engleski

Ureaplasma urealyticum - ethiological agent of immunological disorders?

BACKGROUND Ureaplasma urealyticum (UU) is a microorganism smaller than conventional bacteria, contained by a trilayered cell membrane, and do not possess a cell wall. It is frequently a resident of respiratory and urogenital tract mucosa. It is a known cause of urethritis in men, amnionitis in pregnant women, and is also associated with a preterm labor and different pathological states of newborns. It is also connected with reactive arthritis (ReA). The aim of this study was to determine the prevalence of UU infection in patients with different immunological disorders of unknown etiology. METHOD Urine specimens and cervical or urethral swabs were analyzed for the presence of UU, by commercial Mycoplasma IST 2 test (bioMerieux® ; ; ; sa). It is a complete kit for the diagnosis of urogenital mycoplasma, which enables culture, identification, indicative enumeration, and antibiotic susceptibility testing of Ureaplasma urealyticum and Mycoplasma hominis. RESULTS Sixty patients with different immunological disorders and UU isolated from urogenital tract were analyzed. Patients were aged from 18 to 64 years (median 41.32 years), 73.33% (n=44) were females, and 26.67% (n=16) were males. Dominant disorder, present in 43.33% (n=26) of patients, was urticaria. Angioedema was present in 15.00% (n=9), and both urticaria and angioedema in 11.67% (n=7) of patients. Polyarthralgia was present in 13.33% (n=8), and both urticaria and polyarthralgia in 1.67% (n=1) of patients. Another 6.67% (n=4) of patients had dermatitis, 3.33% (n=2) reactive arthritis, 1.67% (n=1) erythema nodosum, 1.67% (n=1) polymyalgia, and 1.67% (n=1) vasculitis. In a few patients Mycoplasma hominis was isolated together with UU (data not shown). CONCLUSION The majority of patients with isolated UU suffered from urticaria, angioedema or their combination. Symptoms completely disappeared following the antibiotic treatment. In a few patients with a relapse, UU was reisolated after the treatment. Causes of those relapses were poor compliance in taking therapy by a patient or his/her sexual partner(s). We consider urogenital infections with UU a possible cause of mentioned immunological disorders. Further research is needed, especially of the pathogenic mechanisms.

ureaplasma; urticaria; angioedema

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