Ureaplasmas: from commensal flora to serious infections

The two existing human pathogen Ureaplasma species containing 14 serovars are associated with a variety of maladies. Colonizing the human urogenital tract, ureaplasmas cause infections mainly in these organs. However, in the special population of immunosuppressed patients or preterm and very low birth weight newborns such serious Ureaplasma infections such as meningitis or pericarditis have been described. Because they lack a cell wall, ureaplasmas are very susceptible to drying and other adverse environmental conditions; therefore, careful attention has to be given to specimen collection and transportation. Commercially available culture based tests made the laboratory diagnosis of Ureaplasma species much easier. PCR methods provide further facilities to get faster diagnosis, simultaneously with serovar identification, quantitation of Ureaplasma or detection of other sexually transmitted infectious pathogens. Although fluoroquinolone, macrolide, and tetracycline resistant strains are known, antibiotic treatment of Ureaplasma infections is not problematic for now. The mechanism of antibiotic resistance has not been entirely understood till now. Biofilm-forming ability of Ureaplasmas can be important in chronic infections and antibiotic resistance. The basic microbiology of Ureaplasma species, such as clinical manifestations, the diagnostic opportunities, and the therapeutic options are reviewed in the current article. (C) 2011 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins