U. Parvum serovars exhibit distinct pathogenicity in Chinese women of childbearing age: a multicentre cross-sectional study.
U. parvum serovars
Clinical symptoms
Heterogeneity in pathogenicity
Women of childbearing age
Journal
BMC infectious diseases
ISSN: 1471-2334
Titre abrégé: BMC Infect Dis
Pays: England
ID NLM: 100968551
Informations de publication
Date de publication:
28 Oct 2024
28 Oct 2024
Historique:
received:
25
07
2024
accepted:
23
10
2024
medline:
29
10
2024
pubmed:
29
10
2024
entrez:
29
10
2024
Statut:
epublish
Résumé
Ureaplasma spp. can be classified into different serovars. It is unknown whether distinct serovars are associated with clinical signs and symptoms. We conducted a multicentre cross-sectional study. U. parvum serovars were identified on the basis of their multiple-banded antigen (MBA) genes. After adjusting for demographic variables and other reproductive tract infections, the odds ratio (OR) and 95% confidence interval (CI) were calculated to determine the impact of U. parvum serovars on clinical symptoms. Among 5,277 individuals, U. parvum serovars 3 and 6 were the most prevalent serovars (17.9% and 16.0%, respectively). Potential confounders, such as age, body mass index (BMI), ethnicity, education level, contraceptive methods, number of sexual partners, gravidity, parity, and other sexually transmitted infections (STIs) that are associated with clinical symptoms (P < 0.1) were adjusted for in the univariate analysis. U. parvum serovar 14 was strongly positively associated with certain clinical symptoms, including redness and swelling of the vaginal wall (crude OR: 3.53, 95% CI: 1.92-6.49; adjusted OR: 5.21, 95% CI: 2.56-10.58), cervical bleeding and swelling (crude OR: 3.89, 95% CI: 2.38-6.36; adjusted OR: 7.37, 95% CI: 3.82-14.23), and cervical ectropion (crude OR: 2.08, 95% CI: 1.25-3.45; adjusted OR: 3.04, 95% CI: 1.60-5.74). In contrast, U. parvum serovar 3 was negatively associated with a variety of clinical symptoms, whereas no correlations were detected between U. parvum serovars 1and 6 with clinical symptoms. Different U. parvum serovars exhibit distinct correlations with clinical symptoms, suggesting that U. parvum serovars are pathogenically heterogeneous and that further differentiation of serovars may be necessary. The study was registered with ClinicalTrials.gov ( https://www. gov ; ID: NCT04694495; Registration Date: 2021-01-05).
Sections du résumé
BACKGROUND
BACKGROUND
Ureaplasma spp. can be classified into different serovars. It is unknown whether distinct serovars are associated with clinical signs and symptoms.
METHODS
METHODS
We conducted a multicentre cross-sectional study. U. parvum serovars were identified on the basis of their multiple-banded antigen (MBA) genes. After adjusting for demographic variables and other reproductive tract infections, the odds ratio (OR) and 95% confidence interval (CI) were calculated to determine the impact of U. parvum serovars on clinical symptoms.
RESULTS
RESULTS
Among 5,277 individuals, U. parvum serovars 3 and 6 were the most prevalent serovars (17.9% and 16.0%, respectively). Potential confounders, such as age, body mass index (BMI), ethnicity, education level, contraceptive methods, number of sexual partners, gravidity, parity, and other sexually transmitted infections (STIs) that are associated with clinical symptoms (P < 0.1) were adjusted for in the univariate analysis. U. parvum serovar 14 was strongly positively associated with certain clinical symptoms, including redness and swelling of the vaginal wall (crude OR: 3.53, 95% CI: 1.92-6.49; adjusted OR: 5.21, 95% CI: 2.56-10.58), cervical bleeding and swelling (crude OR: 3.89, 95% CI: 2.38-6.36; adjusted OR: 7.37, 95% CI: 3.82-14.23), and cervical ectropion (crude OR: 2.08, 95% CI: 1.25-3.45; adjusted OR: 3.04, 95% CI: 1.60-5.74). In contrast, U. parvum serovar 3 was negatively associated with a variety of clinical symptoms, whereas no correlations were detected between U. parvum serovars 1and 6 with clinical symptoms.
CONCLUSIONS
CONCLUSIONS
Different U. parvum serovars exhibit distinct correlations with clinical symptoms, suggesting that U. parvum serovars are pathogenically heterogeneous and that further differentiation of serovars may be necessary.
TRIAL REGISTRATION
BACKGROUND
The study was registered with ClinicalTrials.gov ( https://www.
CLINICALTRIALS
RESULTS
gov ; ID: NCT04694495; Registration Date: 2021-01-05).
Identifiants
pubmed: 39468466
doi: 10.1186/s12879-024-10113-9
pii: 10.1186/s12879-024-10113-9
doi:
Banques de données
ClinicalTrials.gov
['NCT04694495']
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
1213Subventions
Organisme : National Natural Science Foundation of China
ID : 82205157
Organisme : National Natural Science Foundation of China
ID : 82302610
Organisme : National Natural Science Foundation of China
ID : 81925026
Organisme : China Postdoctoral Science Foundation
ID : 2022M721538
Organisme : Basic and Applied Basic Research Foundation of Guangdong Province
ID : 2021B1515230007
Investigateurs
Bingbing Xiao
(B)
Shuyi Han
(S)
Xuefeng Wang
(X)
Feng Fang
(F)
Weiguang Luo
(W)
Jing Zhao
(J)
Bo Wang
(B)
Xiaojuan Li
(X)
Kewei Zhao
(K)
Guofeng Xue
(G)
Hong Chen
(H)
Shuhua Li
(S)
Liangzhi Cai
(L)
Pengming Sun
(P)
Yingxiu Chen
(Y)
Wei Liang
(W)
Yan Han
(Y)
Xiaoyan Li
(X)
Yanan Zhang
(Y)
Chunxia Guo
(C)
Zhiyu Pang
(Z)
Qunxiang Liu
(Q)
Liping Huang
(L)
Jinbo Liu
(J)
Ping Zhan
(P)
Fan Lu
(F)
Hualei Cai
(H)
Ming Li
(M)
Xianjin Wu
(X)
Maocheng Li
(M)
Yi Zhang
(Y)
Ruizhe Wang
(R)
Xuesu He
(X)
Jing Sha
(J)
Kaifeng Wu
(K)
Chengmin Deng
(C)
Guijie Zhang
(G)
Beibei Sun
(B)
Dehua Sun
(D)
Yufeng Xiong
(Y)
Liang Peng
(L)
Zhijuan Liu
(Z)
Shuzhong Yao
(S)
Meng Xia
(M)
Haitao Yu
(H)
Xiaojuan Gao
(X)
Xiuming Zhang
(X)
Fen Lin
(F)
Yonghao Wu
(Y)
Meiling Luo
(M)
Changzhong Li
(C)
Zhaofan Luo
(Z)
Xue Guo
(X)
Chaoxin Jiang
(C)
Guoqing Hao
(G)
Guanghui Chen
(G)
Hui Chen
(H)
Lianhua Wei
(L)
Zhemei Zhang
(Z)
Informations de copyright
© 2024. The Author(s).
Références
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(4):e00137–18.
doi: 10.1128/CMR.00137-18
pubmed: 31270127
pmcid: 6750135
Shimizu T, Kida Y, Kuwano K. Ureaplasma parvum lipoproteins, including MB antigen, activate NF-κB through TLR1, TLR2 and TLR6. Microbiology. 2008;154(5):1318–25.
doi: 10.1099/mic.0.2007/016212-0
pubmed: 18451040
Razin S, Yogev D. Genetic relatedness among Ureaplasma urealyticum serotypes (serovars). Pediatr Infect Disease. 1986;5(6 Suppl):S300–4.
doi: 10.1097/00006454-198611010-00022
Fanrong K, James G, Zhenfang M, Gordon S, Wang B, Gilbert GL. Phylogenetic analysis of Ureaplasma urealyticum–support for the establishment of a new species, Ureaplasma parvum. Int J Syst Evol MicroBiol. 1999;49(4):1879–89.
doi: 10.1099/00207713-49-4-1879
Stellrecht KA, Woron AM, Mishrik NG, Venezia RA. Comparison of multiplex PCR assay with culture for detection of genital mycoplasmas. J Clin Microbiol. 2004;42(4):1528–33.
doi: 10.1128/JCM.42.4.1528-1533.2004
pubmed: 15070999
pmcid: 387538
Kim Y, Kim J, Lee KA. Prevalence of sexually transmitted infections among healthy Korean women: implications of multiplex PCR pathogen detection on antibiotic therapy. J Infect Chemother. 2014;20(1–2):74–6.
doi: 10.1016/j.jiac.2013.08.005
pubmed: 24462432
Leli C, Mencacci A, Latino MA, Clerici P, Rassu M, Perito S, et al. Prevalence of cervical colonization by Ureaplasma parvum, Ureaplasma urealyticum, Mycoplasma hominis and Mycoplasma genitalium in childbearing age women by a commercially available multiplex real-time PCR: an Italian observational multicentre study. J Microbiol Immunol Infect. 2018;51(2):220–5.
doi: 10.1016/j.jmii.2017.05.004
pubmed: 28711440
Lobao TN, Campos GB, Selis NN, Amorim AT, Souza SG, Mafra SS, et al. Ureaplasma urealyticum and U. Parvum in sexually active women attending public health clinics in Brazil. Epidemiol Infect. 2017;145(11):2341–51.
doi: 10.1017/S0950268817001145
pubmed: 28637523
pmcid: 9148828
Doroftei B, Ilie OD, Armeanu T, Anton E, Scripcariu I, Maftei R. The prevalence of Ureaplasma Urealyticum and Mycoplasma Hominis Infections in Infertile patients in the Northeast Region of Romania. Med (Kaunas). 2021;57(3):211.
Jonduo ME, Vallely LM, Wand H, Sweeney EL, Egli-Gany D, Kaldor J, et al. Adverse pregnancy and birth outcomes associated with Mycoplasma hominis, Ureaplasma urealyticum and Ureaplasma parvum: a systematic review and meta-analysis. BMJ open. 2022;12(8):e062990.
doi: 10.1136/bmjopen-2022-062990
pubmed: 36028274
pmcid: 9422885
Rittenschober-Böhm J, Waldhoer T, Schulz SM, Pimpel B, Goeral K, Kasper DC, et al. Vaginal Ureaplasma parvum serovars and spontaneous preterm birth. Am J Obstet Gynecol. 2019;220(6):594. e1-. e9.
doi: 10.1016/j.ajog.2019.01.237
Plummer EL, Vodstrcil LA, Bodiyabadu K, Murray GL, Doyle M, Latimer RL, et al. Are Mycoplasma hominis, Ureaplasma urealyticum and Ureaplasma parvum Associated with specific genital symptoms and clinical signs in Nonpregnant women? Clin Infect Dis. 2021;73(4):659–68.
doi: 10.1093/cid/ciab061
pubmed: 33502501
Zhao N, Li KT, Gao YY, Xu JJ, Huang DS. Mycoplasma Genitalium and Mycoplasma Hominis are prevalent and correlated with HIV risk in MSM: a cross-sectional study in Shenyang, China. BMC Infect Dis. 2019;19(1):494.
doi: 10.1186/s12879-019-4138-5
pubmed: 31164096
pmcid: 6549264
Kim MS, Lee DH, Kim TJ, Oh JJ, Rhee SR, Park DS, Yu YD. The role of Ureaplasma parvum serovar-3 or serovar-14 infection in female patients with chronic micturition urethral pain and recurrent microscopic hematuria. Transl Androl Urol. 2021;10(1):96–108.
doi: 10.21037/tau-20-920
pubmed: 33532300
pmcid: 7844479
De Francesco M, Negrini R, Pinsi G, Peroni L, Manca N. Detection of Ureaplasma biovars and polymerase chain reaction-based subtyping of Ureaplasma parvum in women with or without symptoms of genital infections. Eur J Clin Microbiol Infect Dis. 2009;28(6):641–6.
doi: 10.1007/s10096-008-0687-z
pubmed: 19130104
Krausse R, Schubert S. In-vitro activities of tetracyclines, macrolides, fluoroquinolones and clindamycin against Mycoplasma hominis and Ureaplasma ssp. isolated in Germany over 20 years. Clin Microbiol Infect. 2010;16(11):1649–55.
doi: 10.1111/j.1469-0691.2010.03155.x
pubmed: 20047607
Ma H, Zhang X, Shi X, Zhang J, Zhou Y. Phenotypic antimicrobial susceptibility and genotypic characterization of clinical ureaplasma isolates circulating in Shanghai, China. Front Microbiol. 2021;12:724935.
doi: 10.3389/fmicb.2021.724935
pubmed: 34690966
pmcid: 8531517
Ghofran K, Al-khafaji S. Antimicrobial Resistance of Genital Ureaplasma Parvum. Nano Biomed Eng. 2017;9(3):236–41.
Zhou Z, Hou Y, Qing W, Shi Y, Zhang Y, Chen R et al. The association of HPV infection and vaginal microbiota of reproductive women in China: a multicenter cohort study protocol. 2023;15:100072.
Bai S, Li Y, Wan Y, Guo T, Jin Q, Liu R, et al. Sexually transmitted infections and semen quality from subfertile men with and without leukocytospermia. Reproductive Biology Endocrinol. 2021;19(1):92.
doi: 10.1186/s12958-021-00769-2
Zhao N, Li KT, Gao Y-y, Xu J-j, Huang D-S. Mycoplasma Genitalium and Mycoplasma Hominis are prevalent and correlated with HIV risk in MSM: a cross-sectional study in Shenyang, China. BMC Infect Dis. 2019;19:1–7.
doi: 10.1186/s12879-019-4138-5
Zhang N, Wang R, Li X, Liu X, Tang Z, Liu Y. Are Ureaplasma spp. a cause of nongonococcal urethritis? A systematic review and meta-analysis. PLoS ONE. 2014;9(12):e113771.
doi: 10.1371/journal.pone.0113771
pubmed: 25463970
pmcid: 4252037
Workowski KA, Bachmann LH, Chan PA, Johnston CM, Muzny CA, Park I, et al. Sexually Transmitted Infections Treat Guidelines 2021 MMWR Recomm Rep. 2021;70(4):1–187.
pubmed: 34292926
Nugent RP, Krohn MA, Hillier SL. Reliability of diagnosing bacterial vaginosis is improved by a standardized method of gram stain interpretation. J Clin Microbiol. 1991;29(2):297–301.
doi: 10.1128/jcm.29.2.297-301.1991
pubmed: 1706728
pmcid: 269757
Donders GG, Vereecken A, Bosmans E, Dekeersmaecker A, Salembier G, Spitz B. Definition of a type of abnormal vaginal flora that is distinct from bacterial vaginosis: aerobic vaginitis. BJOG: Int J Obstet Gynecol. 2002;109(1):34–43.
doi: 10.1111/j.1471-0528.2002.00432.x
Robertson JA, Stemke GW, Davis JW, Harasawa R, Thirkell D, Kong F, et al. Proposal of Ureaplasma parvum sp. nov. and emended description of Ureaplasma urealyticumShepard (1974) Robertson 2001. Int J Syst Evol Microbiol. 2002;52(Pt 2):587–97.
doi: 10.1099/00207713-52-2-587
pubmed: 11931172
Wetmore CM, Manhart LE, Lowens MS, Golden MR, Jensen NL, Astete SG, et al. Ureaplasma urealyticum is Associated with Nongonococcal Urethritis among men with fewer lifetime sexual partners: a case-control study. J Infect Dis. 2011;204(8):1274–82.
doi: 10.1093/infdis/jir517
pubmed: 21917901
pmcid: 3173507
Kletzel HH, Rotem R, Barg M, Michaeli J, Reichman O. Ureaplasma urealyticum: the role as a Pathogen in Women’s Health, a systematic review. Curr Infect Dis Rep. 2018;20(9):1–12.
doi: 10.1007/s11908-018-0640-y
Horner P, Donders G, Cusini M, Gomberg M, Jensen J, Unemo M. Should we be testing for urogenital Mycoplasma hominis, Ureaplasma parvum and Ureaplasma urealyticum in men and women?–a position statement from the European STI guidelines Editorial Board. J Eur Acad Dermatol Venereol. 2018;32(11):1845–51.
doi: 10.1111/jdv.15146
pubmed: 29924422
Wada K, Hamasuna R, Sadahira T, Araki M, Yamamoto S. UAA-AAUS guideline for M. genitalium and non-chlamydial non-gonococcal urethritis. J Infect Chemother. 2021;27(10):1384–8.
doi: 10.1016/j.jiac.2021.07.007
pubmed: 34332883
Song T, Ye A, Xie X, Huang J, Ruan Z, Kong Y, et al. Epidemiological investigation and antimicrobial susceptibility analysis of ureaplasma species and Mycoplasma hominis in outpatients with genital manifestations. J Clin Pathol. 2014;67(9):817–20.
doi: 10.1136/jclinpath-2014-202248
pubmed: 24982440
Zhu C-t, Hu Z-y, Dong C-l, Zhang C-s, Wan M-z, Ling Y. Investigation of Ureaplasma urealyticum biovars and their relationship with antimicrobial resistance. Ind J Med Microbiol. 2011;29(3):288–92.
doi: 10.4103/0255-0857.83915
Boujemaa S, Mlik B, Ben Allaya A, Mardassi H, Mardassi BB. Spread of multidrug resistance among Ureaplasma serovars. Tunisia Antimicrob Resist Infect Control. 2020;9(1):1–10.
Lusk MJ, Garden FL, Rawlinson WD, Naing ZW, Cumming RG, Konecny P. Cervicitis aetiology and case definition: a study in Australian women attending sexually transmitted infection clinics. Sex Transm Infect. 2016;92(3):175–81.
doi: 10.1136/sextrans-2015-052332
pubmed: 26586777
Lillis RA, Martin DH, Nsuami MJ. Mycoplasma genitalium infections in women attending a sexually transmitted Disease Clinic in New Orleans. Clin Infect Dis. 2019;69(3):459–65.
doi: 10.1093/cid/ciy922
pubmed: 30351348