Mycoplasma and Ureaplasma Testing: What You Need to Know

Key takeaways

• Mycoplasma and Ureaplasma are distinct types of bacteria that can colonize the genital and urinary tracts without causing symptoms.
• Some species, such as Mycoplasma genitalium and Ureaplasma urealyticum, are linked to urethritis and other genital tract infections.
• Testing is typically recommended for people with persistent urinary or genital symptoms, or when other common causes have been ruled out.
• Routine screening for all sexually active people is not universally recommended, so testing decisions should be based on symptoms and risk factors.

What Are Mycoplasma and Ureaplasma?

Mycoplasma and Ureaplasma are genera of bacteria that lack a cell wall, which makes them different from many other bacteria and affects which antibiotics are effective against them. They can be found in the respiratory and urogenital tracts of healthy people. Several species are considered part of the normal flora, meaning they can exist without causing any disease.

The species most often associated with genital tract infections are Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma urealyticum, and Ureaplasma parvum. Mycoplasma genitalium is recognized as a cause of urethritis and cervicitis, while Ureaplasma species have been linked to similar conditions in some individuals. The presence of these bacteria does not always mean an infection is present or that treatment is needed.

How Are They Transmitted?

Mycoplasma and Ureaplasma are primarily transmitted through sexual contact, including vaginal, anal, and oral sex. They can also be passed from a pregnant person to a newborn during delivery, which in rare cases can lead to complications in the infant. Because these bacteria can be present without symptoms, a person may carry and transmit them without knowing.

It is important to note that Mycoplasma and Ureaplasma are not always sexually transmitted in the traditional sense. Some species can be part of the normal genital microbiome and may be acquired through non-sexual routes. This complexity is one reason why routine screening for all sexually active individuals is not currently recommended by major health organizations.

When Is Testing Recommended?

Testing for Mycoplasma and Ureaplasma is generally recommended when a person has persistent symptoms such as urethral discharge, burning during urination, pelvic pain, or unusual vaginal discharge, and more common causes like chlamydia and gonorrhea have been ruled out. Testing may also be considered for individuals with recurrent urethritis or cervicitis that has not responded to standard treatment.

In some cases, testing may be advised for people with unexplained infertility or recurrent pregnancy loss, as certain Mycoplasma and Ureaplasma species have been associated with these conditions. However, routine screening of asymptomatic individuals is not universally endorsed. A healthcare provider can help determine whether testing is appropriate based on individual symptoms and risk factors.

How Testing Works and What Results Mean

Testing for Mycoplasma and Ureaplasma is typically done using a urine sample or a swab from the affected area, such as the urethra, cervix, or vagina. Nucleic acid amplification tests (NAATs) are the preferred method because they are highly sensitive and can identify specific species. Some laboratories may also use culture, but this is less common due to the fastidious nature of these bacteria.

A positive test result indicates that the bacteria were detected, but it does not always mean they are causing symptoms or require treatment. Treatment decisions should be made with a healthcare provider, who will consider symptoms, test results, and other factors. When treatment is needed, antibiotics that target bacteria without cell walls, such as macrolides or tetracyclines, are often used, though resistance is a growing concern.

Frequently Asked Questions

Sources

• CDC - Mycoplasma genitalium
• MedlinePlus - Ureaplasma
• NIH - Mycoplasma and Ureaplasma
• Mayo Clinic - Urethritis