Mycoplasmas are microorganisms that fall under the category of bacteria. Some are naturally present in the genital tract in non-pathogenic amounts. But in some situations, they can be responsible for infections and require antibiotic treatment. This is the case with ureaplasma urealyticum. Explanations.

The bacteria ureaplasma urealyticum is a member of the mycoplasma family, microorganisms that reproduce on their own and proliferate rapidly. This bacterium is said to be commensal, that is to say that it is naturally present in the genital tract, in small quantities, and does not represent any danger. “In France, it is estimated that 30 to 40% of women are carriers of Ureaplasma urealyticum, specifies Dr. Carole Maître, gynecologist in the medical department of INSEP. But in the event of an imbalance in the vaginal flora, favored by hormonal changes, taking antibiotics or using vaginal toilets, the bacteria will then multiply ”.

At the female genital level, a concentration of these bacteria greater than 10000 ucc / ml (unit of color change specific to medical analysis laboratories) is suggestive of infection. In this case, the bacteria can become pathogenic and cause certain infections of the genital tract such as: 

• In women:
  • salpingitis (inflammation of the uterine tubes)
  • endocervicitis (inflammation of the cervix) 
• at men’s :
  • urethritis (inflammation of the urethra)
  • prostatitis (inflammation of the prostate)

During pregnancy

Vaginal colonization is common during pregnancy. It can affect up to 80% of pregnant women for ureaplasma urealyticum. “Mycoplasma infection can be more dangerous for pregnant women,” warns the doctor. This is because a high level of ureaplasma urealyticum can cause premature deliveries. And the mother can transmit the bacteria to her child during pregnancy or at the time of childbirth ”. Endometrial damage (endometriosis) is possible postpartum (period after childbirth) but rare.

Any imbalance in the vaginal flora can lead to the appearance of Ureaplasma Urealyticum in large quantities. The proliferation of these bacteria can come from antibiotic treatment, poor vaginal hygiene, but also tobacco consumption or hormonal changes.

In most cases, patients (male or female) infected with genital mycoplasma have no symptoms. “However, when there are symptoms, it is most often:

• in women, abnormal discharge, more abundant, usually yellow, and burning at the time of sexual intercourse, ”continues the gynecologist. These discharge can be smelly if associated with vaginosis.
• in humans, we can see inflammation of the urethra (urethritis) with burning sensations when urinating ”.

The diagnosis will be made after the practice of localized samples. Screening for genital mycoplasma infections is done using biological samples such as:

• the first jet of urine,
• a vaginal sample (in order to detect a possible imbalance of the flora) or urethral (for an examination of the semen or the urine).

These tests can be carried out by a general practitioner, or in a screening center and are intended to isolate the strains. “A quantitative evaluation is necessary to undertake a treatment,” adds our interlocutor. There is no treatment below a certain threshold of positivity. For example, the vaginal sample is pathological when the UU level is equal to or greater than 100 ”.

Generally, the treatment is based on taking an antibiotic treatment (azithromycin or doxycycline) for a period of 5 to 10 days. For more persistent infections, it is sometimes necessary to undergo a different treatment, for example with moxifloxacin. In all cases, it is recommended to perform a control test a few weeks later to ensure the effectiveness of the treatment.

• “In women, it is also important to rebalance the vaginal flora with the addition of probiotics, insists Dr. Maître.
• in men who have symptoms of urethritis or pain, a short course of antibiotics is recommended.

On the other hand, in the absence of symptoms, he should not follow any treatment. Usually only patients with symptoms are treated with an antibiotic ”.

At present, there is no vaccine to protect against mycoplasma infection.