From the Guidelines
Ureaplasma urealyticum, but not Ureaplasma parvum, is considered a potential pathogen in non-gonococcal urethritis, suggesting that U. parvum may be part of the normal vaginal flora. According to the European Association of Urology guidelines on urological infections, published in 2024 1, the role of Ureaplasma spp. in causing urethritis is debated, with recent data suggesting that U. urealyticum, but not U. parvum, is an aetiological agent in non-gonococcal urethritis. This implies that U. parvum may be a commensal organism in the female genital tract. Some key points to consider include:
- Ureaplasma species are commonly found in the genital tract of sexually active women without causing any symptoms or disease
- They can exist as commensals, but may sometimes act as opportunistic pathogens under certain conditions
- Ureaplasma species have been associated with conditions such as urethritis, cervicitis, pelvic inflammatory disease, and adverse pregnancy outcomes in some cases
- Routine screening or treatment for asymptomatic colonization is not recommended, as this represents a normal finding in many women and unnecessary antibiotic use could disrupt the beneficial vaginal microbiome and contribute to antibiotic resistance, as suggested by the guidelines 1.
From the Research
Ureaplasma urealyticum parvum as part of normal vaginal flora
- Ureaplasma species, including Ureaplasma parvum, are commonly found in the urogenital tract of both men and women 2
- A study found that Ureaplasma parvum was detected in 43.5% of patients with normal vaginal flora, suggesting that it may be part of the normal vaginal flora 3
- However, the presence of Ureaplasma parvum and other mycoplasmas may also be associated with altered vaginal microflora, such as bacterial vaginosis (BV) 3
- The role of Ureaplasma parvum in the female genital tract is not fully understood, and further research is needed to determine its significance as part of the normal vaginal flora
Prevalence of Ureaplasma parvum in healthy women
- A study of 2594 unselected female patients found that Ureaplasma parvum was detected in 43.5% of patients with normal vaginal flora 3
- Another study found that Ureaplasma parvum was detected in 59.9% of patients with bacterial vaginosis (BV) 3
- The prevalence of Ureaplasma parvum may vary depending on the population being studied and the methods used for detection
Ureaplasma parvum and Ureaplasma urealyticum
- Ureaplasma parvum and Ureaplasma urealyticum are two biovars of the Ureaplasma species 2
- Both biovars have been associated with genital tract infections and other diseases, including adverse pregnancy outcomes and diseases in newborns 2, 4
- The antimicrobial susceptibility of Ureaplasma parvum and Ureaplasma urealyticum may differ, with Ureaplasma parvum generally being more susceptible to certain antibiotics 4, 5