Ureaplasma urealyticum, Mycoplasma hominis and adverse pregnancy outcomes

Curr Opin Infect Dis. 2013 Jun;26(3):231-40. doi: 10.1097/QCO.0b013e328360db58.

Abstract

Purpose of review: Mycoplasma hominis and Ureaplasma urealyticum may colonize the human genital tract and have been associated with adverse pregnancy outcomes. Chorioamnionitis, spontaneous preterm labour and preterm premature rupture of membranes are significant contributors to neonatal morbidity and mortality. However, as these bacteria can reside in the normal vaginal flora, there are controversies regarding their true role during pregnancy and thus the need to treat these organisms.

Recent findings: We review here the recent data on the epidemiology of mycoplasmas and their clinical role during pregnancy. The association of these organisms with preterm labour has been suggested by many observational studies, but proof of causality remains limited. PCR is an excellent alternative to culture to detect the presence of these organisms, but culture allows antibiotic susceptibility testing. Whether antimicrobial treatment of mycoplasma-colonized pregnant patients can effectively reduce the incidence of adverse pregnancy outcomes warrants further investigations.

Summary: The role of Mycoplasma spp. and U. urealyticum in adverse pregnancy outcomes is increasingly accepted. However, sole presence of these microorganisms in the vaginal flora might be insufficient to cause pathological issues, but their combination with other factors such as bacterial vaginosis or cervical incompetence may be additionally needed to induce preterm birth.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Anti-Bacterial Agents / pharmacology
  • Female
  • Humans
  • Microbial Sensitivity Tests
  • Mycoplasma Infections / complications*
  • Mycoplasma Infections / diagnosis
  • Mycoplasma hominis* / drug effects
  • Mycoplasma hominis* / isolation & purification
  • Pregnancy
  • Pregnancy Complications, Infectious / microbiology*
  • Pregnancy Outcome
  • Premature Birth / microbiology
  • Reproductive Tract Infections / complications*
  • Ureaplasma Infections / complications*
  • Ureaplasma Infections / diagnosis
  • Ureaplasma urealyticum* / drug effects
  • Ureaplasma urealyticum* / isolation & purification

Substances

  • Anti-Bacterial Agents