Ureaplasma parvum vulvovaginal infections

Ureaplasma parvum has been identified as a commensal microbiome in a healthy human uterus. Ureaplasma are part of the Mycoplasma family of bacteria, lacking a cell wall. This lack of cell wall makes these tiny microbes osmotically fragile.

Mycoplasmas have the smallest genome that we know of so far, being the smallest required for independent life.

U. parvum can be found inside human cells (intracellularly), meaning they can get into and survive in human cells without being attacked by our immune systems. They have an affinity for the urogenital tract of humans, and survive in the epithelial cells that line the vagina, vulva and urinary tract. U. parvum can be found outside the genitourinary tract, but less commonly, and typically where the immune system has been compromised.

U. parvum is known to be sexually transmitted, but can be transmitted to babies during birth. It is possible in those circumstances for mycoplasmas to survive in a child into adulthood.

Infection with mycoplasmas closely resembles that of Chlamydia trachomatis and Neisseria gonorrhoeae (chlamydia and gonorrhoea) in terms of who it affects.

Genital mycoplasmas can all vary the immunogenic proteins on their cell surface, which is likely how these microbes avoid our immune system and can persist for months or years in one person. U. parvum is a coloniser, with several genes coding for surface proteins, with the most important being Multiple Banded Antigen (MBA).

U. parvum was formerly known as Ureaplasma urealyticum biovar. 

Testing for U. parvum

The best test is a PCR test, as U. parvum is very difficult to culture and requires special medium. Most labs are not equipped with these special tools.

Genital mycoplasmas include:

• Ureaplasma spp.
• Mycoplasma hominis – can cause vulvovaginal infections and infections post-birth, can be cultured, but sensitivity is poor
• Mycoplasma genitalium – cause of urethritis and endocervicitis, pelvic inflammatory disease (PID), cannot be cultured at all outside research labs
• Ureaplasma urealyticum – causes urethritis
• Ureaplasma parvum

Possible ammonia odour – urease positive.

U. parvum can cause inflammation^​1​. U. parvum is associated with preterm birth^​1,2​. U. urealyticum is linked with male infertility^​3,4​ and bacterial vaginosis (BV), with that effect increasing with the joint efforts of U. parvum^​5​.

Ureaplasma species can form biofilms (in vitro at least), with biofilms strengthening antibiotic resistance^​6​.

References