureaplasma

Ureaplasma is an inhabitant of the microflora of the genitourinary tract, but it is far from permanent.

In essence, it is a conditionally pathogenic microorganism that can be found in the urinary system and not cause any symptoms. On the other hand, if a certain provoking factor affects the human body, being infected with ureaplasma, ureaplasma infection can be activated.

In the pathogenesis of the disease, the leading role is played by the inflammatory process, which develops as a result of the vital activity of ureaplasma. There are several ways of infection with this pathogen - this is the sexual route and vertical. The latter includes infection of the fetus from the mother during pregnancy or during labor.

Ureaplasma was first discussed in the mid-20th century, when an unknown microorganism was discovered in a patient with non-gonococcal urethritis. The microorganism was characterized by its small size, slightly larger than viruses, and the absence of a cell membrane and its own DNA. The typical location of ureaplasma is the mucous membranes of the urinary tract and genitals.

Ureaplasma parvum

Ureaplasma parvum (parvum) belongs to the mycoplasma family, in particular to ureaplasmas. The size of the microorganism is very small, but the urease activity is quite pronounced. This property provides the ability to break down urea with the release of ammonia. As a result, there is a risk of developing an inflammatory reaction and the formation of stones in the organs of the urinary system.

Ureaplasma's habitat is the body's cells, since they do not have their own membrane. As a result, the pathogen attaches to the cell membranes of the mucous membranes, with their subsequent destruction.

In addition, ureaplasma is capable of producing enzymes that have the property of provoking the destruction of proteins, namely immunoglobulin A. This choice is justified by the ability of the protein to produce antibodies in response to the action of pathogens that are tropic to the cells of the mucous membranes.

Having destroyed the protection of cell membranes, ureaplasma parvum freely penetrates into the cell due to a decrease in local immunity.

Ureaplasma urealyticum

Ureaplasma urealyticum is an intracellular microorganism that belongs to the mycoplasmas. This type of bacteria is distinguished by the absence of a cell membrane and DNA.

The pathogen is considered a conditionally pathogenic inhabitant of the microflora of the genitourinary tract, however, despite this, it is classified as an infection transmitted through sexual contact.

Ureaplasma urealyticum, when exposed to certain factors on a weakened organism, can provoke the development of an inflammatory process in the urinary and reproductive systems, and also affect the joints. More than 40% of people are carriers of ureaplasma and do not even suspect it. This situation is associated with the lack of activity of the pathogen and, accordingly, clinical manifestations of the disease.

Due to the fact that drug therapy for ureaplasma during pregnancy can negatively affect the development of the fetus, it is therefore recommended to conduct a laboratory test for the presence of this pathogen when planning a pregnancy. The analysis should be carried out for both future parents and, if ureaplasma is detected, treatment should be carried out.

Ureaplasma hominis

Ureaplasma hominis (hominis) refers to mycoplasmas, which have a similar structure to ureaplasmas and are intracellular parasites. The size and shape of the pathogen may vary, but their common feature is a three-layer cytoplasmic membrane.

Ureaplasma hominis, after penetrating the host cell, contributes to the development of serious disturbances in protein metabolism, its synthesis, the formation of nucleic acids, and also changes genetic information.

The pathogen reproduces by dividing the mother cell or by budding of daughter cells from it.

The danger of infection with ureaplasma during or before pregnancy without any clinical manifestations may include provoking spontaneous abortion, premature birth, stillbirth or pathological conditions during pregnancy or labor.

This threat is caused by the ability of the pathogen to increase the volume of arachidonic acid in a free state, which in turn leads to the activation of prostaglandin production.

Ureaplasma genitalium

Ureaplasma genitalium is part of the mycoplasma family, which are intracellular pathogens. After entering the cells of the urogenital mucosa, mycoplasmas begin to process such substances of the host cell as fatty acids and cholesterol.

The ability of the intracellular parasite to attach is still not fully understood. It is only known that after the mycoplasma binds to the urethral epithelium, a fairly strong bond is formed that does not break under the pressure of the urine flow.

However, during microscopic examination using an electron microscope, it was established that ureaplasma genitalium does not have direct tight adhesion to the host cell membrane.

There are not many ways of infection - sexual and vertical, but still, the most predisposing factors for infection with ureaplasma are identified. These include the age category from 14 to 30 years. In addition, early onset of sexual activity (before 18 years), promiscuous change of partners, as well as previous gynecological pathology in the form of tubal pregnancy, sexually transmitted infections and chronic inflammatory processes of unknown origin.

Symptoms of ureaplasma

The period from the moment ureaplasma enters the body until the first clinical signs appear can last from several days to a month. This period depends on the immune defense of the human body, as well as on the degree of pathogenicity of the pathogenic microorganism.

The incubation period can last even more than a couple of months, during which the person is already infected and is a source of infection. Thus, at this stage, the sexual partner can be infected even at an asymptomatic stage.

Symptoms of ureaplasma begin to manifest themselves not very noticeably, and therefore it is not possible to accurately determine the moment of infection and the duration of the incubation period.

In some cases, the clinical manifestations of the disease can be so subtle that a person will not even suspect that they are infected or that their sexual partner is infected. This is especially true for the female half of humanity, in whom ureaplasma infection can proceed virtually asymptomatically for decades.

Symptoms of Ureaplasma in Women

With a normal level of immune protection of the body of a woman, ureaplasma may not manifest itself for quite a long period of time. However, as soon as the body is exposed to any provoking factor, with the addition of a secondary infection or the development of concomitant pathology, ureaplasma begins to remind of its presence.

In addition, pregnancy can become such a trigger, which subsequently does not allow the use of the entire range of drugs that are necessary to kill ureaplasma.

Symptoms of ureaplasma in women are characterized by the presence of vaginal discharge, the color of which is usually transparent and has no specific odor. However, it is worth remembering that with the development of the inflammatory process, the discharge may acquire a yellowish or greenish tint, as well as an unpleasant odor.

Localization of inflammation in the uterus or appendages may be indicated by painful sensations of a pulling nature in the lower abdomen. In case of oral-genital infection, inflammation of the oropharynx with pain syndrome and purulent plaque on the tonsils may develop.

In addition, symptoms of ureaplasma in women are manifested by frequent urge to urinate, which is accompanied by a burning sensation and pain along the urethra. Pain and discomfort can also accompany sexual intercourse.

Symptoms of Ureaplasma in Men

Symptoms of ureaplasma in men begin their manifestation with minor expression. In most cases, the disease is detected far from the first months of infection. The most common clinical manifestations are burning in the urethra during urination.

Often, mucous discharge may be observed, which, in combination with other symptoms, may periodically appear and disappear for no apparent reason.

If the disease is not given due attention, it can become chronic, which will worsen the situation, as it is much more difficult to treat. In addition, the epididymis and prostate gland may become involved in the process, which will lead to infertility.

Symptoms of ureaplasma in men with damage to the urethra are manifested by cutting pain, burning and discomfort in the area of the urethra. These clinical manifestations bother during urination and can disappear on their own. In chronic cases, each subsequent exacerbation has more pronounced symptoms.

Epididymitis does not manifest itself with any symptoms, but leads to an increase in the appendages, which acquire a dense consistency. Prostatitis is considered a complication of uraplasma infection and is characterized by difficulty urinating, frequent urges and discomfort in the perineum, which subsequently contributes to erectile dysfunction and the development of impotence.

Diagnostics of ureaplasma

Ureaplasma diagnostics is based on the same principles in women and men, but there are still some nuances. To diagnose ureaplasma in men, it is necessary to examine the external genitalia, palpate the scrotum, including the epididymis, the testicles themselves and the spermatic cord.

Next, it is necessary to examine the prostate gland and seminal vesicles through the rectum, i.e. rectally. Among the laboratory and instrumental examination methods, it is necessary to highlight the microscopic examination of the urethral smear, the urinary sediment of the 2-glass sample, as well as the prostate secretion.

In some cases, a spermogram and ultrasound examination of the structures of the scrotum and prostate gland are required.

Ureaplasma diagnostics in women consists of external and internal examination of the vaginal mucosa, its walls and the cervix. Using a bimanual examination, it is necessary to palpate the uterus and appendages, determining soreness, consistency and size.

Microscopic methods include examination of urinary sediment, smear from the urethra, cervical canal and vagina. Instrumental methods include ultrasound of the female reproductive system, as well as laparoscopy if necessary.

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Ureaplasma test

A ureaplasma test is performed after a gynecologist (if a woman is seeking help) or a urologist (for men) has examined the genitals, performed a palpation examination of the structures accessible for this procedure, and, using the medical history, has identified the factors that could have caused the ureaplasma infection.

Ureaplasma testing is performed for several purposes.

Firstly, this is the determination of the causal factor that became the trigger in the development of the chronic inflammatory process in the genitourinary system.

Secondly, additional examination is necessary in the absence of barrier contraceptives, as a result of which infection with ureaplasma may occur during sexual intercourse. In addition, frequent change of sexual partners is also an indication for a more thorough examination.

Thirdly, tests to detect ureaplasma are needed when planning a pregnancy to avoid infection of the fetus or the development of the disease during this period. Quite often, ureaplasma is detected as a cause of infertility, as well as in ectopic pregnancy.

And finally, the analysis can be carried out for preventive purposes to avoid the development of the disease and infection of your sexual partner.

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Ureaplasma culture

Of all the tests performed to diagnose a pathogen, it is worth highlighting the ureaplasma culture. It is considered the most accurate, so it is used most often. This study is also called a bacteriological or cultural diagnostic method.

In order to conduct a ureaplasma culture, it is necessary to first take smears from the mucous membrane of the vaginal vault, cervix or urethra. It is possible to conduct a bacteriological study using morning urine.

After collecting the material, it is placed on a suitable nutrient medium, where ureaplasma will be grown. In addition to the growth of the pathogen, it is necessary to evaluate the quantitative composition. This requires bacteriological seeding.

In addition, with its help it is possible not only to count the number of microorganisms, but also to determine their sensitivity to antibacterial agents, which greatly facilitates the treatment process. Thanks to this method, it became possible to purposefully use drugs that will lead to the death of ureaplasma.

PCR ureaplasma

PCR is the most informative method for determining the pathogen in vaginal or urethral discharge. This type of research is a molecular diagnostics of infectious agents that are transmitted through sexual contact.

With the help of PCR, ureaplasma, or rather its DNA, is detected even if there are only a few units in the smear. Correct analysis ensures 100% accuracy.

Using PCR, ureaplasma and other sexually transmitted infections are detected in minimal quantities, which allows this method to be distinguished from others. PCR is especially relevant in the case of a latent course of the disease, as well as in cases where other methods do not allow the pathogen to be detected.

Thanks to PCR, pathogens are accurately identified even in chronic and sluggish disease. In this regard, ureaplasmas can be diagnosed even at the incubation stage, which prevents infection of the sexual partner.

The method is also widely used when laboratory test results are negative and there are no clinical manifestations.

Ureaplasma titers

Ureaplasma titers are determined using PCR or culture medium. The result of the first analysis will be the degree of microflora activity, and the second - the quantitative composition and sensitivity of the pathogen to antibacterial agents. Thanks to the latter, treatment is more effective, since antibacterial drugs are used that can lead to the death of ureaplasma.

A titer reading of 101 to 104 implies the presence of ureaplasma in the sample, but is not a basis for a therapeutic drug course. A titer of 101 can be observed in a woman's body when the disease has been treated, but not completely. In the process, ureaplasma has passed from pathological flora to normal.

Indicators 102 and 103 indicate the presence of ureaplasma as a conditionally pathogenic microorganism, which does not require treatment. However, if clinical symptoms are present or if the disease is detected in a sexual partner, it is necessary to conduct further examination and most likely undergo a therapeutic course.

Ureaplasma titers of 104 and more indicate the activity of the disease, so in this case it is necessary to carry out treatment. However, there may be no clinical manifestations, but in the future ureaplasma can cause infertility.

Treatment of ureaplasma

Treatment of ureaplasma includes the use of several groups of drugs, as well as compliance with certain rules. Treatment should be carried out simultaneously by both sexual partners. It consists of antibacterial agents to which the microorganism is sensitive. This course should be continued for up to 2 weeks.

In addition, it is necessary to use immunostimulants to increase the body's defenses. Among local treatment methods, it is worth highlighting the introduction of special drugs into the urethra, for example, uroseptics. This procedure is called installation.

Treatment of ureaplasma also involves the use of physiotherapy procedures, and in the case of prostatitis, as a complication of ureaplasma infection, also in combination with prostate massage.

During the treatment, you should abstain from sexual intercourse and follow a special diet. Monitoring the dynamics of the therapeutic course is carried out using PCR. This analysis is used several times over 3-4 months.

Sensitivity of ureaplasma to antibiotics

The sensitivity of upeaplasma to antibiotics is determined by the culture method, when the antibacterial agent that has the maximum effectiveness in combating this type of pathogen is determined. Treatment should be started when clinical signs of the disease appear, as well as when the titer exceeds 104 as a result of PCR.

First, we should list the groups of antibacterial drugs to which ureaplasma is absolutely not sensitive, so their use will not bring any effect. These include cephalosporins, rifampicin and penicillin.

Ureaplasma sensitivity to antibiotics of the following groups has been proven: macrolides, tetracyclines, lincosamines, fluoroquinolones and aminoglycosides. However, certain doses of drugs should be taken into account, because even effective antibiotics in insufficient dosages will not be able to contribute to the death of ureaplasma.

Thus, for the treatment of ureaplasma it is rational to use doxycycline (Unidox Solutab), but it is contraindicated during pregnancy and up to 8 years. Oflokacin, a representative of fluoroquinolones, has the same contraindications.

Of the macrolides, josamycin, erythrmycin, midecamycin, azithromycin and clarithromycin are worth highlighting. The first is well tolerated and can be prescribed in the first trimester of pregnancy, as are the following two antibiotics.

As for clarithromycin and azithromycin, they have a high ability to penetrate into the cell, but are contraindicated during pregnancy.

Medicines for the treatment of ureaplasma

The treatment complex for the disease includes physiotherapy procedures, installations, and medications for the treatment of ureaplasma.

Antibacterial agents are the drugs of choice, since without them, the death of ureaplasma is impossible. Macrolides, tetracyclines and fluoroquinolones, to which the pathogen is sensitive, are widely used for this purpose. The form of application of antibacterial drugs can change, so you can use tablet forms, in the form of powders, solutions or suppositories. In addition, if necessary, it is rational to use metronidazole as an antifungal agent.

Immunotherapy includes the use of immunostimulants, since ureaplasma infection is observed in most cases in people with insufficient levels of immune protection. Such drugs are needed for rapid recovery. Among them, preference is given to Cycloferon.

In addition, from the restorative therapy, it is necessary to highlight such drugs for the treatment of ureaplasma as antioxidants, adaptogens and biostimulants.

Ureaplasma is a sexually transmitted infection, so when the first clinical manifestations of the disease appear, you should immediately contact a specialist. Early detection and treatment will prevent infection of the sexual partner and the transition of the disease to a chronic form, which entails serious consequences.