[09-031 ] Ureaplasma parvum, DNA [real-time PCR]
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Identification of the causative agent of urogenital ureaplasmosis (Ureaplasma parvum), during which the genetic material (DNA) of the ureaplasma is determined.
Synonyms Russian
The causative agent of ureaplasmosis, ureaplasma.
English synonyms
Ureaplasma parvum, DNA.
Research method
Real-time polymerase chain reaction.
What biomaterial can be used for research?
The first portion of morning urine, scraping from the rectum, urogenital scraping.
General information about the study
The incubation period is 2-5 weeks. Symptoms of ureaplasma infection may be mild or absent altogether (typical for women). In men, ureaplasma parvum can cause inflammation of the urethra (non-gonococcal urethritis), bladder (cystitis), prostate (prostatitis), damage to the testicles (orchitis) and their appendages (epididymitis), disturbances in the composition of sperm (decreased motility and sperm count - which threatens infertility ), as well as reactive arthritis and urolithiasis. In women, ureaplasma parvum can cause inflammation of the vagina (vaginitis), cervix (cervicitis), and when immunity is weakened, inflammation of the uterus (endometritis) and its appendages (adnexitis), which can lead to ectopic pregnancy or infertility. In addition, ureaplasma parvum in pregnant women can cause miscarriages, inflammation of the membranes, the birth of children with low body weight, as well as the cause of the development of bronchopulmonary diseases (pneumonia, dysplasia), bacteremia and meningitis in newborns.
As a cause of inflammatory diseases of the genitourinary system, Ureaplasma parvum is considered if laboratory tests do not reveal other pathogenic microorganisms that can cause these diseases. Differentiating Ureaplasma parvum from another type of ureaplasma - U. urealyticum - can only be done using molecular genetic methods, including polymerase chain reaction. Determining the type of ureaplasma is important when choosing the optimal tactics for treating a patient.
What is research used for?
- To establish the cause of chronic inflammatory diseases of the genitourinary system.
- For the differential diagnosis of diseases caused by sexually transmitted infections and occurring with similar symptoms: chlamydia, gonorrhea, mycoplasma infection (along with other studies).
- To evaluate the effectiveness of antibiotic therapy.
- For preventive examination.
When is the study scheduled?
- If ureaplasma infection and ureaplasmosis are suspected, including after casual sexual intercourse and with symptoms of inflammation of the genitourinary system.
- When planning pregnancy (for both spouses).
- With infertility or miscarriage.
- With an ectopic pregnancy.
- If necessary, evaluate the effectiveness of antibiotic therapy (1 month after treatment).
What do the results mean?
Reference values: negatively.
Positive result
- The detection of Ureaplasma parvum DNA in biomaterial may indicate that this microorganism caused inflammatory diseases of the genitourinary system, only in the presence of symptoms of inflammation and in the absence of other pathogenic microorganisms (chlamydia, mycoplasma, gonococci).
- Detection of Ureaplasma parvum DNA in the absence of symptoms of inflammatory diseases of the genitourinary system is regarded as a carrier.
Negative result
- The absence of Ureaplasma parvum DNA in the studied biomaterial in the presence of symptoms of inflammatory diseases of the genitourinary system indicates that this pathogen is not the cause of these diseases.
What can influence the result?
- Antibacterial therapy.
Bacteria that live on the mucous membranes of the genitals and in the urinary tract.
Medical practice shows that most often ureaplasmosis is detected in the fairer sex than in men. Pathology can be diagnosed in perfectly healthy people, as well as in patients suffering from infectious diseases of the genitourinary system.
Types of bacteria
Recently, more and more often in analyzes they put Ureaplasma spp (or species) - this is a term that combines two species. Because, by and large, it makes no sense to separate them.
Types of ureaplasma are determined only by a genetic test. For this, a biomaterial is taken and carried out (PCR). As a result of the study, the name of the microorganism is issued.
Ureaplasmopositivity
Ureaplasma-positive (Ureaplasma-positive) or carriage is the detection of ureaplasma by laboratory diagnostic methods in the absence of a disease that can be associated with the presence of ureaplasma infection.
Ureaplasma positivity is a fairly common phenomenon, in 2.5% - 30% (according to various sources) of sexually active women (having 2 or more partners per year) and up to 10-20% of sexually active men have ureaplasmas.
Positivity is temporary (transitory) from several hours to several weeks and persistent (months-years, and sometimes all life). Despite the fact that diseases do not develop with ureaplasmopositivity, positivity is considered a risk factor.
Ureaplasma parvum is a bacterium that is considered opportunistic. This suggests that parvum only under certain conditions provokes complications and diseases. Although parvum is not life threatening, the lack of proper treatment can lead to unpleasant consequences. Ureaplasma parvum is more common in women, although this diagnosis is not good news for men either.
Ureaplasma parvum are a type of ureaplasma. Moreover, it acts as the most common. This bacterium used to have a different name - biovar parvo. So in old reference books you will probably find just such a designation for this microorganism.
As soon as parvum infects a person, the disease of ureaplasmosis does not appear immediately. The incubation period usually lasts about a month. By themselves, parvum ureaplasmas are safe if the immune system works well and the body is not infected with other infectious diseases. In this case, ureaplasmosis will not appear, since there are no appropriate favorable conditions for ureaplasma parvum.
Important! Bubnovsky: "There is an effective treatment for ureaplasmosis! The disease will pass in a week if .."
Unfortunately, ureaplasmosis is a potential threat to the children of pregnant women. So the answer to the question of whether it is necessary to treat ureaplasma with parvum is often obvious. Statistics say that ureaplasma is more often transmitted to girls than to boys during childbirth.
What to do if parvum is detected
A prerequisite for an accurate diagnosis is the conduct of appropriate tests and examinations.
Ureaplasma in women is also characterized by the fact that it is often not accompanied by symptoms. Ureaplasma, including parvum, has no specific signs. Therefore, with a superficial examination, it is impossible to accurately determine the cause of the disease.
There are at least two reasons to prescribe treatment in women when diagnosing ureaplasma.
- Ureaplasma in women leads to the development of infectious diseases of the genitourinary system. This affects the urinary and genital tract. As a result, it negatively affects the protective properties of the body. Parvum, when activated, seriously changes the composition of the beneficial microflora for the worse, and also provides easier penetration of other pathogenic microorganisms into the mucous membranes;
- If you do not start treatment for ureaplasmosis, this will entail the development of all sorts of complications. They can negatively affect the work of the excretory and reproductive systems. It is especially important to cure ureaplasmosis when planning pregnancy or in fact during the period of bearing a child.
How to treat ureaplasma, the doctor will tell you in detail. Some believe that the body itself is able to fight off infection. Yes, our immune system can resist the ureaplasma parvum, preventing it from multiplying and going beyond the normal range. But if the body gave a slack, and the parvum became more active, entailed complications, then it is no longer worth counting on self-healing in such a situation.
An important impetus for treatment is the fact that parvum is sexually transmitted. Therefore, even after treatment, repeated contact with the carrier will lead to a new infection. This will continue until you and your sexual partner undergo a course of therapy together.
Treatment features
Treatment of ureaplasma parvum in women has several key features that are extremely important to pay attention to.
- The treatment regimen for ureaplasma is always developed individually. For this, before prescribing drugs, the doctor conducts a comprehensive examination and checks the patients' analyzes. This helps to fully understand the picture of what is happening and identify drugs that will be really effective;
- The mainstay of treatment for ureaplasmosis caused by ureaplasma parvum is antibiotic therapy. Antibiotics are considered the most effective against ureaplasma;
- At the same time, not all antibiotics can help in this or that situation. This is due to the development of resistance to active substances. No antibiotic can guarantee a 100% result;
- Ureaplasma bacteria are highly sensitive to the active substances of drugs. Therefore, drugs are usually prescribed not as a whole complex, but only one medicine is prescribed. If it is selected correctly, then the treatment will be effective and safe for the patient;
- Symptoms and treatment are closely interrelated when choosing therapy. Therefore, during the treatment period, it is important to observe how the patient's body reacts to the chosen tactics of exposure. Therefore, during and after the completion of the course of antibiotics, it is imperative to undergo a second examination and make sure that the ureaplasmas were really destroyed, and not just passed into a latent state;
- This method of therapy involves the destruction of not only opportunistic microorganisms, but also beneficial microflora. Therefore, in no case should antibiotics be taken without the parallel use of probiotics and vitamin complexes. This will help preserve useful microflora and maintain immunity at a sufficiently high level.
Possible consequences
Lack of proper treatment or complete ignorance of the problem of parvum ureaplasma can lead to serious consequences. To a greater extent, this applies to women, although men can also suffer from the vigorous activity of parvum.
The consequences of ureaplasmosis include:
- uterine adhesions;
- abortion;
- fetal developmental disorders during pregnancy;
- female infertility;
- sexual dysfunction in men;
- male infertility;
- pyelonephritis (kidney disease);
- urethritis, etc.
The insidiousness of the disease
Ureaplasmosis, provoked by ureaplasma parvum, can indeed be considered an insidious disease. This is due to the fact that the disease has certain features of the course.
- Initially, ureaplasmosis may not manifest itself at all, allowing a woman not to worry about her health. Ureaplasmosis does not entail menstrual irregularities, no discharge or pain is formed;
- This continues until the immune system weakens. The protective functions of the body can be weakened under the influence of various external and internal reasons - stress, respiratory diseases or undergone surgery, for example. After this, ureaplasmosis makes itself felt;
- Often, the first visible sign of ureaplasmosis is vaginal discharge, which does not have any smell. Gradually, the disease progresses and parvum captures the uterine region. Now abdominal pain joins;
- Soon, the pain gets worse and the discharge smells foul. This suggests that other pathogens and infections have joined the ureaplasmosis. But there is one more insidiousness - such signs are similar to thrush, which misleads both women and doctors;
- Ureaplasmosis also actively manifests itself in the form of pain, burning and discomfort during sexual intercourse and even ordinary urination.
All these are nonspecific symptoms, that is, they are characteristic of other diseases, in addition to ureaplasmosis. How to find out that the problems are caused precisely by ureaplasma parum? Only a comprehensive examination will give you the answer. It is almost impossible to detect ureaplasmosis by external signs.
Ureaplasma parvum in women belongs to the mycoplasma family, is a cross between bacteria and viruses and belongs to opportunistic microflora. The microorganism is found in laboratory tests of healthy people and does not require medical correction if the immune system is normal. Therapy is required with the intensive growth of colonies of pathogenic environments and with the appearance of characteristic symptoms. Ureaplasma parvum is difficult to treat, contributes to the development of an infectious process and unpleasant symptoms.
What it is?
Ureaplasma parvum in women - an infection of the genital tract, the causative agent of which is the simplest microorganisms
Ureaplasma parvum (Ureaplasma parvum) belongs to the genus Mollicutes (the causative agent is mycoplasma hominis), which differ from other species in biochemical, morphophysical and antigenic properties. A few decades ago, these microorganisms were attributed to one species, and only now they are classified into subspecies. The differences from bacteria and viruses are as follows:
- lack of a cell wall;
- tolerance to standard indicators, so they are not detected by typical laboratory methods;
- growing in special nutrient media;
- resistance to antibiotics that affect the cell membrane.
Ureaplasma more often than other types provokes the development of the inflammatory process, but this requires a number of predisposing conditions.
When is pathogenic activity possible?
With an increase in the colonies of protozoa, an inflammatory process occurs, which is supported by the ability of ureaplasmas to break down urea to ammonia. Against the background of pathogenic effects, immunoglobulin A is destroyed - the cells that protect the mucous membranes from infections.
Inflammation is also facilitated by a decrease in immunity, the addition of concomitant infections. Active inflammation always leads to severe symptoms.
Development mechanisms
The mechanisms of development are due to the transmission of infection. Clinicians identify several common routes of infection:
- unprotected sex;
- infection of the child during childbirth;
- intrauterine, when the baby is affected by a sick mother.
In rare cases, it is possible to transmit the infection through the contact-household route, oral-genital, during the transplantation of donor organs.
After Ureaplasma P. enters the body, a person becomes a carrier of pathogenic microflora. The development of inflammation depends on the nature of the infectious process, the activity of the immune system, and the severity of the clinical history. Activation of ureaplasma is possible in newborns with prematurity, immunodeficiency.
The reasons
Among the reasons and various predisposing factors for the onset of the infectious process are:
- chronic inflammation of the organs of the genitourinary system;
- frequent respiratory infections;
- operations on the pelvic organs;
- frequent medical and diagnostic measures (catheterization, instillations, endoscopic examinations);
- long-term drug therapy;
- genital infections;
- dysbiosis of the vagina.
All these factors in one way or another affect the vaginal microflora, contribute to a decrease in immunity. The risk group is not only women, but also men with autoimmune diseases, severe kidney damage and failure against the background of pyelonephritis, nephritis. Given the many causes of infection, it is important to eliminate the direct factor of the disease.
Clinical manifestations
Symptoms are highly variable, and infection is usually latent.
Ureaplasma parvum in most cases provokes the onset of the inflammatory process. The main localization is the organs of the genitourinary system.
Symptoms:
- abundant discharge of mucus and pus from the cervical canal (this symptom also occurs in the case of gardnerella lesion);
- dysuric disorders;
- soreness in the lower abdomen;
- increased pain during menstruation;
- swelling of the mucous membranes of the urethra, vagina;
- signs of intoxication: hyperthermia, malaise.
Often, Ureaplasma parvum has a long latent course, so the disease is discovered by chance. Women are recommended to undergo regular preventive examinations, aimed in particular at identifying pathogenic environments. Ureaplasma plays a special role in the conception of a child and throughout the entire gestational period - when pathogens are detected, it is important to undergo timely therapy.
If clinical manifestations are ignored, inflammation of the ovaries, uterine cavity, infertility may develop. When ureaplasmosis occurs in men, sperm motility is impaired, and the body's resistance is suppressed.
Diagnostic measures
To detect infectious environments, including ureaplasma parvum, a number of the following studies are prescribed:
- Serodiagnostics. The analysis is used to determine antibodies of the IgG, IgA, IgM classes. If the result is positive, they speak of infection. With a low titer, the patient is considered a carrier of the disease.
- Polymerase chain reaction (PCR). Helps to detect bacterial cells, is used to detect even the smallest cell fragments characteristic of the ureaplasma parvum. A positive result indicates a genital infection.
- Bacteriological examination by culture method. In laboratory conditions, urine, a sample from the urethra or vagina, and blood are examined. The material is studied on nutrient media, the crops are incubated in special equipment, after which the grown colonies are studied.
The norm of microorganisms in a smear is 104 CFU. If there are too many bacteria, and the value is seriously higher than the norm, an additional test for antibiotic susceptibility is performed. If a woman is poorly prepared for the study, then false positive results may be obtained. Additional research is possible to exclude errors. The norm is an insignificant increase in units in the field of view (by about 1-2).
Positive results do not always indicate the occurrence of an infection caused by parvum ureaplasma. Women with a burdened gynecological history, problems with conception, miscarriages, premature birth, and unclear symptoms are subject to examination.
Ureaplasma parvum during pregnancy
Ureaplasma parvum in women often provokes infertility, endometriosis, violation of the vaginal microflora
A woman's immunity decreases during pregnancy so that the ovum does not reject. Even with the planning of pregnancy and the complete exclusion of any infectious environments against the background of conception, the risk of ureaplasmosis always remains. With reduced immunity, the likelihood of various diseases increases, including infection by fungi, viruses, bacteria, and protozoa. The pathological process during pregnancy can be accompanied by the following manifestations:
- pathological abnormalities in the formation of organs, systems of the fetus;
- developmental anomalies of a different nature;
- miscarriage, premature birth;
- fetal hypoxia and neurological problems.
At any gestational age, treatment of ureaplasma is difficult due to the need to prescribe etiotropic therapy with antibacterial drugs. Not all antibiotics are suitable against ureaplasma, especially during gestation. In case of premature birth, miscarriages, and other pathologies of pregnancy, an examination for ureaplasma is indicated.
Treatment
Ureaplasma parvum in women is much more difficult to respond to conservative therapy than its other types - urealiticum, specialty. The scheme assumes the appointment of the following drugs:
- antibiotics to suppress pathogenic microflora;
- antifungal agents;
- means for the normalization of the vaginal, intestinal microflora;
- local treatment: suppositories, douching.
If necessary, instillation of the bladder, vitamin complexes, immunomodulators may be required. At the end of the course, control studies are required. Treatment can take from 14 days to several months.
Physiotherapy
Ureapolasma parvum in women significantly impairs the quality of life, therefore it requires special attention, as well as the ratio of other opportunistic microorganisms. Physiotherapeutic measures are indicated for the chronic form of the disease, with a complicated course, and active clinical symptoms. The following methods are popular:
- electrophoresis with antibiotics, non-steroidal anti-inflammatory drugs;
- massage;
- magnetotherapy with drugs that reduce puffiness, improve blood flow;
- hirudotherapy;
- mud therapy.
Therapy of infection caused by ureaplasma parvum is always complex, including the appointment of several methods at once. Compliance with all medical recommendations ensures quick recovery and reduces the risk of relapse.
Complications and prognosis
The main complication of ureaplasmosis is the chronicity of the pathological process. It is the latent asymptomatic course that leads to the development of a number of complications:
- infertility;
- pathology of pregnancy;
- incomplete gestation (miscarriages, premature birth);
- inflammation of the urinary tract;
- thrush - a lesion of the genitals by fungi of the genus Candida albicans.
Do not underestimate the threat of ureaplasmosis to the female body. Before planning a pregnancy, you should undergo a full examination, including a study for the presence of pathogenic environments and ureaplasma parvum, spices.
Most of the diseases of the genitourinary system of men and women are caused by the reproduction of pathogenic microflora. A common disease is ureaplasmosis caused by the bacteria ureaplasma parvum and ureaplasma urealyticum.
Ways of infection
Millions of bacteria live in the human body. They are useful, conditionally useful, conditionally harmful, and harmful. Ureaplasma parvum belongs to the penultimate, that is, to conditionally pathogenic representatives of microflora.
Getting into the body of men during unprotected sexual intercourse, the infection "settles" in the genitourinary system, "lurks" for a while.
While the immune system copes with its task, it does not manifest itself in any way.
The patient has no symptoms. As soon as a favorable environment is formed, the infection is activated. The man begins to feel its manifestations.
The symptoms of ureaplasmosis are similar to the clinical manifestations of other diseases of the urinary tract, this greatly complicates the procedure for making a diagnosis and prescribing therapeutic therapy. Bacteria continue to multiply, leading to complications.
UR parvum may not manifest itself for a long time, this is dangerous, since the patient remains the carrier of the infection for the entire period and continues to infect his sexual partners. The bacterium is discovered by accident when a man undergoes an annual medical examination and tests.
Ureaplasma parvum and ureaplasma urealiticum are microorganisms to which the immune system cannot develop antibodies. Having been ill once, it is impossible to count on the fact that the disease will not return.
A guarantee of cure will be the therapy of both partners, sexual rest for the entire time, while the therapy is being carried out, and further maintenance of the purity of the relationship. Otherwise, ureaplasmosis may return again at the first contact with an infected person.
Diagnostics
In order for the treatment of ureaplasmosis to be fast, it must be started immediately after the bacteria has entered the body.
How to do this if they do not show themselves, especially at first?
The first symptoms of their development do not have characteristic clinical features, therefore, the infection is simply confused with another disease of the genitourinary system. The UR bacteria itself is not dangerous as long as its concentration does not exceed the permissible limits. Only the growth of the UR microflora is dangerous, especially uncontrolled, this leads to damage to the organs of the reproductive system and urinary tract.
It is difficult to diagnose a UR bacterium, since it does not have a shell and DNA structure; only specific studies can reveal it. It is important to determine the presence of flora in the body and its volume. The last parameter is considered in conjunction with the general condition of the patient.
If the titers show an excess of the permissible limits of ureaplasma parvum, but the man does not show inflammatory processes in the genitourinary system, there is no reason for panic. However, even if the readings of the study are below acceptable limits, this is not a guarantee of the absence of the disease if there are symptoms of inflammation.
Treatment is prescribed, and both the man and his sexual partner (or partners) must undergo it.
UR-parvum and UR-urealiticum are characterized by the same clinical manifestations. These symptoms are weak, they are often not paid attention to, the pathogenic flora is actively multiplying and provokes severe complications. Usually this is a discharge from the urethra, weak but noticeable, burning and discomfort when going to the toilet.
Symptoms can disappear as quickly as they appear - within a few days. However, ureaplasmosis itself will not disappear anywhere, the microflora will continue its vital activity, penetrating into all organs of the reproductive and urinary systems.
Complications, pathologies
If treatment is not carried out, a dangerous disease begins to develop - inflammation of the testis. It refers to the complications of ureaplasmosis, but allows you to detect the underlying disease in time and begin its treatment.
Inflammatory processes in the testicle also do not immediately make themselves felt, however, the patient himself can find a seal in the scrotum, performing hygiene procedures. Palpation does not deliver painful sensations, but a change in the structure of the skin of the scrotum should be a reason for immediate seeking medical help.
An unpleasant phenomenon for men, which is caused by the reproduction of the UR-flora, is a decrease in the quality of semen. The change in sperm condition occurs in different ways, depending on the type of bacteria:
- Ureaplasmosis destroys the DNA of sperm, which simply kills them, the number of healthy and active sperm decreases, and the chances of becoming a father are rapidly falling.
- The second method is the attachment of the microorganism to the sperm DNA. As they get heavier, sperm cannot remain as active and fast as the procedure for successful fertilization of an egg requires.
- The third way is to reduce the quality of sperm due to foreign substances in the semen. They appear as a result of the vital activity of UR-bacteria and their withering away. By accumulating in the semen, making it thicker and more viscous, they prevent sperm from moving correctly.
The most severe complication of ureaplasmosis for men is infertility. The treatment will be difficult and long, but if therapy is still not carried out, the UR flora can penetrate into the bone tissue, causing the development of arthritis of the lower extremities. It is very difficult to find the cause of the pathology in this case, and without fighting the pathogenic microflora, successful treatment of diseases of the musculoskeletal system is impossible.
A great health hazard is caused by a virus in women:
- cystitis, urethritis, urolithiasis, pyelonephritis;
- vaginitis, cervicitis, endometritis;
- adnexitis, salpingitis;
- infertility.
There is scientific evidence that ureaplasma can lead to:
- to infection of the fetus, fetal membranes;
- to its low weight;
- premature birth;
- to the development of pneumonia and meningitis in newborns.
This mainly happens when the carrier of the infection has a weakened immune system.
Treatment methods
Treatment of the resulting ureaplasmosis in both sexes is carried out in the same way. Antibiotic drugs are prescribed, which are selected by the attending physician, depending on the stage of the disease, the existing complications of the patient.
UR bacteria are resistant to some types of drugs, and therefore antibiotics are prescribed individually.
Drug therapy is supplemented with drugs that strengthen the body's defenses to resist infections and prevent them from multiplying. These medicines will make the defense stronger and lead to recovery faster.
Treatment of the disease is carried out only by a doctor. All medications are prescribed based on the results of the patient's blood and urine analysis, concomitant and chronic diseases, symptoms of the disease and complaints of the man himself.
The main task of therapy is to create such a microclimate in the patient's body, which will not allow ureaplasma bacteria to multiply and provoke complications.
Strengthening the immune system is the primary goal of treatment. Only a man with strong defenses will defeat the disease. For the treatment of ureaplasmosis, immunomodulators are not enough: while the bacterium is within the normal range, the body does not react to it, therefore the immune system does not know how to deal with this type of infection.
The treatment regimen prescribed by the doctor must be followed strictly. Departure from it will lead to the loss of the effectiveness of therapy. Repeated application of this scheme will not give results, it will be useless. This will complicate drug therapy, since it is very difficult to destroy the ureaplasma bacteria. Lacking its own membrane and DNA structure, it hides in the deep layers of the mucous membranes of the urinary and reproductive systems.
It is important, when analyzing for the presence of ureaplasma, to study its sensitivity to representatives of different types of antibiotic drugs. Only then will it be possible to prescribe medications that can defeat harmful microflora.
Timeliness of detection of ureaplasmosis is of great importance in the success of therapy. If a man or woman takes care of themselves, undergo a preventive examination, any diseases are detected in the early stages.
In this case, usually one treatment course of antibiotics, supplemented with drugs to strengthen the immune system, is sufficient. In case of violation of the treatment regimen, it will have to start over. This time it will take more time, and the drugs will have to be taken in large dosages. Medical therapy will be difficult if the disease is found in an advanced state.
To prevent the disease, you need to be choosy in sexual relations, as well as use contraceptive methods. It is important to have regular preventive examinations. For a more successful and quick cure, you need to strengthen your immunity by all means.
Doctor sexopathologist-andrologist 1st category. Head of the Kherson branch of the Ukrainian Family Planning Association.