Usually, mycoplasma is not easily infected, but when the environment in the reproductive tract is disturbed, it can cause a variety of diseases such as human non-gonococcal urethritis, cervicitis, pelvic inflammatory disease, etc. Infection during pregnancy can lead to miscarriage, premature delivery, premature rupture of membranes and other adverse pregnancy outcomes.
1, urethritis.
Mycoplasma is a common pathogenic microorganism of urinary tract infections. Urinary tract infections caused by mycoplasma are most common with urethritis, and others include pyelonephritis.
2. Cervicitis and pelvic inflammatory disease.
In recent years, there has been a lot of evidence that Mycoplasma genitalium (Mg) is the cause of cervicitis, endometritis, and pelvic inflammatory disease. About 10% of patients with pelvic inflammatory disease can be cultured for Mh. Also, some studies have shown that Mh infection can also cause postpartum fever, which may be caused by endometritis.
3. Chorioamnionitis and preterm delivery.
Currently, most clinical studies do not consider intervention and treatment for patients with Uu detected in the lower genital tract during pregnancy to be necessary. Therefore, if an upstream infection of mycoplasma in the lower genital tract to the uterine cavity is suspected to cause chorioamnionitis and preterm delivery, samples from the upper genital tract are needed for evaluation.
4. Female infertility.
Mycoplasma infection in women is closely associated with tubal infertility, which can lead to tubal inflammation and scar formation, affecting tubal peristaltic function and patency, resulting in infertility.
5. Effects on male semen quality.
Mycoplasma can also cause male infertility. Most results show that mycoplasma infection causes adverse consequences to sperm and seminal plasma from various pathways. The infection has no effect on some semen parameters, such as semen volume, viability, and morphology. Mycoplasma can cause damage to sperm acrosome membranes, affecting sperm morphology and causing damage to acrosomal enzymes, leading to male infertility. It has also been reported that mycoplasma infection can affect the liquefaction time of semen and increase the rate of abnormal semen liquefaction.
6, the impact on assisted reproduction.
Several studies have shown that positive reproductive Uu cultures in both sexes have no significant effect on the fertilization rate, abnormal fertilization rate, egg cleavage rate, clinical pregnancy rate and miscarriage rate of IVF. It is believed that positive cervical Mycoplasma decidua does not affect the pregnancy outcome of in vitro fertilization and embryo transfer.
Principles of management of mycoplasma positivity
If positive mycoplasma is found during outpatient examination, you may wish to refer to the following countermeasures to avoid unnecessary panic and overtreatment, as well as to treat the related disease in a timely manner
1. If both men and women have no symptoms related to genitourinary tract infection and are only Uu-positive, consider them carriers and do not panic, let alone abuse drug treatment.
2. Patients with symptoms and signs of "mycoplasma positive" are recommended to be treated actively.
3. If the symptoms and signs of Uu infection disappear after treatment, and only the Uu laboratory test results are positive, you should consider whether to become a Uu carrier, and do not need to continue drug treatment.
If a man is diagnosed with Uu urethritis, it is recommended that he treat his sexual partner at the same time and pay attention to avoid unprotected intercourse during this period.
5. For men with abnormal semen quality and a need for fertility, a course of treatment is recommended for both men and women at the same time.
6. If reproductive mycoplasma testing is available, Mg testing should be actively performed when UTIs and cervicitis are suspected.
7. When treating pelvic inflammatory disease, the possible involvement of mycoplasma in the development of pelvic inflammatory disease should be considered and an antimicrobial spectrum covering mycoplasma is appropriate.
8. Patients with Uu detected in the lower genital tract during pregnancy do not require intervention and treatment.
Treatment options for mycoplasma infections
The choice of treatment options is still based on antibiotics, and the more commonly used drugs in clinical practice are tetracyclines, macrolides and quinolones, of which tetracyclines are preferred. In order to improve the cure rate of mycoplasma infections, we should pay attention to the combination of mycoplasma culture and drug sensitivity test results, rational selection of antibacterial drugs, to avoid blind drug use, in order to prevent the production and spread of drug-resistant bacteria.
