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Xiao F, Qu Q, Zou M, Su F, Wu H, Sun Y, Zhou M, Zhao F, Yao Y, Abudushalamu G, Chen Y, Zhang C, Fan X, Wu G. Detection of Ureaplasma urealyticum by Catalytic Hairpin Assembly Combined with a Lateral Flow Immunoassay Strip. ACS OMEGA 2022; 7:33830-33836. [PMID: 36188314 PMCID: PMC9520684 DOI: 10.1021/acsomega.2c02457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 09/05/2022] [Indexed: 06/16/2023]
Abstract
Ureaplasma urealyticum is a common genital mycoplasma in men and women, which can cause reproductive tract infection and infertility, and is also related to adverse pregnancy outcomes and neonatal diseases. Pathogen culture and polymerase chain reaction (PCR) are the main methods for the diagnosis of U. urealyticum. However, pathogen culture takes too long, and PCR requires professional personnel and sophisticated instruments. Here, we report a simple, convenient, sensitive, and specific detection method, which combines catalytic hairpin assembly with a lateral flow immunoassay strip. Only a water bath and a fluorescence reader are needed to detect the results in 30 min. We can realize the point-of-care testing of U. urealyticum by this method. To verify this method, we selected 10 clinical samples for testing, and the test results were exactly the same as the clinical report.
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Affiliation(s)
- Feng Xiao
- Diagnostics
Department, Medical School of Southeast
University, Nanjing 210009, People’s Republic of China
| | - Qingrong Qu
- Department
of Tuberculosis, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai 200433, China
| | - Mingyuan Zou
- Diagnostics
Department, Medical School of Southeast
University, Nanjing 210009, People’s Republic of China
| | - Feiya Su
- Diagnostics
Department, Medical School of Southeast
University, Nanjing 210009, People’s Republic of China
| | - Huina Wu
- Diagnostics
Department, Medical School of Southeast
University, Nanjing 210009, People’s Republic of China
| | - Yan Sun
- Diagnostics
Department, Medical School of Southeast
University, Nanjing 210009, People’s Republic of China
| | - Meiling Zhou
- Diagnostics
Department, Medical School of Southeast
University, Nanjing 210009, People’s Republic of China
| | - Fengfeng Zhao
- Diagnostics
Department, Medical School of Southeast
University, Nanjing 210009, People’s Republic of China
- Zhongda
Hospital, Center of Clinical Laboratory Medicine, Medical School, Southeast University, Nanjing 210009, People’s Republic of China
| | - Yuming Yao
- Diagnostics
Department, Medical School of Southeast
University, Nanjing 210009, People’s Republic of China
| | - Gulinaizhaer Abudushalamu
- Diagnostics
Department, Medical School of Southeast
University, Nanjing 210009, People’s Republic of China
| | - Yaya Chen
- Diagnostics
Department, Medical School of Southeast
University, Nanjing 210009, People’s Republic of China
| | - Chen Zhang
- Zhongda
Hospital, Center of Clinical Laboratory Medicine, Medical School, Southeast University, Nanjing 210009, People’s Republic of China
| | - Xiaobo Fan
- Diagnostics
Department, Medical School of Southeast
University, Nanjing 210009, People’s Republic of China
| | - Guoqiu Wu
- Diagnostics
Department, Medical School of Southeast
University, Nanjing 210009, People’s Republic of China
- Zhongda
Hospital, Center of Clinical Laboratory Medicine, Medical School, Southeast University, Nanjing 210009, People’s Republic of China
- Jiangsu
Provincial Key Laboratory of Critical Care Medicine, Southeast University, Nanjing 210009, People’s Republic
of China
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Beeton ML, Payne MS, Jones L. The Role of Ureaplasma spp. in the Development of Nongonococcal Urethritis and Infertility among Men. Clin Microbiol Rev 2019; 32:e00137-18. [PMID: 31270127 PMCID: PMC6750135 DOI: 10.1128/cmr.00137-18] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Ureaplasma spp. are a genus of bacteria for which two human-associated species exist: Ureaplasma urealyticum and Ureaplasma parvum Their definition as a pathogen in the context of nongonococcal urethritis (NGU) and infertility among males remains highly controversial, largely due to historically high rates of isolation of these bacteria from the urethra of seemingly healthy men. This review summarizes the emerging evidence suggesting a true pathogenic role of these bacteria under specific conditions, which we term risk factors. We examine the historical, clinical, and experimental studies which support a causal role for Ureaplasma spp. in the development of NGU as well as some of the proposed mechanisms behind the association of Ureaplasma spp. and the development of infertility. Finally, we discuss the potential for developing a case-by-case risk-based approach toward the management of men who present with seemingly idiopathic NGU but who are positive for Ureaplasma spp.
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Affiliation(s)
- Michael L Beeton
- Cardiff School of Sport and Health Sciences, Department of Biomedical Science, Cardiff Metropolitan University, Cardiff, United Kingdom
| | - Matthew S Payne
- Division of Obstetrics and Gynaecology, The University of Western Australia, Crawley, Western Australia, Australia
| | - Lucy Jones
- Department of Integrated Sexual Health, Dewi Sant Hospital, Cwm Taf University Health Board, Pontypridd, United Kingdom
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3
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Taylor-Robinson D, Pallecaros A, Horner P. Diagnosis of some genital-tract infections: part 1. An historical perspective. Int J STD AIDS 2017; 28:1143-1149. [PMID: 28186463 DOI: 10.1177/0956462417693171] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Making a prompt and accurate diagnosis of genital tract infections is the key to instituting appropriate treatment and the linchpin of sexually transmitted infection control. We present a brief history, not covering syphilis, of diagnostic events for each of six bacteria and one protozoan from the time of discovery up to the molecular revolution. The latter is touched upon but its impact will form the substance of a further presentation. Here, hindsight is helpful in understanding the way in which progress was made over 135 years, often when microbiology, not even seen as a distinct discipline, had a difficult time in providing what was required in terms of dependable diagnostic techniques. Gram-staining, growth on artificial media, growth in cultured cells, enzyme immunoassays, metabolic and immunofluorescence tests have all had their place and some still do despite the avalanche of the molecular era. Serology to determine the existence of organism-specific antibodies has been important in managing syphilis, but has only sometimes been helpful in supporting a diagnosis for other infections and has rarely been the primary deciding factor.
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Affiliation(s)
- David Taylor-Robinson
- 1 Section of Infectious Diseases, Wright-Fleming Institute, Faculty of Medicine, Imperial College London, London, UK
| | - Anna Pallecaros
- 2 Department of Genito-urinary Medicine, Princess Grace Hospital, London, UK
| | - Patrick Horner
- 3 School of Social and Community Medicine, University of Bristol, UK.,4 National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Evaluation of Interventions in partnership with Public Health England, University of Bristol, UK.,5 Bristol Sexual Health Centre, University Hospitals Bristol NHS Trust, Bristol, UK
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4
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Russell MW, Whittum-Hudson J, Fidel PL, Hook EW, Mestecky J. Immunity to Sexually Transmitted Infections. Mucosal Immunol 2015. [DOI: 10.1016/b978-0-12-415847-4.00112-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Ireland DJ, Keelan JA. The Maternal Serological Response to Intrauterine Ureaplasma sp. Infection and Prediction of Risk of Pre-Term Birth. Front Immunol 2014; 5:624. [PMID: 25538708 PMCID: PMC4260765 DOI: 10.3389/fimmu.2014.00624] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Accepted: 11/21/2014] [Indexed: 01/06/2023] Open
Abstract
Pre-term birth (PTB) associated with intrauterine infection and inflammation (IUI) is the major cause of early PTB less than 32 weeks of gestation. Ureaplasma spp. are common commensals of the urogenital tract in pregnancy and are the most commonly identified microorganisms in amniotic fluid of pre-term pregnancies. While we have an understanding of the causal relationship between intra-amniotic infection, inflammation and PTB, we are still unable to explain why vaginal Ureaplasma sp. colonization is tolerated in some women but causes PTB in others. It is now known that placental tissues are frequently colonized by bacteria even in apparently healthy pregnancies delivered at term; usually this occurs in the absence of a significant local inflammatory response. It appears, therefore, that the site, nature, and magnitude of the immune response to infiltrating microorganisms are key in determining pregnancy outcome. Some evidence exists that the maternal serological response to Ureaplasma sp. colonization may be predictive of adverse pregnancy outcome, although issues such as the importance of virulence factors (serovars) and the timing, magnitude, and functional consequences of the immune response await clarification. This mini-review discusses the evidence linking the maternal immune response to risk of PTB and the potential applications of maternal serological analysis for predicting obstetric outcome.
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Affiliation(s)
- Demelza J Ireland
- School of Women's and Infants' Health, The University of Western Australia , Perth, WA , Australia
| | - Jeffrey A Keelan
- School of Women's and Infants' Health, The University of Western Australia , Perth, WA , Australia
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Eun HS, Lee SM, Park MS, Park KI, Namgung R, Lee C. Serological investigation of Ureaplasma urealyticum in Korean preterm infants. KOREAN JOURNAL OF PEDIATRICS 2013; 56:477-81. [PMID: 24348660 PMCID: PMC3859880 DOI: 10.3345/kjp.2013.56.11.477] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Revised: 05/24/2013] [Accepted: 06/13/2013] [Indexed: 11/27/2022]
Abstract
Purpose Ureaplasma colonization is related with perinatal complications in preterm infants. Little is known about the difference in virulence among various Ureaplasma urealyticum serovars. The aim of this study was to determine U. urealyticum serovars of preterm infants in order to assess whether any of the serovars were associated with bronchopulmonary dysplasia (BPD). Methods Three hundred forty-four preterm infants with a gestational age less than 34 weeks admitted to Gangnam Severance Hospital neonatal intensive care unit from July 2011 to December 2012 were included in this study. Tracheal and gastric aspirations were conducted on infants to confirm Ureaplasma colonization. Ureaplasma colonization was confirmed in 9% of infants, of these, serovars were determined by real-time polymerase chain reaction. Results A total of 31 infants (gestational age, 29.3±3.1 weeks; birth weight, 1,170±790 g) were U. urealyticum positive. The Ureaplasma positive group treated for more days with oxygen and ventilation than the negative group (P<0.05). Histologic chorioamnionitis and moderate to severe BPD were more frequent in the Ureaplasma positive group than in the negative group (P<0.05). U. urealyticum isolates were either found to be a mixture of multiple serovars (32%), serovar 9 alone or combined with other serovars (39%), serovar 11 (26%), 2 (13%), 8 (10%), 10 (13%), and 13 (25%). No individual serovars were significantly associated with moderate to severe BPD and chorioamnionitis. Conclusion This is the first study to describe the distribution of U. urealyticum serovars from Korean preterm infants. Ureaplasma-colonized infants showed higher incidence of BPD and chorioamnionitis.
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Affiliation(s)
- Ho Seon Eun
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Soon Min Lee
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Min Soo Park
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Kook In Park
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Ran Namgung
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Chul Lee
- Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea
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7
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Production of recombinant antigens of Ureaplasma parvum serotypes 3 and 6 for development of a serological assay. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2007; 15:447-51. [PMID: 18094114 DOI: 10.1128/cvi.00379-07] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Recombinant antigens of Ureaplasma parvum serotypes 3 and 6 were produced in order to develop a serological assay for Ureaplasma antibody detection. The genes of the multiple banded antigen (MBA) were amplified by PCR and cloned in a pTrcHis TOPO plasmid. Purified recombinant proteins were evaluated in Western blotting and enzyme-linked immunosorbent assay (ELISA) with monoclonal antibodies and human sera. Our approach was successful in the production of the recombinant MBAs (rMBAs) for serotypes 3 and 6. The antigens tested positive with serotype-specific monoclonal antibodies in Western blotting and in ELISA. Prominent reactions were detected with the rMBAs and their homologous monoclonal antibodies. Strong cross-reactions were visible in ELISA between rMBA 3 and the monoclonal antibodies from the other U. parvum serotypes. A weak cross-reaction was seen with rMBA 3 and the monoclonal antibody from serotype 4. rMBA 6 showed cross-reaction only with the monoclonal antibody from U. parvum serotype 1. Fifty-one percent of the sera obtained from culture-positive women reacted with one or both rMBAs. Only three (15%) of the sera from culture-negative women reacted with the rMBA. The positive reactions were observed only with rMBA 6. These preliminary tests showed the potential usefulness of the rMBAs produced for detecting an antibody response against Ureaplasma antigens.
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Reyes L, Reinhard M, O'donell LJ, Stevens J, Brown MB. Rat strains differ in susceptibility to Ureaplasma parvum-induced urinary tract infection and struvite stone formation. Infect Immun 2006; 74:6656-64. [PMID: 16982825 PMCID: PMC1698052 DOI: 10.1128/iai.00984-06] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Individuals with struvite uroliths are susceptible to recurrent urinary tract infections (UTI), sepsis, and renal disease. Unfortunately, little is known about the host-specific factors that predispose to this disease. In order to develop a rodent model that can address this problem, we inoculated female Fischer 344 (F344), Lewis (LEW), Sprague-Dawley (SD), and Wistar (WIS) rats with a host-adapted strain of Ureaplasma parvum. Animals were necropsied at 2 weeks postinoculation; 100% of F344, 42% of SD, 10% of LEW, and 10% of WIS rats remained infected. Severe bladder lesions and struvite calculi were seen in 64% of F344 rats; in other rat strains, bladder lesions were mild or absent. F344 rats with struvite uroliths had the highest urinary levels of proinflammatory cytokines, such as GRO/KC, interleukin-1alpha (IL-1alpha), and IL-1beta. F344 rats without struvite stones at necropsy had milder bladder lesions and significantly lower urinary levels of proinflammatory cytokines but a more prominent inflammatory response than did other rat strains. Based on our results, struvite stone formation is linked to a robust inflammatory response that does not resolve UTI but instead promotes damage to surrounding tissues.
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Affiliation(s)
- Leticia Reyes
- Deptartment of Infectious Disease and Pathology, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610-0880, USA.
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9
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Abstract
The genital mycoplasmas represent a complex and unique group of microorganisms that have been associated with a wide array of infectious diseases in adults and infants. The lack of conclusive knowledge regarding the pathogenic potential of Mycoplasma and Ureaplasma spp. in many conditions is due to a general unfamiliarity of physicians and microbiology laboratories with their fastidious growth requirements, leading to difficulty in their detection; their high prevalence in healthy persons; the poor design of research studies attempting to base association with disease on the mere presence of the organisms in the lower urogenital tract; the failure to consider multifactorial aspects of diseases; and considering these genital mycoplasmas only as a last resort. The situation is now changing because of a greater appreciation of the genital mycoplasmas as perinatal pathogens and improvements in laboratory detection, particularly with regard to the development of powerful molecular nucleic acid amplification tests. This review summarizes the epidemiology of genital mycoplasmas as causes of neonatal infections and premature birth; evidence linking ureaplasmas with bronchopulmonary dysplasia; recent changes in the taxonomy of the genus Ureaplasma; the neonatal host response to mycoplasma and ureaplasma infections; advances in laboratory detection, including molecular methods; and therapeutic considerations for treatment of systemic diseases.
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Affiliation(s)
- Ken B Waites
- Department of Pathology, University of Alabama, Birmingham, Alabama 35249, USA.
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10
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Yoshida T, Ishiko H, Yasuda M, Takahashi Y, Nomura Y, Kubota Y, Tamaki M, Maeda SI, Deguchi T. Polymerase chain reaction-based subtyping of ureaplasma parvum and ureaplasma urealyticum in first-pass urine samples from men with or without urethritis. Sex Transm Dis 2005; 32:454-7. [PMID: 15976604 DOI: 10.1097/01.olq.0000158932.78183.95] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Our previous study suggested a significant association between Ureaplasma urealyticum and nongonococcal urethritis (NGU). However, association of the serovars of U. urealyticum with NGU remains unclear. A polymerase chain reaction (PCR)-based assay can distinguish 4 serovars of Ureaplasma parvum from each other and categorize 10 serovars of U. urealyticum into 3 subtypes: subtype 1 (serovars 2, 5, 8, and 9), subtype 2 (serovars 4, 10, 12, and 13), and subtype 3 (serovars 7 and 11). GOAL The goal of this study was to determine which subtypes of U. urealyticum are associated with NGU as determined by PCR-based assay. STUDY The prevalence of U. urealyticum subtypes in 106 ureaplasma-positive men with urethritis was compared with that in 30 ureaplasma-positive men without urethritis. RESULTS : In men with nonchlamydial NGU and men with Mycoplasma genitalium-negative nonchlamydial NGU, only U. urealyticum subtype 1 (serovars 2, 5, 8, and 9) was detected significantly more often than in men without urethritis. CONCLUSION This study suggests that subtype 1 of U. urealyticum (serovars 2, 5, 8, and 9) is associated with NGU independently of Chlamydia trachomatis or M. genitalium.
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Affiliation(s)
- Takashi Yoshida
- Research and Development Department 1, Mitsubishi Kagaku Bio-Clinical Laboratories, Inc., Tokyo, Japan
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Debata NK, Venkatesh V, Misra RN, Chander Y, Ohri VC, Sharma RK. UREAPLASMAS UREALYTICUM AND HUMAN INFERTILITY: EFFECT ON SPERMATOZOA MORPHOLOGY. Med J Armed Forces India 1999; 55:193-196. [PMID: 28775630 PMCID: PMC5531877 DOI: 10.1016/s0377-1237(17)30439-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Seminal fluids of 197 males with complaints of involuntary infertility were examined for spermatozoal counts, morphological changes in the spermatozoa and cultured for ureaplasmas and mycoplasmas. In 12, no spermatozoa were present, 29 had a count of less than one million and 156 had more than one million spermatozoa per mL of the seminal fluid. Various morphological changes were detected in the spermatozoa in some cases. U urealyticum and M hominis were grown in 43.15% and 16.75% in comparison to control figures of 15.9% and 11.4% respectively. There was no correlation between growth of ureaplasmas and the spermatozoal count. Among the morphological changes, presence of coiled tails, presence of a fuzzy coat around the tail and microcolonies were highly specific for culture positivity (98.2, 98.2 and 97.35% respectively) but of low sensitivity (55.2%, 14.1% and 8.2% respectively).
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Affiliation(s)
- N K Debata
- Associate Professor, Armed Forces Medical College, Pune 411 040
| | - Vimla Venkatesh
- Post Graduate Student, Armed Forces Medical College, Pune 411 040
| | - R N Misra
- Reader, Department of Microbiology, Armed Forces Medical College, Pune 411 040
| | - Yogesh Chander
- Reader, Department of Microbiology, Armed Forces Medical College, Pune 411 040
| | - V C Ohri
- Commandant, 167 Military Hospital, C/o 56 APO
| | - R K Sharma
- Reader, Department of Gynaecology & Obstetrics, Armed Forces Medical College, Pune 411 040
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Povlsen K, Jensen JS, Lind I. Detection of Ureaplasma urealyticum by PCR and biovar determination by liquid hybridization. J Clin Microbiol 1998; 36:3211-6. [PMID: 9774567 PMCID: PMC105303 DOI: 10.1128/jcm.36.11.3211-3216.1998] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
An assay which combines the direct detection of Ureaplasma urealyticum with biovar determination was developed and applied to 618 urogenital specimens. U. urealyticum was detected by inhibitor-controlled PCR. A 429-bp fragment of the urease gene was amplified. The amplicons were labelled with digoxigenin during PCR. Biovar determination was performed by liquid hybridization with biotin-labelled biovar-specific probes, and the hybrids were detected with peroxidase-conjugated sheep anti-digoxigenin immunoglobulin G Fab fragments. Results of PCR and culture for 453 urogenital specimens from women and 105 urethral specimens from men could be compared. Among the specimens from women, 63% were PCR positive as well as culture positive, 0.9% were positive only by PCR, and 4% were positive only by culture. Among the specimens from men, 15% were PCR positive as well as culture positive, 1% were positive only by PCR, and 9% were positive only by culture. By using culture as the reference method, the PCR had a sensitivity of 94% and a specificity of 98% when applied to specimens from women and a sensitivity of 64% and a specificity of 99% when applied to specimens from men. Overall, 80% of the PCR-positive specimens contained biovar 1,13.5% contained biovar 2, and 6.5% contained both biovars.
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Affiliation(s)
- K Povlsen
- Mycoplasma Laboratory, Neisseria Department, Statens Serum Institut, Copenhagen, Denmark.
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14
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Cunningham CK, Bonville CA, Hagen JH, Belkowitz JL, Kawatu RM, Higgins AM, Weiner LB. Immunoblot analysis of anti-Ureaplasma urealyticum antibody in pregnant women and newborn infants. CLINICAL AND DIAGNOSTIC LABORATORY IMMUNOLOGY 1996; 3:487-92. [PMID: 8877123 PMCID: PMC170394 DOI: 10.1128/cdli.3.5.487-492.1996] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The purpose of the present study was to determine the frequency in which antibody reactive to Ureaplasma urealyticum could be detected in a population of pregnant women and newborn infants. Serum samples from a prospective cohort of 80 healthy, U. urealyticum culture-positive and culture-negative pregnant women and a retrospective cohort of 522 infants born at between 25 and 42 weeks of gestation were studied by immunoblot analysis. Cultures of specimens from the lower genital tract were positive for U. urealyticum for 83% of the pregnant women, and serum immunoglobulin G (IgG) antibody which reacted to U. urealyticum was detectable in 93% of the pregnant women. Samples from five women (8%) had increases in the number of anti-U. urealyticum IgG bands over the course of the pregnancy. Samples from four of these five women had corresponding increases in the number of antibody bands present in IgA immunoblots. Six of the 522 samples from newborns or cord blood (1.1%) were positive for anti-U. urealyticum IgA; 5 of these 6 samples were also positive for IgM. The six anti-U. urealyticum IgA-positive infants were distributed as follows; 3 of 67 (4.5%) infants were delivered at 25 to 30 weeks of gestation, 3 of 176 (1.7%) infants were delivered at 31 to 34 weeks of gestation, and 0 of 279 infants were delivered at > or = 35 weeks of gestation. An antibody response to U. urealyticum can be detected in pregnant women and preterm infants and may serve as a marker of infection.
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Affiliation(s)
- C K Cunningham
- Department of Pediatrics, State University of New York Health Science Center at Syracuse.
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15
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Abele-Horn M, Blendinger C, Becher C, Emmerling P, Ruckdeschel G. Evaluation of commercial kits for quantitative identification and tests on antibiotic susceptibility of genital mycoplasmas. ZENTRALBLATT FUR BAKTERIOLOGIE : INTERNATIONAL JOURNAL OF MEDICAL MICROBIOLOGY 1996; 284:540-9. [PMID: 8899972 DOI: 10.1016/s0934-8840(96)80005-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
In this study, commercial media and kits for identification and tests for antibiotic susceptibility of genital mycoplasmas were evaluated in comparison to standardized methods. A total of 298 specimens was routinely enrolled. Our results showed that all media corresponded for qualitative and semiquantitative identification with a specificity of 100% for both microorganisms and a sensitivity of 94% for U. urealyticum and of 88% for M. hominis. Standard methods were superior to commercial kits for qualitative and quantitative identification (sensitivity 85-97% for U. urealyticum and 79-83% for M. hominis). There were large discrepancies when testing antibiotic susceptibility.
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Affiliation(s)
- M Abele-Horn
- Max von Pettenkofer-Institute, Ludwig-Maximillans-University, Munich, Germany
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16
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Abele-Horn M, Wolff C, Dressel P, Zimmermann A, Vahlensieck W, Pfaff F, Ruckdeschel G. Polymerase chain reaction versus culture for detection of Ureaplasma urealyticum and Mycoplasma hominis in the urogenital tract of adults and the respiratory tract of newborns. Eur J Clin Microbiol Infect Dis 1996; 15:595-8. [PMID: 8874078 DOI: 10.1007/bf01709369] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The efficiency of the polymerase chain reaction (PCR) was compared with that of culture for detection of Ureaplasma urealyticum and Mycoplasma hominis in 726 clinical specimens comprising 189 gynecological samples, 362 urological samples, and 175 samples from newborn infants. The sensitivity of PCR versus culture was 95% for both organisms, while the sensitivity of culture versus PCR was 91% for Ureaplasma urealyticum and 84% for Mycoplasma hominis. Furthermore, PCR tests were faster than culture tests, allowing the time to diagnosis to be reduced from two to five days to 24 h.
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Affiliation(s)
- M Abele-Horn
- Max von Pettenkofer Institute, Ludwig-Maximilians-University, Munich, Germany
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17
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Cassell GH, Waites KB, Watson HL, Crouse DT, Harasawa R. Ureaplasma urealyticum intrauterine infection: role in prematurity and disease in newborns. Clin Microbiol Rev 1993; 6:69-87. [PMID: 8457981 PMCID: PMC358267 DOI: 10.1128/cmr.6.1.69] [Citation(s) in RCA: 246] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Ureaplasma urealyticum, a common commensal of the urogenital tract of sexually mature humans, is gaining recognition as an important opportunistic pathogen during pregnancy. While its etiologic significance in many aspects of adverse pregnancy remains controversial, recent evidence indicates that U. urealyticum in the absence of other organisms is a cause of chorioamnionitis. Furthermore, ureaplasmal infection of the chorioamnion is significantly associated with premature spontaneous labor and delivery. In at least some cases, it appears to be causal. Present evidence indicates that U. urealyticum is a cause of septicemia, meningitis, and pneumonia in newborn infants, particularly those born prematurely. There is strong but not definitive evidence that ureaplasmal infection of the lower respiratory tract can lead to development of chronic lung disease in very low-birth-weight infants. Although risk factors for colonization of the lower genitourinary tract have been identified, little information is available concerning risk factors for intrauterine infection and host immune responses to invasive infection. Recent establishment of animal models of respiratory and central nervous system diseases should provide an opportunity to evaluate risk factors, pathogenic mechanisms, and operative immune mechanisms. However, the most critical need is additional information concerning indications for diagnosis and treatment as well as efficacy of treatment.
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Affiliation(s)
- G H Cassell
- Department of Microbiology, University of Alabama, Birmingham 35294
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Stary A, Gschnait F. Nonspecific Urethral Infections and Reiter’s Syndrome. Sex Transm Dis 1989. [DOI: 10.1007/978-1-4612-3528-6_9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Liepmann MF, Wattre P, Dewilde A, Papierok G, Delecour M. Detection of antibodies to Ureaplasma urealyticum in pregnant women by enzyme-linked immunosorbent assay using membrane antigen and investigation of the significance of the antibodies. J Clin Microbiol 1988; 26:2157-60. [PMID: 3183001 PMCID: PMC266836 DOI: 10.1128/jcm.26.10.2157-2160.1988] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Optimal conditions of a microenzyme-linked immunosorbent assay using a group-specific membrane antigen of Ureaplasma urealyticum serotype 7 were established with rabbit antisera and applied for the evaluation of immunoglobulin M (IgM) and IgG antibodies in 139 serum specimens from pregnant women between 26 and 38 weeks of gestation, and the assay was compared with microorganism culture and investigated to determine the role of U. urealyticum in perinatal morbidity and mortality. U. urealyticum was isolated from 75 (54%) of 139 patients; 40 had a colonization greater than or equal to 10(6) cells per ml of swab (29%); 64 (85%) of 75 culture-positive patients had IgG antibodies (absorbance mean, 0.650), versus 4 (6%) of 64 culture-negative patients (absorbance mean, 0.103) (P less than 0.001). There was no cross-reactivity with Chlamydia trachomatis infection from patients from whom no mycoplasmas were isolated, but this cross-reactivity occurred in 24% of patients with other mycoplasma infections. There was a good correlation between quantitative evaluation of U. urealyticum colonization and antibody level (P less than 0.05). However, IgM antibody was found in 30% of culture-positive patients but also in 25% of the culture-negative group. Frequency of U. urealyticum colonization was greater in unmarried young women (less than 25 years old) with a history of genital infection, and a significantly greater frequency was detected in patients who smoked (P less than 0.01) and had a lower socioeconomic status (P less than 0.001). A lower infant birth weight was more associated with U. urealyticum colonization greater than or equal to 10(5) cells per ml. The enzyme-linked immunosorbent assay provided an additional means to diagnose and evaluate U. urealyticum infection in pregnant women.
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Affiliation(s)
- M F Liepmann
- Service de Bactériologie-Virologie B du Centre Hospitalier, Universitaire et de l'Institut Pasteur, France
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Waites KB, Rudd PT, Crouse DT, Canupp KC, Nelson KG, Ramsey C, Cassell GH. Chronic Ureaplasma urealyticum and Mycoplasma hominis infections of central nervous system in preterm infants. Lancet 1988; 1:17-21. [PMID: 2891889 DOI: 10.1016/s0140-6736(88)91002-1] [Citation(s) in RCA: 143] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
In a prospective study of meningitis in 100 predominantly preterm infants, Ureaplasma urealyticum was isolated from the cerebrospinal fluid (CSF) of 8 and Mycoplasma hominis from the CSF of 5 babies undergoing investigation of suspected sepsis or treatment of hydrocephalus. U urealyticum was isolated from 6 infants with severe intraventricular haemorrhage and from 3 with hydrocephalus. In 4 babies multiple isolations were made over several weeks. There were clinical features of congenital infection with major neurological impairment in 1 infant infected with M hominis. Diagnosis is difficult because these organisms cannot be seen on gram stain and cannot readily be cultivated on routine bacteriological media, and CSF pleocytosis may be absent. This study, which used appropriate mycoplasmal media, shows that U urealyticum and M hominis are the most common microorganisms isolated from the CSF of newborn infants in a high-risk population.
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Affiliation(s)
- K B Waites
- Department of Microbiology, University of Alabama, School of Medicine, Birmingham
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Lee GY, Kenny GE. Humoral immune response to polypeptides of Ureaplasma urealyticum in women with postpartum fever. J Clin Microbiol 1987; 25:1841-4. [PMID: 3667910 PMCID: PMC269352 DOI: 10.1128/jcm.25.10.1841-1844.1987] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
We investigated the antibody response in women with postpartum fever from whom Ureaplasma urealyticum had been isolated from the bloodstream. Acute- and convalescent-phase sera were tested for immunoglobulin G to the polypeptides of five serovars (1, 2, 3, 4, and 8), representing the two genomic clusters of U. urealyticum, by the immunoblotting (Western) method. Convalescent-phase sera from the five patients reacted more intensely and with more (up to 27) polypeptides from each of the five serovars, whereas acute-phase sera reacted weakly and with few polypeptides. Although antibody responses in these women with systemic infection could be detected by the use of any of the five different serovars as antigens, the patterns that were produced differed clearly between the two genetic clusters (serovars 1 and 3 versus serovars 2, 4, and 8). Apparently, a single serovar could be used to detect ureaplasmal antibodies in humans regardless of the serovar of the infecting strain.
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Affiliation(s)
- G Y Lee
- Department of Pathobiology SC-38, School of Public Health and Community Medicine, University of Washington, Seattle 98195
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Brown MB, Cassell GH, McCormack WM, Davis JK. Measurement of antibody to Mycoplasma hominis by an enzyme-linked immunoassay and detection of class-specific antibody responses in women with postpartum fever. Am J Obstet Gynecol 1987; 156:701-8. [PMID: 3826222 DOI: 10.1016/0002-9378(87)90082-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The standard conditions for detection of human IgG, IgM, and IgA antibodies to Mycoplasma hominis by an enzyme-linked immunosorbent assay (ELISA) were established with the use of a cell lysate antigen and alkaline phosphatase conjugates. Antigen was used at a concentration of 10 micrograms of protein per milliliter, sera were diluted 1:200, and conjugates were diluted 1:500. Agreement between cultured isolation of M. hominis from the lower genital tract and presence of antibody in 207 women was 71%, 82%, and 86% for IgG, IgM, and IgA, respectively. When the ELISA was compared with the mycoplasmacidal assay, an overall agreement of 81% occurred, with the majority of the discrepancies occurring in the ELISA-positive and mycoplasmacidal-negative category. A linear relationship between end point titer and the A400 value (ELISA or absorbance value at 400 nm) at a standard serum dilution was demonstrated for the IgG, IgM, and IgA classes. Although the ELISA was relatively independent of antigen heterogeneity, no single strain detected more than 87% of positive sera, thus suggesting that optimum detection of antibody to M. hominis by the ELISA will require use of antigen pools derived from multiple strains of M. hominis.
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Cassell GH, Davis JK, Waites KB, Rudd PT, Talkington D, Crouse D, Horowitz SA. Pathogenesis and significance of urogenital mycoplasmal infections. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 1987; 224:93-115. [PMID: 3329816 DOI: 10.1007/978-1-4684-8932-3_10] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
U. urealyticum and M. hominis can no longer be considered as harmless commensals of the lower genitourinary tract. Both can produce disease in humans. Diagnosis and management of infections due to these organisms must be based upon isolation of the organisms from the affected site and preferably the number of organisms present. Due to the frequent resistance of both organisms to tetracycline, treatment must be based upon appropriate antibiotic sensitivities. For a more detailed description of the basic biology of these organisms and isolation and identification and treatment, the reader is referred to several recent reviews.
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Affiliation(s)
- G H Cassell
- Department of Microbiology, University of Alabama School of Medicine, Birmingham, Alabama 35294
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Intravenous gammaglobulin for immunodeficiency: report from The European Group for Immunodeficiencies (EGID). Clin Exp Immunol 1986; 65:683-90. [PMID: 2430746 PMCID: PMC1542496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Physicians treating patients with antibody deficiency now have a choice between intravenous (IVIG) and intramuscular immunoglobulin therapy. The published comparative trials suggest that (IVIG) is superior, and this is supported by numerous anecdotal observations. Reactions during infusions are no longer a major problem, but there is concern over the transmission of viruses, particularly those causing non-A non-B hepatitis. Having solved the technical difficulties of bulk manufacture of IgG concentrates for intravenous use, our attention should now be directed towards preventing viral contamination by both modifying the manufacturing processes and screening the donors for evidence of disease.
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Grenabo L, Claes G, Hedelin H, Pettersson S. Rapidly recurrent renal calculi caused by Ureaplasma urealyticum: a case report. J Urol 1986; 135:995-7. [PMID: 3959253 DOI: 10.1016/s0022-5347(17)45953-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
We report on a patient operated upon 8 times for recurrent bilateral struvite stones. Multiple conventional bacterial cultures had been negative. No etiological agent for the rapidly recurring concrements could be detected until Ureaplasma urealyticum cultures were performed at the time of the seventh operation. Ureaplasma urealyticum was found in the bladder and renal pelvic urine, and in the stones. That operation was followed by appropriate antibiotic treatment (doxycycline), which eradicated the microorganism and no stones recurred for 6 months. The urinary pH, which constantly had been highly alkaline before treatment, was normal as was the ammonium loading test. However, 1 year after the seventh operation the Ureaplasma infection recurred, probably due to sexual transmittance, and a new renal stone was discovered. These findings strongly suggest that Ureaplasma urealyticum can induce the formation of infection concrements.
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Abstract
We report a case of calculi in a Skene's gland abscess produced by Ureaplasma urealyticum. The enzyme urease, produced by the Ureaplasma urealyticum, is thought to be the etiological factor in stone production, vaginitis and urethritis.
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Gibbs RS, Cassell GH, Davis JK, St Clair PJ. Further studies on genital mycoplasmas in intra-amniotic infection: blood cultures and serologic response. Am J Obstet Gynecol 1986; 154:717-26. [PMID: 3515945 DOI: 10.1016/0002-9378(86)90442-4] [Citation(s) in RCA: 34] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Mycoplasma hominis is recovered significantly more often in amniotic fluid of women with intra-amniotic infection than in matched control women, but Ureaplasma urealyticum is found in 50% of amniotic fluid samples of both groups. To gain further understanding, we performed blood cultures for genital mycoplasmas and measured serologic responses by a micro enzyme-linked immunosorbent assay method in women with intra-amniotic infection and in control subjects. In blood cultures of 81 women with intra-amniotic infection, M. hominis was isolated in two (2.5%) and U. urealyticum in 11 (13.6%). In 44 control blood cultures, M. hominis was not isolated, and U. urealyticum was recovered in eight (18.2%). These differences were not significant. Serologic response was determined in 86 patients. Rise in antibody to M. hominis was significantly more common in women with intra-amniotic infection and M. hominis in the amniotic fluid than in either women with intra-amniotic infection or control patients without M. hominis. For U. urealyticum antibody response was significantly more common in the intra-amniotic infection group than in control subjects, but there was no association between antibody response and isolation of this organism in amniotic fluid. When M. hominis was found in amniotic fluid or maternal blood, patients were nearly always symptomatic. The high likelihood of serologic response in these cases supports a pathogenic role of M. hominis in intra-amniotic infection. The role of U. urealyticum remains unclear.
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Wiley CA, Quinn PA. Enzyme-linked immunosorbent assay for detection of specific antibodies to Ureaplasma urealyticum serotypes. J Clin Microbiol 1984; 19:421-6. [PMID: 6201503 PMCID: PMC271078 DOI: 10.1128/jcm.19.3.421-426.1984] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Optimal conditions of a micro-enzyme-linked immunosorbent assay system for the detection of immunoglobulin G antibodies to Ureaplasma urealyticum were established with rabbit antisera. Initially, the antisera, raised against eight U. urealyticum serotypes grown on medium containing horse serum, displayed nonspecific reactions with our enzyme-linked immunosorbent assay antigens. Substitution of fetal bovine serum in the medium eliminated this nonspecificity. The assay was then serotype-specific for the original eight U. urealyticum serotypes. The prominent homologous reaction was easily differentiated from the heterologous reactions. A one-way cross-reaction was observed with serotype 2 antiserum and serotype 5 antigen. The results were reproducible and could be obtained in 4 h with only 10 microliters of serum for eight serotypes. Optimal antigen concentrations for the U. urealyticum serotypes ranged from 0.40 to 1.60 micrograms/ml. Our results indicated that enzyme-linked immunosorbent assay has the potential for the detection of antibodies to specific serotypes of U. urealyticum.
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Kilian M, Brown MB, Brown TA, Freundt EA, Cassell GH. Immunoglobulin A1 protease activity in strains of Ureaplasma urealyticum. ACTA PATHOLOGICA, MICROBIOLOGICA, ET IMMUNOLOGICA SCANDINAVICA. SECTION B, MICROBIOLOGY 1984; 92:61-4. [PMID: 6369873 DOI: 10.1111/j.1699-0463.1984.tb02794.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Thirteen serovars of Ureaplasma urealyticum were analyzed for the ability to cleave human IgA. Strains of all of the serovars tested cleaved IgA 1 in the hinge region of the alpha-chain, resulting in intact Fc and monomeric Fab fragments. IgA 1 protease activity was also observed in concentrated cell-free extracts of spent cultivation medium, indicating that the IgA 1 protease was excreted into the medium during growth of the micro-organisms. Five clinical isolates of U. urealyticum obtained from urine, cervix, vagina, amniotic fluid, and synovial fluid were positive for IgA 1 protease activity. No proteolytic activity was observed against human IgA 2, IgG, or IgM. Strains of Mycoplasma fermentans, M. salivarium and seven serovars of M. hominis were negative for IgA 1 protease activity.
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Taylor-Robinson D. Mycoplasma infections of the human urogenital tract with particular reference to non-gonococcal urethritis. ANNALES DE MICROBIOLOGIE 1984; 135A:129-34. [PMID: 6712055 DOI: 10.1016/s0769-2609(84)80069-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The criteria which need to be fulfilled before regarding a microorganism as a cause of non-gonococcal urethritis (NGU) are considered in relation to Mycoplasma hominis, Ureaplasma urealyticum and M. genitalium. There is no evidence to support an aetiological role for M. hominis, but few appropriate investigations have been undertaken. The criteria have been met, for the most part, in the case of U. urealyticum, but further quantitative studies are required. The role of M. genitalium is unknown, but its biological and morphological features and ability to cause genital disease in animals suggest that it may be pathogenic for man. It is emphasized that the criteria for regarding a microorganism as a cause of NGU should also be used where feasible when investigating the infectious aetiology of other genito-urinary conditions.
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Minion FC, Brown MB, Cassell GH. Identification of cross-reactive antigens between Mycoplasma pulmonis and Mycoplasma arthritidis. Infect Immun 1984; 43:115-21. [PMID: 6690399 PMCID: PMC263396 DOI: 10.1128/iai.43.1.115-121.1984] [Citation(s) in RCA: 29] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Serological cross-reactivity between Mycoplasma pulmonis and Mycoplasma arthritidis was investigated by enzyme-linked immunosorbent assay, immunoanalysis of electrophoretic blots, and protein A immunoprecipitation reactions. The results demonstrate that one-way cross-reactivity was present in both hyperimmunized and naturally infected rats and that the predominant cross-reactive antigens were M. pulmonis surface proteins. Distinct immunoblot patterns were demonstrated for M. pulmonis and M. arthritidis, allowing differentiation of the two species. The response to M. arthritidis antigens during natural infections differed greatly from that during hyperimmunization. Evidence suggested that nonprotein antigens were major determinants eliciting the antibody response to this mycoplasma.
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Taylor-Robinson D. The role of mycoplasmas in non-gonococcal urethritis: a review. THE YALE JOURNAL OF BIOLOGY AND MEDICINE 1983; 56:537-43. [PMID: 6433572 PMCID: PMC2590532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
The criteria that need to be fulfilled before regarding a mycoplasma as a cause of non-gonococcal urethritis (NGU) are outlined. Of the seven mycoplasmas that have been isolated from the human genitourinary tract, most cannot be considered as contenders for causing NGU. Although there is no evidence to support an etiological role for Mycoplasma hominis, it may be unwise to ignore this mycoplasma in view of its known pathogenicity in other situations. The cumulative weight of evidence indicates that strains of Ureaplasma urealyticum (ureaplasmas) cause NGU in some patients. The reason for their occurrence in the urethra of some men without disease needs to be established. Ureaplasmas do not seem to cause post-gonococcal urethritis. The role in NGU of M. genitalium, newly discovered in the male urethra, is unknown, but its biological features, morphological appearance, and ability to cause genital disease in marmosets suggest that it may be pathogenic for man.
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