Ureaplasma infections: update on epidemiology, antimicrobial resistance, and pathogenesis

Abstract

Human Ureaplasma species are being increasingly recognized as opportunistic pathogens in human genitourinary tract infections, infertility, adverse pregnancy, neonatal morbidities, and other adult invasive infections. Although some general reviews have focused on the detection and clinical manifestations of Ureaplasma spp., the molecular epidemiology, antimicrobial resistance, and pathogenesis of Ureaplasma spp. have not been adequately explained. The purpose of this review is to offer valuable insights into the current understanding and future research perspectives of the molecular epidemiology, antimicrobial resistance, and pathogenesis of human Ureaplasma infections. This review summarizes the conventional culture and detection methods and the latest molecular identification technologies for Ureaplasma spp. We also reviewed the global prevalence and mechanisms of antibiotic resistance for Ureaplasma spp. Aside from regular antibiotics, novel antibiotics with outstanding in vitro antimicrobial activity against Ureaplasma spp. are described. Furthermore, we discussed the pathogenic mechanisms of Ureaplasma spp., including adhesion, proinflammatory effects, cytotoxicity, and immune escape effects, from the perspectives of pathology, related molecules, and genetics.

Keywords:

• Ureaplasma species
• clinical diagnostics
• molecular epidemiology
• antimicrobial resistance
• pathogenic mechanisms

Ethical approval

This review does not involve any studies with human or animal subjects.

CreDIT authorship statement

ZR and XYX designed and directed the review. WWL, TY, and YYK contributed to collecting the resources, designing the figures, and writing the manuscript. All authors critically read and approved the final manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study was supported by the National Natural Science Foundation of China [82072342 and 82102429] and the Zhejiang Provincial Medical and Health Science and Technology Plan [2023RC185].