Skip to main content

Advertisement

SpringerLink
Log in

Prevalence of Ureaplasma species among patients at a tertiary hospital in China: a 10-year retrospective study from 2013 to 2022

  • Original Article
  • Published:
European Journal of Clinical Microbiology & Infectious Diseases Aims and scope Submit manuscript

Abstract

Background

Ureaplasma species are common pathogens of the urogenital tract and can cause a range of diseases. Unfortunately, there is still a scarcity of large-scale and cross-sectional studies on the prevalence of Ureaplasma species in China to clarify their epidemic patterns.

Methods

This study retrospectively analyzed the data of 18667 patients who visited Peking Union Medical College Hospital for showing various symptoms of (suspected) Ureaplasma species infection during the period 2013–2022. The overall prevalence of Ureaplasma species was calculated, and subgroup analyses were conducted in view of gender, age, specimen types, and diagnosis in every year within the period studied. Furthermore, previous literature that reported on the prevalence of Ureaplasma species in various regions of China was searched and summarized.

Results

The overall positive rate of Ureaplasma species in this study reached 42.1% (7861/18667). Specifically, the prevalence of Ureaplasma species was significantly higher in female patients, while the highest detection rate was found in the 21–50 age group. From 2013 to 2022, there were no significant differences in positive rates of Ureaplasma species among years. However, the detection rate of Ureaplasma species was decreased in COVID-19 period (2020–2022) compared to pre-COVID-19 period (2017–2019). In view of the distribution of patients, outpatients predominated, but the detection rate was lower than inpatients. Urine was the most common specimen type, while cervical swabs had the highest detection rate of Ureaplasma species. When grouped by diagnosis, the highest positive rate of Ureaplasma species was seen in patients with adverse pregnancy outcomes and the lowest rate in patients with prostate disease. The previous literature, although heterogeneous, collectively suggested a high prevalence of Ureaplasma species in China.

Conclusions

Our study has shown that Ureaplasma species have reached a significant prevalence in China and demands adequate attention.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

References

  1. Kokkayil P, Dhawan B (2015) Ureaplasma: current perspectives. Indian J Med Microbiol 33(2):205–214

    Article  CAS  PubMed  Google Scholar 

  2. Robertson JA, Stemke GW, Davis JW, Harasawa R, Thirkell D, Kong F, Shepard MC, Ford DK (2002) Proposal of Ureaplasma parvum sp. nov. and emended description of Ureaplasma urealyticum (Shepard et al. 1974) Robertson et al. 2001. Int J Syst Evol Microbiol 52(Pt 2):587–597

    Article  PubMed  Google Scholar 

  3. Shepard MC (1954) The recovery of pleuropneumonia-like organisms from Negro men with and without nongonococcal urethritis. Am J Syph Gonorrhea Vener Dis 38(2):113–124

    CAS  PubMed  Google Scholar 

  4. Shepard MC, Lunceford CD (1967) Occurrence of urease in T strains of Mycoplasma. J Bacteriol 93(5):1513–1520

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Hudson MM, Talbot MD (1997) Ureaplasma urealyticum. Int J STD AIDS 8(9):546–551

    Article  CAS  PubMed  Google Scholar 

  6. Couldwell DL, Gidding HF, Freedman EV, McKechnie ML, Biggs K, Sintchenko V, Gilbert GL (2010) Ureaplasma urealyticum is significantly associated with non-gonococcal urethritis in heterosexual Sydney men. Int J STD AIDS 21(5):337–341

    Article  CAS  PubMed  Google Scholar 

  7. Perni SC, Vardhana S, Korneeva I, Tuttle SL, Paraskevas LR, Chasen ST, Kalish RB, Witkin SS (2004) Mycoplasma hominis and Ureaplasma urealyticum in midtrimester amniotic fluid: association with amniotic fluid cytokine levels and pregnancy outcome. Am J Obstet Gynecol 191(4):1382–1386

    Article  CAS  PubMed  Google Scholar 

  8. Huang C, Zhu HL, Xu KR, Wang SY, Fan LQ, Zhu WB (2015) Mycoplasma and ureaplasma infection and male infertility: a systematic review and meta-analysis. Andrology 3(5):809–816

    Article  CAS  PubMed  Google Scholar 

  9. Liu L, Cao G, Zhao Z, Zhao F, Huang Y (2014) High bacterial loads of Ureaplasma may be associated with non-specific cervicitis. Scand J Infect Dis 46(9):637–641

    Article  PubMed  Google Scholar 

  10. Capoccia R, Greub G, Baud D (2013) Ureaplasma urealyticum, Mycoplasma hominis and adverse pregnancy outcomes. Curr Opin Infect Dis 26(3):231–240

    Article  PubMed  Google Scholar 

  11. Dewan B, Sharma M, Nayak N, Sharma SK (1997) Upper urinary tract stones & Ureaplasma urealyticum. Indian J Med Res 105:15–21

    CAS  PubMed  Google Scholar 

  12. Ghosh A, Rawre J, Khanna N, Dhawan B (2013) Co-infections with Ureaplasma parvum, Mycoplasma hominis and Chlamydia trachomatis in a human immunodeficiency virus positive woman with vaginal discharge. Indian J Med Microbiol 31(2):190–192

    PubMed  Google Scholar 

  13. Dando SJ, Nitsos I, Kallapur SG, Newnham JP, Polglase GR, Pillow JJ, Jobe AH, Timms P, Knox CL (2012) The role of the multiple banded antigen of Ureaplasma parvum in intra-amniotic infection: major virulence factor or decoy? PLoS One 7(1):e29856

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. De Silva NS, Quinn PA (1986) Endogenous activity of phospholipases A and C in Ureaplasma urealyticum. J Clin Microbiol 23(2):354–359

    Article  PubMed  PubMed Central  Google Scholar 

  15. Waites KB, Katz B, Schelonka RL (2005) Mycoplasmas and ureaplasmas as neonatal pathogens. Clin Microbiol Rev 18(4):757–789

    Article  PubMed  PubMed Central  Google Scholar 

  16. Pandelidis K, McCarthy A, Chesko KL, Viscardi RM (2013) Role of biofilm formation in Ureaplasma antibiotic susceptibility and development of bronchopulmonary dysplasia in preterm neonates. Pediatr Infect Dis J 32(4):394–398

    Article  PubMed  PubMed Central  Google Scholar 

  17. Lukic A, Canzio C, Patella A, Giovagnoli M, Cipriani P, Frega A, Moscarini M (2006) Determination of cervicovaginal microorganisms in women with abnormal cervical cytology: the role of Ureaplasma urealyticum. Anticancer Res 26(6c):4843–4849

    CAS  PubMed  Google Scholar 

  18. Moridi K, Hemmaty M, Azimian A, Fallah MH, Khaneghahi Abyaneh H, Ghazvini K (2020) Epidemiology of genital infections caused by Mycoplasma hominis, M. genitalium and Ureaplasma urealyticum in Iran; a systematic review and meta-analysis study (2000-2019). BMC Public Health 20(1):1020

    Article  PubMed  PubMed Central  Google Scholar 

  19. Zhu C, Liu J, Ling Y, Dong C, Wu T, Yu X, Hou Y, Dong L, Cheng X (2012) Prevalence and antimicrobial susceptibility of Ureaplasma urealyticum and Mycoplasma hominis in Chinese women with genital infectious diseases. Indian J Dermatol Venereol Leprol 78(3):406–407

    Article  PubMed  Google Scholar 

  20. Ye G, Jiang Z, Wang M, Huang J, Jin G, Lu S (2014) The resistance analysis of Ureaplasma urealyticum and Mycoplasma hominis in female reproductive tract specimens. Cell Biochem Biophys 68(1):207–210

    Article  CAS  PubMed  Google Scholar 

  21. Huang C, Long X, Jing S, Fan L, Xu K, Wang S, Zhu W (2016) Ureaplasma urealyticum and Mycoplasma hominis infections and semen quality in 19,098 infertile men in China. World J Urol 34(7):1039–1044

    Article  PubMed  Google Scholar 

  22. Chen LS, Wu JR, Wang B, Yang T, Yuan R, Zhao YY, Xu JS, Guo HX, Huan XP (2015) Epidemiology of Mycoplasma acquisition in male HIV-1 infected patients: a multistage cross-sectional survey in Jiangsu, China. Epidemiol Infect 143(15):3327–3334

    Article  CAS  PubMed  Google Scholar 

  23. Wang QY, Li RH, Zheng LQ, Shang XH (2016) Prevalence and antimicrobial susceptibility of Ureaplasma urealyticum and Mycoplasma hominis in female outpatients, 2009-2013. J Microbiol Immunol Infect 49(3):359–362

    Article  CAS  PubMed  Google Scholar 

  24. Zhu X, Li M, Cao H, Yang X, Zhang C (2016) Epidemiology of Ureaplasma urealyticum and Mycoplasma hominis in the semen of male outpatients with reproductive disorders. Exp Ther Med 12(2):1165–1170

    Article  PubMed  PubMed Central  Google Scholar 

  25. Zeng XY, Xin N, Tong XN, Wang JY, Liu ZW (2016) Prevalence and antibiotic susceptibility of Ureaplasma urealyticum and Mycoplasma hominis in Xi'an, China. Eur J Clin Microbiol Infect Dis 35(12):1941–1947

    Article  CAS  PubMed  Google Scholar 

  26. Xu WH, Chen JJ, Sun Q, Wang LP, Jia YF, Xuan BB, Xu B, Sheng HM (2018) Chlamydia trachomatis, Ureaplasma urealyticum and Neisseria gonorrhoeae among Chinese women with urinary tract infections in Shanghai: a community-based cross-sectional study. J Obstet Gynaecol Res 44(3):495–502

    Article  PubMed  Google Scholar 

  27. Qing L, Song QX, Feng JL, Li HY, Liu G, Jiang HH (2017) Prevalence of Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium and Ureaplasma urealyticum infections using a novel isothermal simultaneous RNA amplification testing method in infertile males. Ann Clin Microbiol Antimicrob 16(1):45

    Article  PubMed  PubMed Central  Google Scholar 

  28. Cai S, Pan J, Duan D, Yu C, Yang Z, Zou J (2020) Prevalence of Ureaplasma urealyticum, Chlamydia trachomatis, and Neisseria gonorrhoeae in gynecological outpatients, Taizhou, China. J Clin Lab Anal 34(2):e23072

    Article  CAS  PubMed  Google Scholar 

  29. Gu X, Liu S, Guo X, Weng R, Zhong Z (2020) Epidemiological investigation and antimicrobial susceptibility analysis of mycoplasma in patients with genital manifestations. J Clin Lab Anal 34(4):e23118

    Article  CAS  PubMed  Google Scholar 

  30. Zheng WW, Zhang WJ, Cui D, Nie ZC, Ding BS, Cheng JH, Mei CZ (2020) Examination of Ureaplasma urealyticum and Mycoplasma hominis in 4082 Chinese patients. Braz J Med Biol Res 54(2):e10099

    Article  PubMed  PubMed Central  Google Scholar 

  31. Shao L, Wu X, Gao S, Liu L, Zhang Y, Zhao H (2021) Epidemiological investigation and antimicrobial susceptibility analysis of Ureaplasma and Mycoplasma hominis in a teaching hospital in Shenyang, China. J Infect Chemother 27(8):1212–1216

    Article  CAS  PubMed  Google Scholar 

  32. Zhang W, Li L, Zhang X, Fang H, Chen H, Rong C (2021) Infection prevalence and antibiotic resistance levels in Ureaplasma urealyticum and Mycoplasma hominis in gynecological outpatients of a tertiary hospital in China from 2015 to 2018. Can J Infect Dis Med Microbiol 2021:8842267

    Article  PubMed  PubMed Central  Google Scholar 

  33. Luo R, Xun K, Zuo L, Sha F, Chen Y, Yu N, Jin D, Xie Y, He M, Liu F (2022) Prevalence and antimicrobial resistance of Ureaplasma urealyticum and Mycoplasma hominis in patients with genital tract infection in Jiangsu. China. Clin Lab 68(6):1151–1158

    CAS  Google Scholar 

  34. Liu T, Lai SY, Zhou W, Liu YL, Chen SS, Jiang YM (2022) Analysis of Ureaplasma urealyticum, Chlamydia trachomatis, Mycoplasma genitalium and Neisseria gonorrhoeae infections among obstetrics and gynecological outpatients in southwest China: a retrospective study. BMC Infect Dis 22(1):283

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Lu Z, Zhao P, Lu H, Xiao M (2023) Analyses of human papillomavirus, Chlamydia trachomatis, Ureaplasma urealyticum, Neisseria gonorrhoeae, and co-infections in a gynecology outpatient clinic in Haikou area, China. BMC Womens Health 23(1):117

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Liang YY, Zhai HY, Li ZJ, Jin X, Chen Y, Chen SP (2018) Prevalence of Ureaplasma urealyticum, Chlamydia trachomatis, Neisseria gonorrhoeae and herpes simplex virus in Beijing, China. Epidemiol Infect 147:e59

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Horner P, Donders G, Cusini M, Gomberg M, Jensen JS, Unemo M (2018) 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 32(11):1845–1851

    Article  CAS  PubMed  Google Scholar 

  38. Tadera K, Kitagawa H, Kitano H, Hara T, Kashiyama S, Nomura T, Omori K, Shigemoto N, Yokozaki M, Ohge H (2023) Prevalence of Mycoplasma hominis, Ureaplasma urealyticum, and Ureaplasma parvum detection in urine and respiratory tract samples in Hiroshima, Japan. Heliyon 9(3):e14543

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. Glaser K, Silwedel C, Waaga-Gasser AM, Henrich B, Fehrholz M, Claus H, Speer CP (2018) Ureaplasma isolates differentially modulate growth factors and cell adhesion molecules in human neonatal and adult monocytes. Cytokine 105:45–48

    Article  CAS  PubMed  Google Scholar 

  40. Zhu GX, Lu C, Chen CJ, Feng PY, Ma H, Lu RB, Yuan YL (2011) Pathogenicity of Ureaplasma urealyticum and Ureaplasma parvum in the lower genital tract of female BALB/c mice. Can J Microbiol 57(12):987–992

    Article  CAS  PubMed  Google Scholar 

  41. Sharma A, Ahmad Farouk I, Lal SK (2021) COVID-19: a review on the novel coronavirus disease evolution, transmission, detection, control and prevention. Viruses 13(2):202

  42. Pan A, Liu L, Wang C, Guo H, Hao X, Wang Q, Huang J, He N, Yu H, Lin X, Wei S, Wu T (2020) Association of Public Health Interventions With the Epidemiology of the COVID-19 Outbreak in Wuhan, China. Jama 323(19):1915–1923

    Article  CAS  PubMed  Google Scholar 

  43. Knox CL, Cave DG, Farrell DJ, Eastment HT, Timms P (1997) The role of Ureaplasma urealyticum in adverse pregnancy outcome. Aust N Z J Obstet Gynaecol 37(1):45–51

    Article  CAS  PubMed  Google Scholar 

  44. Pavlidis I, Spiller OB, Sammut Demarco G, MacPherson H, Howie SEM, Norman JE, Stock SJ (2020) Cervical epithelial damage promotes Ureaplasma parvum ascending infection, intrauterine inflammation and preterm birth induction in mice. Nat Commun 11(1):199

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  45. Viscardi RM (2014) Ureaplasma species: role in neonatal morbidities and outcomes. Arch Dis Child Fetal Neonatal Ed 99(1):F87–F92

    Article  PubMed  Google Scholar 

Download references

Funding

This work was supported by the National Key Research and Development Program of China (2022YFC2406500) and the Beijing Key Clinical Specialty for Laboratory Medicine Excellent Project (No. ZK201000).

Author information

Authors and Affiliations

  1. Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China

    Ziran Wang, Yu Chen, Zhuo Yang, Jie Yi, Lingjun Kong, Han Zhang, Guoju Luo, Rui Li & Yaling Dou

  2. Department of Education, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China

    Mingqi Xia

Authors
  1. Ziran Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mingqi Xia
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yu Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Zhuo Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jie Yi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Lingjun Kong
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Han Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Guoju Luo
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Rui Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Yaling Dou
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

ZW and YD conceptualized and designed this study; ZW, YC, ZY, JY, and LK collected data; ZW and MX analyzed data and prepared tables and figures; ZW, HZ, GL, and RL performed the literature search and analysis; ZW drafted the manuscript; YD critically revised the manuscript. All authors read and approved the final version of the manuscript.

Corresponding author

Correspondence to Yaling Dou.

Ethics declarations

Ethics approval and consent to participate

This study was performed in compliance with Declaration of Helsinki and approved by the Ethics Committee of Peking Union Medical College Hospital (No. K4146).

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

ESM 1

(DOCX 16 kb)

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wang, Z., Xia, M., Chen, Y. et al. Prevalence of Ureaplasma species among patients at a tertiary hospital in China: a 10-year retrospective study from 2013 to 2022. Eur J Clin Microbiol Infect Dis 42, 1425–1437 (2023). https://doi.org/10.1007/s10096-023-04678-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10096-023-04678-7

Keywords

Search

Navigation