Mycoplasmosis

STDs can affect the urogenital system and other human organs. Scientists are gradually discovering new types of bacteria and viruses that can cause inflammatory processes in the urogenital tract. While in the past bacterial urethritis was almost always associated with chlamydia and gonorrhea, today physicians also consider the pathogenetic role of mycoplasmas. This class of unicellular microorganisms is capable of causing infectious diseases affecting the genitourinary and respiratory systems.

Sexually transmitted diseases often cause dangerous complications. Such pathological processes lead to infertility, impaired fetal development during pregnancy and extensive inflammation of the pelvic organs. Experts have already described in detail the most common urogenital infections, but the role of some microorganisms in the formation of such diseases remains poorly understood.

Read more about the disease

Mycoplasmosis is a group of infectious diseases of bacterial nature. Various members of the class of mycoplasmas can cause inflammatory processes in the urethra, uterus, fallopian tubes, lungs and other organs. All people are susceptible to such diseases regardless of gender and age, but most often mycoplasmosis is diagnosed in sexually active young women. In men, the pathology manifests itself as nonspecific urethritis. The early symptoms of the disease include pain during urination and discharge of clear fluid from the urethra.

Many people are carriers of mycoplasmosis, as bacteria of this class may be present in different anatomical areas. There are also exclusively pathogenic representatives of sexually transmitted bacteria. Scientists have only begun to study the pathogenetic role of mycoplasma in the development of genitourinary tract diseases in recent decades, so many features of the infection have yet to be investigated. During the examination of patients, it is very important to make a differential diagnosis to exclude gonorrhea, chlamydia and other pathologies, the symptoms of which are almost identical to mycoplasmosis.

The pathogens of infection

Mycoplasmas are the smallest free-living microorganisms with a unique structure. The lack of a cell wall brings these infectious agents closer to viruses, but mycoplasmas are still considered bacteria in the scientific community. Also unique biological properties of these microorganisms include the ability to maintain vitality in a cell-free environment and the absence of a nucleus. Mycoplasmas are not Gram stained and are not identified with a light microscope.

The absence of a rigid cell wall explains the many protective properties of mycoplasmas. These bacteria are immune to many antimicrobials, including beta-lactam antibiotics. Conditionally pathogenic representatives of mycoplasmas live in the mucous membranes of different anatomical areas, including the urogenital and respiratory tracts. Active spread of these microorganisms into the submucosa and bloodstream is only observed in immunosuppressive conditions. In this case, the bacteria can cause a systemic infection.

Representatives of mycoplasmas and associated diseases:

• Mycoplasma pneumoniae – A well-studied infectious agent that causes SARS;
• Ureaplasma urealyticum and Ureaplasma parvum are responsible for the occurrence of nonspecific urethritis and other inflammatory processes in the urogenital system;
• Mycoplasma hominis and Mycoplasma genitalium also affect the organs of the excretory and reproductive systems;
• Mycoplasma incognitos may provoke the development of disseminated infection.

Scientists are also aware of certain members of this bacterial class that can cause inflammatory processes in HIV-infected people. Further study of mycoplasmas will help physicians improve the treatment of these diseases.

Patterns of infection

When considering the etiology of mycoplasmosis, it is necessary to take into account that many conditionally pathogenic representatives of these bacteria may be present in human mucous membranes without clinical manifestations. Carrier prevalence ranges from 8% to 16%. Exclusively pathogenic mycoplasma species are sexually transmitted, but other variants of infection are possible.

Methods of infection and risk factors.

1. Unprotected oral or vaginal intercourse. Mycoplasmosis transmitted in this way is often combined with herpes, candidiasis, and chlamydia.
2. Domestic transmission due to sharing personal hygiene items.
3. Intrauterine injury to the fetus and transmission during childbirth.
4. Disturbance of the immune system, leading to the active reproduction of opportunistic pathogenic flora.
5. The presence of other genitourinary tract infections in an individual history.
6. Promiscuity.

Because of the asymptomatic course, patients may continue to infect others, so it is important to be screened for genitourinary infections even in the absence of complaints. It has been noted that the carrier and latent course of mycoplasmosis is more common in women.

Symptoms

Asymptomatic course of the disease is observed in about 10% of patients. Carriers of the infection mycoplasmosis can also manifest itself when exposed to adverse factors, such as deterioration of local immunity. Usually in the early stages, the bacteria affect the mucosa of the urethra, but as the disease progresses, mycoplasmas may retrograde to the uterus, ureters, kidneys, and other organs. Also ascending infection is the cause of fetal lesions in pregnant women.

• Lower abdominal pain;
• A discharge of clear, viscous fluid from the urethra and cervix;
• an increase in body temperature (fever) in the acute form of the infection;
• Vaginal bleeding not related to menstruation;
• pain during urination and sexual intercourse;
• menstrual irregularities;
• weakness and fatigue;
• loss of libido.

Because of the frequent coinfection, doctors are not always able to detect the symptoms of mycoplasmosis, so the main methods of diagnosis are based on laboratory indicators.

Diagnosis

To be screened, see a urologist or gynecologist. The doctor will ask the patient about the complaints, collect anamnestic information and conduct an initial examination of the genitourinary system. Mycoplasmosis has no specific external and symptomatic signs, so the specialist will need the results of several laboratory tests to make a final diagnosis. Visual examination of the internal organs may also be necessary to detect complications of the disease.

Reliable diagnostic methods.

1. Bacterial culture isolation. This study is suitable for the detection of Mycoplasma hominis and Ureaplasma urealyticum. The susceptibility of microorganisms to antibiotics can also be determined from the bacterial culture obtained.
2. Smear followed by microscopic examination to rule out other bacterial infections.
3. Polymerase chain reaction – Obtaining specific DNA sites of the bacterium. This method allows high accuracy in identifying the causative agent.
4. Serologic studies aimed at detecting specific immunoglobulins in the patient’s blood.
5. Ultrasound examination of the kidneys and bladder.

On the basis of the data obtained, the physician will conclude which infectious agent causes the clinical manifestations of the disease. In the chronic form of the pathology, it is important to test for antibiotic sensitivity before starting treatment.

Treatment

Methods of therapy depend on the specific pathogen, the presence of secondary infection, and the clinical manifestations of mycoplasmosis. Conditionally pathogenic representatives of mycoplasmas, including Mycoplasma hominis and Ureaplasma urealyticum, may be components of the natural microflora of the urogenital tract, so the question of mandatory elimination of these microorganisms in the absence of complaints from the patient remains controversial. On the contrary, the detection of Mycoplasma genitalium in laboratory tests undoubtedly indicates the need for drug therapy.

The main methods of treatment:

• doxycycline or azithromycin – Recommended antibiotics for mycoplasmosis;
• Tetracycline-type antibiotics, macrolides, and fluoroquinolones as alternative antimicrobial therapy;
• Topical antimicrobials and antiseptics;
• Antifungal drugs to rule out opportunistic infection;
• Physical therapy to eliminate complications.

Medications can only be prescribed by a doctor. It is important to follow the dosage and frequency of antibiotics to prevent the disease from progressing to a chronic form. In pregnancy, it is important to choose safe medications that do not affect the fetus. On average, drug therapy for mycoplasmosis lasts for 2-3 weeks, after which the doctor evaluates laboratory indicators and decides whether to stop treatment.

Prognosis and complications

Timely use of antibiotics can eliminate the symptoms of mycoplasmosis in most patients. In the latent form of the pathology, many women and men go to the doctor too late, resulting in various negative consequences. Mycoplasmosis does not cause life-threatening complications, but the risk of secondary infection must be considered.

1. Male and female infertility. Such negative effects of the infection develop when the reproductive organs are affected.
2. Various pregnancy complications, including miscarriage. Mycoplasmas are carried to fetal tissue with the bloodstream and disrupt the development of the new organism.
3. Inflammation of the pelvic organs.
4. Inflammation of the brain membranes and heart.
5. Mycoplasma pneumonia, characterized by a severe course.

People with a weakened immune system are at the highest risk of complications. First of all, these are HIV-infected patients. You should also consider the pathological effects of other pathogens that develop against the background of mycoplasmosis.

Prevention

Infections caused by mycoplasma are not as well preventable as other venereal infections. This is primarily due to conditionally pathogenic bacterial species present in the natural microflora of the urogenital tract. These microorganisms can begin to multiply when the human body is exposed to any adverse factors. Nevertheless, there are methods to prevent the transmission of Mycoplasma genitalium from one person to another.

Recommended methods of prevention:

• Use of a latex condom during intimate contact;
• In order to avoid disruption of the natural urogenital microflora, it is recommended to avoid frequent ejaculation in the vaginal area;
• Thorough hygiene of the external genitalia.

Thus, mycoplasmosis is perfectly treatable. Because of the risk of asymptomatic infection, sexually active men and women are advised to be screened regularly for sexually transmitted infections. Screening is also necessary for planning a pregnancy.