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Retrospective Analysis of the Ureaplasma spp. Prevalence with Reference to Other Genital Tract Infections in Women of Reproductive Age

Katarzyna Rak
Katarzyna Rak
, 
Aneta Kiecka
Aneta Kiecka
, 
Joanna Białecka
Joanna Białecka
, 
Anna Kawalec
Anna Kawalec
, 
Paweł Krzyściak
Paweł Krzyściak
 and 
Anna Białecka
Anna Białecka
   | Nov 20, 2022
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Article Category: Original Paper
Published Online: Nov 20, 2022
Page range: 509 - 518
Received: Jun 01, 2022
Accepted: Sep 11, 2022
DOI: https://doi.org/10.33073/pjm-2022-044
Keywords
© 2022 Katarzyna Rak et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Fig. 1

The prevalence of mycoplasmas and C. trachomatis according to the multiplicity of colonization in the population studied (n = 1,155).
The prevalence of mycoplasmas and C. trachomatis according to the multiplicity of colonization in the population studied (n = 1,155).

Fig. 2

Distribution of vaginal pH values in women with and without the presence of specific microorganisms. Dots denote extreme values; vertical segments are placed at median values, and boxes are located at quartile values. All differences in pH levels between groups were statistically significant.
Distribution of vaginal pH values in women with and without the presence of specific microorganisms. Dots denote extreme values; vertical segments are placed at median values, and boxes are located at quartile values. All differences in pH levels between groups were statistically significant.

Relationship between the presence of U. urealyticum and other microorganisms.

Microorganisms Without Ureaplasma urealyticum (n = 1,066) With Ureaplasma urealyticum (n = 89) p* OR*** (95% CI) p**
n (%) n (%)
Lactobacillus spp. 1,024 (96.1) 83 (9 3.3) 0.319 0.57(0.23–1.37) 0.203
Garderella vaginalis 43 (4 .0) 13 (1 4.6) < 0.001 4.07(2.10–7.89) < 0.001
Chlamydia trachomatis 8 (0.8) 0 (0.0) 1.000# 0.00(0.04–12.15) 0.412
Mycoplasma hominis 13 (1.2) 8 (9.0) < 0.001# 8(3.22–19.86) < 0.001
Mycoplasma genitalium 1 (0.1) 1 (1.1) 0.148# 5.98(1.24–116.95) 0.025
Ureaplasma parvum 185 (1 7.4) 2 (2 .2) < 0.001 0.11(0.03–0.45) < 0.001
Aerobic bacteria 137 (1 2.9) 16 (1 8.0) 0.227 1.48(0.84–2.63) 0.171
Yeast 173 (1 6.2) 19 (2 1.3) 0.272 1.40(0.82–2.39) 0.213
Streptococcus group B 77 (7 .2) 11 (1 2.4) 0.122 1.81(0.88–3.42) 0.083

Association between the prevalence of microorganisms and clinical symptoms – multivariable analyses. The fully adjusted model and the most parsimonious model.

Microorganisms Model 1* Model 2**
OR*** (95% CI) p** OR*** (95% CI) p**
Ureaplasma parvum 3.06(2.17–4.31) < 0.001 3.07(2.18–4.31) < 0.001
Ureaplasma urealyticum 5.25(3.20–8.62) < 0.001 5.20(3.17–8.51) < 0.001
Mycoplasma hominis 49.30(3.09–787.71) 0.006 48.97(2.94–815.88) 0.007
Chlamydia trachomatis 10.03(1.66–60.42) 0.012 10.04(1.66–60.66) 0.012
Lactobacillus spp. 0.47(0.23–0.98) 0.045 0.48(0.24–0.94) 0.033
Gardnerella vaginalis 3.92(1.89–8.14) < 0.001 3.87(1.90–7.91) < 0.001
Yeast 1.73(1.23–2.43) 0.002 1.73(1.23–2.43) 0.002
DF   12    7
AICc 207.5 197.8
ΔAICc    9.7 0.0

The prevalence of specific microorganisms across groups of women manifesting or not clinical symptoms.

Microorganisms Microbiological method Total Without symptoms (n = 756) With symptoms (n = 399) p* OR*** (95% CI) p**
n (%) n (%) n (%)
Lactobacillus spp. microscopic 1,107 (95.8) 737 (97.5) 370 (92.7) < 0.001 0.33(0.18–0.60) < 0.001
Gardnerella vaginalis microscopic, culture 56 (4.8) 11 (1.5) 45 (11.3) < 0.001 8.32(4.30–16.08) < 0.001
Ureaplasma spp. PCR 276 (23.9) 108 (14.3) 166 (41.6) < 0.001 4.26(3.21–5.66) < 0.001
Ureaplasma parvum PCR 187 (16.2) 81 (10.7) 106 (26.6) < 0.001 3.01(2.19–4.14) < 0.001
Ureaplasma urealyticum PCR 89 (7.7) 27 (3.6) 62 (15.5) < 0.001 4.91(3.08–7.83) < 0.001
Mycoplasma hominis PCR 21 (1.8) 0 (0.0) 21 (5.3) < 0.001# 85.94(5.19–1,422.62) 0.002
Mycoplasma genitalium PCR 2 (0.2) 0 (0.0) 2 (0.5) 0.119# 9.62(0.469.62 –198.69) 0.146
Chlamydia trachomatis PCR 8 (0.7) 1 (0.1) 7 (1.8) 0.003# 9.62(1.66–55.79) 0.012
Aerobic bacteria (with GBS) culture 153 (13.2) 95 (12.6) 58 (14.5) 0.396 1.19(0.84–1.68) 0.339
Streptococcus group B (GBS) culture 88 (7.6) 57 (7.5) 31 (7.8) 0.981 1.04(0.66–1.63) 0.865
Yeast microscopic, culture 192 (16.6) 100 (13.2) 92 (23.1) < 0.001 1.97(1.44–2.69) < 0.001
Neisseria gonorrhoeae culture – – – – –
Trichomonas vaginalis culture – – – – –

Relationship between the detection of Ureaplasma spp. and pH > 4.5 regarding Gardnerella vaginalis coinfections.

pH ≤ 4.5 n (%) pH > 4.5 n (%) OR*** (95% CI) p**
Ureaplasma spp. 180 (1 5.6%) 94 (8 .1%) 2.1(1.56–2.84) < 0.005
Ureaplasma Garnerella vaginalis spp. without coinfection 173 (15.7%) 65 (5.9%) 1.60(1.15–2.24) 0.004

Distribution of vaginal pH values in women with and without the presence of specific microorganisms.

Microorganisms Not prevalent Prevalent p* pH > 4.5 OR (95% CI)** p**
n Q2 (Q1-Q3) n Q2 (Q1-Q3)
Lactobacillus spp. 48 5.5 (5.0–5.5) 1,107 4.5 (4.0–4.5) < 0.001   0.01 (0.00–0.05) < 0.001
Gardnerella vaginalis 1,099 4.5 (4.0–4.5) 56 5.0 (4.9–5.5) < 0.001 11.18 (6.05–20.65) < 0.001
Ureaplasma spp. 881 4.5 (4.0–4.5) 274 4.5 (4.5–5.0) < 0.001   2.09 (1.55–2.82) < 0.001
Ureaplasma parvum 968 4.5 (4.0–4.5) 187 4.5 (4.5–5.0) 0.001   1.71 (1.21–2.41) 0.002
Ureaplasma urealyticum 1,066 4.5 (4.0–4.5) 89 4.5 (4.5–5.0) 0.004   2.42 (1.55–3.78) < 0.001
Mycoplasma hominis 1,134 4.5 (4.0–4.5) 21 4.5 (4.5–5.0) 0.008   3.07 (1.31–7.16) 0.010
Aerobic bacteria (with GBS) 1,002 4.5 (4.0–4.5) 153 5.0 (4.5–5.0) < 0.001   7.44 (5.17–10.69) < 0.001
Streptococcus group B 1,067 4.5 (4.0–4.5) 88 5.0 (4.5–5.1) < 0.001   5.89 (3.76–9.24) < 0.001
Yeast 963 4.5 (4.0–4.5) 192 4.5 (4.5–5.0) 0.003   1.49 (1.06–2.10) 0.023

Relationship between the presence of U. parvum and other microorganisms.

Microorganisms Without Ureaplasma parvum (n = 968) With Ureaplasma parvum (n = 187) p* OR*** (95% CI) p**
n (%) n (%)
Lactobacillus spp. 930 (9 6.1) 177 (9 4.7) 0.489 0.72(0.35–1.48) 0.372
Garderella vaginalis 32 (3 .3) 24 (1 2.8) < 0.001 4.30(2.44–7.49) < 0.001
Chlamydia trachomatis 5 (0.5) 3 (1.6) 0.125# 2.60(0.86–12.81) 0.101
Mycoplasma hominis 14 (1.4) 7 (3.7) 0.064# 2.65(1.05–6.66) 0.0313
Mycoplasma genitalium 2 (0.2) 0 (0.0) 1.000# 0.00(0.05–21.56) 0.534
Ureaplasma urealyticum 87 (9 .0) 2 (1 .1) < 0.001 0.11(0.03–0.45) < 0.001
Aerobic bacteria 134 (1 3.8) 19 (1 0.2) 0.214 0.70(0.42–1.17) 0.174
Yeast 150 (1 5.5) 42 (2 2.5) 0.025 1.58(1.07–2.32) 0.019
Streptococcus group B 82 (8 .5) 6 (3 .2) 0.020 0.36(0.14–0.77) 0.017

Association between the prevalence of microorganisms and pH > 4.5 – multivariable analyses. The fully adjusted model and the most parsimonious model.

Microorganisms Model 1* Model 2**
OR (95% CI) p*** OR (95% CI) p***
Ureaplasma parvum 1.81 (1.21–2.73) 0.004 1.86 (1.24–2.79) 0.003
Ureaplasma urealyticum 2.23 (1.31–3.78) 0.003 2.32 (1.37–3.92) 0.002
Lactobacillus spp. 0.03 (0.01–0.11) < 0.001 0.03 (0.01–0.11) < 0.001
Gardnerella vaginalis 5.91 (2.91–12.00) < 0.001 6.54 (3.25–13.18) < 0.001
Aerobic bacteria (with GBS) 7.31 (4.14–12.91) < 0.001 6.85 (4.61–10.18) < 0.001
DF   11   5
AICc 287.7 275.0
ΔAICc   12.7   0.0
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