Molecular evaluation of 7 sexually transmissible microorganisms in symptomatic and asymptomatic Italian childbearing age women: is Ureaplasma parvum a real innocent bystander?

Background: Symptoms of most common bacterial and parasitic sexually transmitted infections tend to be non-specific and typically have a variety of different potential causal agents that may require different treatments. In this field the pathogenic potential of genital Ureaplasma species is still uncertain and debated. The goal of this study was to investigate the prevalence of Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Trichomonas vaginalis (TV), Mycoplasma genitalium (MG), Mycoplasma hominis (MH), Ureaplasma urealyticum (UU) and Ureaplasma parvum (UP) in a cohort of symptomatic and asymptomatic childbearing age women and to assess the relationships between bacterial vaginosis and symptoms with both UU and UP.
Materials and Methods: DNA of 2735 endocervical specimens was consecutively analysed by a commercial multiplex real-time polymerase chain reaction for detection of 7 multiple target sequences simultaneously: CT, NG, TV, MG, MH, UU and UP.
Results: Out of the total number of population studied (n=2735), UP was found to be the species with highest prevalence (30.9%) followed by MH (6.5%), UU (6.3%), CT (2.6%), MG (0.8%) and TV (0.9%). UP single species detection was extremely significant in symptomatic women with normal flora (P<0.0001). The correlation of UP in symptomatic women with bacterial vaginosis was not significant (P=0.3387).
Conclusions: Our results suggest a potential specific etiological role to UP, still considered rightly or wrongly innocent bystander, despite the lack so far of specific-species culture tests.