Ureaplasma urealyticum
Species of bacterium
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Through Bacteria, Strain (biology) and Species
Classification
The six recognised Ureaplasma species have a GC content of 27 to 30 percent and a genome size ranging from 0.76 to 1.17 million base pairs, and cholesterol is required for growth. A defining characteristic of the genus is that they perform urea hydrolysis, which creates ammonia as a product. Some strains originally classified as U. urealyticum should be treated as a new species, U. parvum. Both strains of Ureaplasma urealyticum have had their DNA sequenced, using a PCR amplification and dideoxy termination method. Their sequences can be accessed through public records and databases. Most of the 16S rDNA sequence of the two strains constitute the exact same nucleotides bases (97.3% homology), yet small differences have been acknowledged. Due to the direct similarity and the increased variation in other species of Ureaplasma, it is thought that the two strains of Ureaplasma urealyticum (T960 and 27) have evolutionary diverged together. In the same study conducted, using the same 16s rDNA aligned sequences, they concluded all the mammalian strains diverged and coevolved with their corresponding species (canine, feline, human, bovine) during the Cretaceous period. It was found that the most closely related species strain of Ureaplasma to Ureaplasma urealyticum was Ureaplasma diversum (isolated from bovine).
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Microbiology
Gram Staining
U. urealyticum represents one of the 14 distinct types within the Ureaplasma genus. Classified within the Mollicutes class, Ureaplasma species have undergone significant evolutionary adaptations from their Gram-positive bacterial ancestors, a phenomenon termed degenerative evolutions (Kallapur, Suhas G, et al 2013). This evolutionary trajectory has resulted in the loss of the peptidoglycan cell wall, a hallmark characteristic of Gram-positive bacteria. Due to this evolutionary divergence, instances have been reported where U. urealyticum, upon gram staining, exhibited the same characteristics as Gram-negative bacteria. Notably, despite such staining outcomes, it is imperative to recognize that the U. urealyticum remains a Gram-Positive bacterium. This discrepancy underscores the importance of discerning between staining outcomes and bacterial classification (“Ureaplasma Urealyticum.” Microbewiki).
Clinical relevance
Ureaplasma urealyticum can cause urethritis and may cause bacterial vaginosis. Infection can occur in extragenital sites. A common symptom associated with these infections is the "fishy" smell that is created due to the production of ammonia by the hydrolysis of urea. Patients should confirm diagnosis with a doctor. The bacterium has high correlations with the Human Papillomavirus (HPV). It has also been linked to infertility in both males and females. In addition, this pathogen may latently infect the chorionic villi tissues of pregnant women, thereby impacting pregnancy outcome. Issues that arise from Ureaplasma urealyticum infections during pregnancy include preterm birth and impacted embryonic development. Some patients have given birth to children subjected to bronchopulmonary dysplasia, Intraventricular hemorrhage, and necrotizing enterocolitis. Patients can evolve resistances to normal antibiotic treatments due to the distinctive physiology of these organisms. In the Western World, approximately 40% of Ureaplasma species are resistant to fluoroquinolones (i.e. ciprofloxacin). Patients who are pregnant have further limitations on the treatment course of a Ureaplasma urealyticum infection, making it far harder to successfully cure.
Treatment
Since these bacteria lack a cell wall, they are resistant to antibiotics commonly used for urinary tract infections like penicillins and cephalosporins. The reason that many individuals get this infection can be damage to the uterus wall lining, causing the bacteria to thrive in a carbon-rich environment.
The types of antibiotics that can be used are quinolones, tetracyclines, and macrolides, since they affect a large part of the mycoplasma family of bacteria where U. urealyticum falls under. Yet, it is not recommended they are prescribed frequently due to antibiotic resistance. Other drugs that have β-lactamases are infective to treat infection because of how fast the bacteria's circular genome can mutate (Fan et al. 2023). However, there are new movements to use Azithromycin, a macrolide, to treat these infections. When Azithromycin is ingested, macrophages take it up and deliver it to the sites of infection. (Fan et al. 2023) This helps control the infection where the bacteria grows. Additionally, it is also a great alternative to when a pregnant woman is infected to prevent harm to the fetus, as this antibiotic is transported and acts locally.