Chapter 10 : Ureaplasma Infection

MyBook is a cheap paperback edition of the original book and will be sold at uniform, low price.

Preview this chapter:
Zoom in

Ureaplasma Infection, Page 1 of 2

| /docserver/preview/fulltext/10.1128/9781555818210/9781555811327_Chap10-1.gif /docserver/preview/fulltext/10.1128/9781555818210/9781555811327_Chap10-2.gif


The most controversial area in mycoplasmology today continues to be the potential role of in adverse pregnancy outcome in humans. can be isolated from the cervix and vagina in 52 to 76% of postpubertal girls in the absence of symptoms. Since 1970, 13 studies involving approximately 12,000 patients have been conducted to evaluate the role of cervical ureaplasmal infection in premature birth. Analysis of amniocentesis samples taken for prenatal diagnosis in the first or second trimester revealed in the amniotic fluid, in the presence of intact membranes and in the absence of other microorganisms. Two prospective studies were conducted to evaluate the presence of ureaplasmas at the time of genetic amniocentesis at 12 to 20 weeks gestation when membranes were intact and there was no labor. Histologic evidence of chorioamnionitis was present in all 10 placentas and histologic evidence of pneumonia was present in all 9 fetuses. The isolation of organisms from the chorioamnion and/or amniotic fluid was associated with microscopic chorioamnionitis but not with clinical amnionitis. Risk factors for colonization of the female lower genital tract include younger age, lower socioeconomic status, sexual activity with multiple partners, black ethnicity, and oral contraceptive use. Until there is widespread awareness of and acceptance of how common mycoplasmal infections of the central nervous system can be, knowledge of what group is at risk for infection, and development of improved diagnostic capabilities, it is likely that the majority of cases will not be identified.

Citation: Cassell G. 1999. Ureaplasma Infection, p 175-193. In Hitchcock P, MacKay H, Wasserheit J, Binder R (ed), Sexually Transmitted Diseases and Adverse Outcomes of Pregnancy. ASM Press, Washington, DC. doi: 10.1128/9781555818210.ch10
Highlighted Text: Show | Hide
Loading full text...

Full text loading...


1. Blanchard, A.,, J. Hentschel,, L. Duffy,, K. Baldus,, and G. H. Cassell. 1993. Detection of Ureaplasma urealyticum by polymerase chain reaction in the urogenital tract of adults, in amniotic fluid, and in the respiratory tract of newborns. Clin. Infect. Dis. 17: S148 S153.
2. Brus, F.,, W. M. van Waarde,, C. Schoots,, and S. B. Oetomo. 1991. Fetal ureaplasmal pneumonia and sepsis in a newborn infant. Eur. J. Pediatr. 150: 782 783.
3. Cartner, S. C.,, J. W. Simecka,, D. E. Briles,, G. H. Cassell,, and J. R. Lindsey. 1996. Resistance to mycoplasmal lung disease in mice is a complex genetic trait. Infect. Immun. 64: 5326 5331.
4. Cassell, G. H. 1981
5. Cassell, G. H.,, and B. C. Cole. 1981a. Mycoplasmas as agents of human disease. N. Engl. J. Med. 304: 80 89.
6. Cassell, G. H.,, and A. Hill,. 1979. Murine and other small animal mycoplasmas, p. 235 273. In J. G. Tully, and R. F. Whitcomb (ed.), The Mycoplasmas, vol. 2. Human and Animal Mycoplasmas. Academic Press, Inc., New York, N.Y.
7. Cassell, G. H.,, J. R. Lindsey,, R. G. Overcash,, and H. J. Baker. 1973. Murine Mycoplasma respiratory disease. Ann. N. Y. Acad. Sci. 225: 395 412.
8. Cassell, G. H.,, J. R. Lindsey,, and H. J. Baker,. 1979a. Mycoplasmal and rickettsial disease, p. 243 269. In H. J. Baker,, J. R. Lindsey,, and S. H. Weisbroth (ed.), The Laboratory Rat, vol. I. Academic Press, Inc., New York, N.Y.
9. Cassell, G. H.,, R. O. Davis,, K. B. Waites,, M. B. Brown,, P. A. Marriott,, S. Stagno,, and J. K. Davis. 1983a. Isolation of Mycoplasma hominis and Ureaplasma urealyticum from amniotic fluid at 16-20 weeks gestation: potential effect on outcome of pregnancy. Sex. Transm. Dis. 10( 4S): 294 302.
10. Cassell, G. H.,, J. B. Younger,, M. B. Brown,, R. E. Blackwell,, J. K. Davis,, P. Marriott,, and S. Stagno. 1983b. Microbiologic study of infertile women at the time of diagnostic laparoscopy: association of Ureaplasma urealyticum with a defined sub-population. N. Engl. J. Med. 308: 502 505.
11. Cassell, G. H.,, K. B. Waites,, R. S. Gibbs,, and J. K. Davis. 1986. The role of Urea-plasma urealyticum in amnionitis. Pediatr. Infect. Dis. J. 5: S247 S252.
12. Cassell, G. H.,, D. T. Crouse,, K. B. Waites,, P. T. Rudd,, and J. K. Davis. 1988a. Does Ureaplasma urealyticum cause respiratory disease in newborns? Pediatr. Infect. Dis. J. 7: 535 541.
13. Cassell, G. H.,, K. B. Waites,, D. T. Crouse,, P. T. Rudd,, K. C. Canupp,, S. Stagno,, and G. Cutter. 1988b. Association of Ureaplasma urealyticum infection of the lower respiratory tract with chronic lung disease and death in very-low-birthweight infants. Lancet ii: 240 245.
14. Cassell, G. H.,, K. B. Waites,, H. L. Watson,, D. T. Crouse,, and R. Harasawa. 1993. Ureaplasma urealyticum intrauterine infection: role in prematurity and disease in the newborn. Clin. Microbiol. Rev. 6: 69 87.
15. Cassell, G. H.,, K. B. Waites,, and D. T. Crouse,. 1994. Mycoplasmal infections, p. 619 655. In J. S. Remington, and J. O. Klein (ed.), Infectious Disease of the Fetus and Newborn Infant. The W. B. Saunders Co., Philadelphia, Pa.
16. Crouse, D. T.,, G. H. Cassell,, K. B. Waites,, J. M. Foster,, and G. Cassady. 1990. Hyperoxia potentiates Ureaplasma urealyticum pneumonia in newborn mice. Infect. Immun. 58: 3487 3493.
17. Crouse, D. T.,, G. T. Odrezin,, G. R. Cutter,, J. M. Reese,, W. B. Hamrick,, K. B. Waites,, and G. H. Cassell. 1993. Radiographic changes associated with tracheal isolation of Ureaplasma urealyticum from neonates. Clin. Infect. Dis. 17: S122 S130.
18. Davis, J. K.,, R. B. Thorp,, P. A. Maddox,, M. B. Brown,, and G. H. Cassell. 1982. Murine respiratory mycoplasmosis in F344 and LEW rats: evolution of lesions and lung lymphoid cell populations. Infect. Immun. 36: 720 729.
19. Davis, J. K.,, R. F. Parker,, H. White,, D. Dziedzic,, G. Taylor,, M. K. Davidson,, N. R. Cox,, and G. H. Cassell. 1985. S train differences in susceptibility to murine res-piratory mycoplasmosis in C57BL/6 and C3H/HeN mice. Infect. Immun. 50: 647 654.
20. Dyke, M. P.,, A. Grauaug,, R. Kohan,, K. Ott,, and R. Andrews. 1993. Ureaplasma urealyticum in a neonatal intensive care population. J. Paediatr. Child Health. 29: 295 297.
21. Embree, J. E.,, V. W. Krause,, J. A. Embil,, and S. McDonald. 1980. Placental infection with Mycoplasma hominis and Ureaplasma urealyticum: clinical correlation. Obstet. Gynecol. 56: 475 481.
22. Eschenbach, D. 1989. Bacterial vaginosis. Obstet. Gynecol. Clin. North Am. 16: 593.
23. Eschenbach, D. A. 1993 . Ureaplasma urealyticum and premature birth. Clin. Infect. Dis. 17(Suppl. 1): S100 S106.
24. Foulon, W.,, A. Naessens,, M. Dewaele,, S. Lauwers,, and J. J. Amy. 1986. Chronic Ureaplasma urealyticum amnionitis associated with abruptio placentae. Obstet. Gynecol. 68: 280.
25. Fraser, L. R.,, and D. Taylor-Robinson. 1977. The effect of Mycoplasma pulmonis on fertilization and preimplantation development in vitro of mouse eggs. Fertil. Steril. 28: 488 498.
26. Garland, S. M.,, and L. J. Murton. 1987. Neonatal meningitis caused by Ureaplasma urealyticum. Pediatr. Infect. Dis. J. 6: 868 870.
27. Gravett, M. G.,, and D. A. Eschenbach. 1986. Possible role of Ureaplasma urealyticum in preterm premature rupture of fetal membranes. Pediatr. Infect. Dis. J. 5: S253 S257.
28. Gravett, M. G.,, D. Hummel,, D. Eschenbach,, and K. K. Holmes. 1986a. Preterm labor associated with subclinical amniotic fluid infection and with bacterial vaginosis. Obstet. Gynecol. 67: 229 237.
29. Gray, D. J.,, H. B. Robinson,, and J. Malone. 1992. Adverse outcome in pregnancy following amniotic fluid isolation of Ureaplasma urealyticum. Prenatal Diagn. 12: 111 117.
30. Hektoen, L. 1915–1918. Observations on pulmonary infections in rats, 1915–1918. Trans. Chicago Pathol. Soc. 10: 105 108.
31. Hillier, S. L.,, J. Martius,, M. Krohn,, N. Kiviat,, K. K. Holmes,, and D. A. Eschenbach. 1988. A case-control study of chorioamnionic infection and histologic chorioam-nionitis in prematurity. N. Engl. J. Med. 319: 972 978.
32. Hillier, S. L.,, M. A. Krohn,, N. B. Kiviat,, H. D. Watts,, and D. A. Eschenbach. 1991. Microbiologic causes and neonatal outcomes associated with chorioamnion infec-tion. Am. J. Obstet. Gynecol. 165: 955 961.
33. Izraeli, S.,, Z. Samra,, L. Sirota,, P. Merlob,, and S. Davidson. 1991. Genital myco-plasmas in preterm infants: prevalence and clinical significance. Eur. J. Pediatr. 150: 804 807.
34. Kundsin, R. B.,, S. G. Driscoll,, and R. R. Monson. 1984. Association of Ureaplasma urealyticum in the placenta with perinatal morbidity and mortality. N. Engl. J. Med. 310: 941 945.
35. Likitnukul, S.,, H. Kusmiesz,, J. D. Nelson,, and G. H. McCracken. 1986. Role of genital mycoplasmas in young infants with suspected sepsis. J. Pediatr. 109: 971 974.
36. Likitnukul, S.,, J. D. Nelson,, G. H. McCracken,, and H. Kusmiesz. 1987. Rarity of genital mycoplasma infection in young infants with aseptic meningitis. J. Pediatr. 110: 998.
37. Madan, E.,, M. P. Meyer,, and A. J. Amortegui. 1988. Isolation of genital mycoplasmas and Chlamydia trachomatis in stillborn and neonatal autopsy material. Arch. Pathol. Lab. Med. 112: 749 751.
38. Madan, E.,, M. P. Meyer,, and A. J. Amortegui. 1989. Histologic manifestations of perinatal genital mycoplasmal infection. Arch. Pathol. Lab. Med. 113: 465 469.
39. Mardh, P. A. 1983. Mycoplasma hominis infections of the central nervous system in newborn infants. Sex. Transm. Dis. 10: 331 334.
40. McCormack, W. M. 1986. Ureaplasma urealyticum: ecologic niche and epidemiologic considerations. Pediatr. Infect. Dis. J. 5: S232 S233.
41. Naessens, A.,, W. Foulon,, J. Breynaert,, and S. Lauwers. 1989. Postpartum bacteremia and placental colonization with genital mycoplasmas and pregnancy out-come. Am. J. Obstet. Gynecol. 160: 647 650.
42. Nelson, J. B. 1940a. Infectious catarrh of the albino rat. I. Experimental transmission in relation to the role of Actinobacillus muris. J. Exp. Med. 72: 645 654.
43. Nelson, J. B. 1940b. Infectious catarrh of the albino rat. II. The causal relation of coccobacilliform bodies. J. Exp. Med. 72: 666 662.
44. Ohlsson, A.,, E. Want,, and M. Vearncombe. 1993 . Leukocyte counts and colonization with Ureaplasma urealyticum in prematerm neonates. Clin. Infect. Dis. 17(Suppl. 1): S117 S121.
45. Ollikainen, J.,, H. Heikkaniemi,, M. Korppi,, H. Sarkkinen,, and K. Heinonen . 1993a. Ureaplasma urealyticum infection associated with acute respiratory insufficiency and death in premature infants. J. Pediatr. 122: 756 760.
46. Ollikainen, J.,, H. Heikkaniemi,, M. Korppi,, M. L. Katila,, and K. Heinonen . 1993b. Ureaplasma urealyticum cultured from brain tissue of preterm twin who died of intraventricular hemorrhage. Scand. J. Infect. Dis. 25: 529 531.
47. Parker, R. F.,, J. K. Davis,, G. H. Cassell,, H. White,, D. Dziedzic,, D. K. Blalock,, R. B. Thorp,, and J. W. Simecka. 1989. Short-term exposure to nitrogen dioxide enhances susceptibility to murine respiratory mycoplasmosis and decreases intra-pulmonary killing of Mycoplasma pulmonis. Am. Rev. Respir. Dis. 140: 502 512.
48. Payne, N. R.,, S. Steinberg,, P. Ackerman,, B. A. Cheenka,, S. M. Sane,, K. T. Anderson,, and J. J. Fangman. 1993 . New prospective studies of the association of Urea-plasma urealyticum colonization and chronic lung disease. Clin. Infect. Dis. 178(Suppl. 1): S117 S121.
49. Quinn, P. A.,, J. Butany,, M. Chipman,, J. Taylor,, and W. Hannah. 1985a. A prospec-tive study of microbial infection in stillbirths and early neonatal death. Am. J. Obstet. Gynecol. 151: 238 249.
50. Quinn, P. A.,, J. E. Gillian,, T. Markestad, , M. A. St. John, A. Daneman,, K. I. Lie,, H. C. S. Li,, E. Czegledy-Nagy,, and A. M. Klein. 1985b. Intrauterine infection with Ureaplasma urealyticum as a cause of fatal neonatal pneumonia. Pediatr. Infect. Dis. J. 4: 538 543.
51. Romero, R.,, M. Sirtoir,, E. Oyarzun,, C. Avila,, M. Mazor,, R. Callahan,, V. Sabo,, A. P. Athanassiadis,, and J. C. Hobbins. 1989. Infection and labor. V. Prevalence, microbiology, and clinical significance of intraamniotic infection in women with preterm labor and intact membranes. Am. J. Obstet. Gynecol. 161: 817 824.
52. Rudd, P. T.,, and D. Carrington. 1985. A prospective study of chlamydial, myco-plasmal and viral infections in a neonatal intensive care unit. Arch. Dis. Child. 59: 120 125.
53. Rudd, P. T.,, G. H. Cassell,, K. B. Waites,, J. K. Davis,, and L. B. Duffy. 1989. Urea-plasma urealyticum pneumonia: exp eerimental production and demonstration of age-related susceptibility. Infect. Immun. 57: 918 925.
54. Russell, P., 1979. Inflammatory lesions of the human placenta. I. Clinical significance of acute chorioamnionitis. Am. J. Diagn. Gynecol. Obstet. 2: 127 137. Sarff, L. D.,, L. H. Platt,, and G. H. J. McCracken.
55. 1976. Cerebrospinal fluid evalu-ation in neonates: comparison of high-risk infants with and without meningitis. J. Pediatr. 88: 473.
56. Sarff, L. D.,, L. H. Platt,, and G. H. J. McCracken. 1976. Cerebrospinal fluid evaluation in neonates: comparison of high-risk infants with and without meningitis. J. Pediatr. 88: 473.
57. Saxen, H.,, K. Hakkarainen,, M. Pohjavuori,, and A. Miettinen. 1993. Chronic lung disease of preterm infants in Finland is not associated with Ureaplasma urealyticum colonization. Acta Paediatr. 82: 198 201.
58. Shaw, N. J.,, B. C. Pratt,, and A. M. Weindling. 1989. Ureaplasma and mycoplasma infections of central nervous system in preterm infants. Lancet ii: 1530 1531.
59. Sidiropoulos, D.,, U. Herrmann,, A. Morell,, F. P. Koontz,, and L. F. Burmeister. 1986. Transplacental passage of intravenous immunoglobulin in the last trimester of pregnancy. J. Pediatr. 109: 505 508.
60. Simecka, J. W.,, J. K. Davis,, M. K. Davidson,, S. E. Ross,, C. T. K.-H. Städtlaender,, and G. H. Cassell,. 1992. Mycoplasma disease of animals, p. 391 415. In J. Man-iloff,, R. McElhaney,, L. Finch,, and J. Baseman (ed.), Mycoplasmas: Molecular Biology and Pathogenesis. American Society for Microbiology, Washington, D.C.
61. Stancombe, B. B.,, W. F. Walsh,, S. Derdak,, P. Dixon,, and D. Hensley. 1993 . Induc-tion of human neonatal pulmonary fibroblast cytokines by hyperoxia and Urea-plasma urealyticum. Clin. Infect. Dis. 17(Suppl. 1): S154 S157.
62. Tafari, N.,, S. Ross,, and R. L. Naeye. 1976. Mycoplasma ‘T’ stains and perinatal death. Lancet i: 108 109.
63. Taylor-Robinson, D.,, G. W. Csonka,, and M. J. Prentice. 1977. Human intra-urethral inoculation of ureaplasmas. Q. J. Med. 46: 309 326.
64. Taylor-Robinson, D.,, P. M. Furr,, and M. M. Liberman. 1984. The occurrence of genital mycoplasmas in babies with and without respiratory diseases. Acta Paediatr. Scand. 73: 383.
65. Valencia, G. B.,, F. Banzon,, M. Cummings,, W. M. McCormack,, L. Glass,, and M. R. Hammerschlag. 1993. Mycoplasma hominis and Ureaplasma urealyticum in neo-nates with suspected infections. Pediatr. Infect. Dis. J. 12: 571 573.
66. Visser, V. E.,, and R. T. Hall. 1980. L umbar puncture in the evaluation of suspected neonatal sepsis. J. Pediatr. 96: 1063.
67. von Juhr, N.-C. 1971. Untersuchungen zur Chronischen Murinen Pneumonie. Vor-kommen and Resistenz von Mycoplasma pulmonis in der Unweit. Z. Versuchsteirkd. 13: 217 223.
68. Waites, K. B.,, P. T. Rudd,, D. T. Crouse,, K. C. Canupp,, K. G. Nelson,, A. Ramsey,, and G. H. Cassell. 1988. Chronic Ureaplasma urealyticum and Mycoplasma hominis infections of central nervous system in preterm infants. Lancet ii: 17 21.
69. Waites, K. B.,, D. T. Crouse, , J. B. Phillips III,, K. C. Canupp,, and G. H. Cassell. 1989. Ureaplasmal pneumonia and sepsis associated with persistent pulmonary hypertension of the newborn. Pediatrics 83: 79 85.
70. Waites, K. B.,, L. B. Duffy,, D. T. Crouse,, M. E. Dworsky,, M. J. Strange,, K. G. Nelson,, and G. H. Cassell. 1990. Mycoplasmal infections of cerebrospinal fluid in newborn infants from a community hospital population. Pediatr. Infect. Dis. J. 9: 241 245.
71. Walsh, W. F.,, S. Stanley,, K. P. Lally,, R. E. Stribley,, D. P. Greece,, F. McClesky,, and D. M. Null. 1991. Ureaplasma urealyticum demonstrated by open lung biopsy in newborns with chronic lung disease. Pediatr. Infect. Dis. J. 10: 823 827.
72. Walsh, W. F.,, J. Butler,, J. Coalson,, D. Hensley,, G. H. Cassell,, and R. A. Delemos. 1993. A primate model of Ureaplasma urealyticum infection in the premature infant with hyaline membrane disease. Clin. Infect. Dis. 17(Suppl. 1): S158 S162.
73. Watts, D. H.,, M. A. Krohn,, S. L. Hillier,, and D. A. Eschenbach. 1992. The associ-ation of occult amniotic fluid infection with gestational age and neonatal outcome among women in preterm labor. Obstet. Gynecol. 79: 351 357.
74. Zlatnik, F. J.,, T. M. Gellhaus,, J. A. Benda,, G. von Muralt,, and S. Barandun. 1990. Histologic chorioamnionitis, microbial infection, and prematurity. J. Obstet. Gynaecol. 76: 355 359.

This is a required field
Please enter a valid email address
Please check the format of the address you have entered.
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error