Dr. Wojo. Healthy Living. Simplified.

During nearly every Emergency Department shift I deal with genitourinary problems and pregnancy complications. Usually, common infections are found. But sometimes, less common infections - such as bacterial mycoplasma and ureaplasma infections - are diagnosed.

What are these infections? Mycoplasmas are some of the smallest living organisms that, unlike most bacteria, do not have cell walls - instead they live within other live cells. A close relative is ureaplasma.  Both of these organisms can be found in up to 70% of sexually active adults.  But when there is significant overgrowth problems can occur, such as pelvic inflammatory disease, urethritis and pregnancy loss.

Because mycoplasmas and ureaplasmas naturally occur in the body, patients are not routinely tested for the bacteria. However, women who experience infertility, recurrent pregnancy loss, pelvic pain, premenstrual symptoms or vaginal symptoms should be tested. A culture test, similar to a pap test, is taken.

The organism can be found in the male prostate gland and be transmitted during intercourse. Sexual partners may unknowingly pass the infection to one another repeatedly. Infection usually occurs in younger women, those who have multiple sexual partners, and those who use oral contraceptives rather than condoms.

Can this cause infertility? Usually asymptomatic, these infections can lead to fertility problems including tubal disease, recurrent miscarriages, and decreased sperm motility and count. In infertile males, the bacteria have been found to adhere to sperm and inhibit reproduction.

Research shows that infection when pregnant also increases the risk of miscarriage if the organisms are found in the placenta or endometrium. Both organisms invade the amniotic sac in second trimester. Ureaplasma in the placenta is associated with infection, stillbirth, premature labor and low birth weight.  Post-partum infections can occur as well.

How does this affect the newborn? This infection may be transmitted to about 40% of infants born to infected mothers. Mycoplasma and ureaplasma are causes of pneumonia, respiratory problems in low birth weight infants and meningitis.

How is this treated? Because these bacteria do not have cell walls - and most antibiotics work by damaging a cell wall - it can be difficult to treat the infection. Only very specific antibiotics, such as erythromycin, a flouroquinolone, or a tetracycline, can be prescribed. If you are pregnant, the appropriate antibiotic will be chosen.

If you are dealing with infertility or multiple miscarriages, request a culture be taken. Get tested and treated to prevent repeated infection.