Kletzel Hanna Hershko, Rotem Reut, Barg Moshe, Michaeli Jennia, Reichman Orna
Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, Hebrew University, Jerusalem, Israel.
Curr Infect Dis Rep. 2018 Jun 29;20(9):33. doi: 10.1007/s11908-018-0640-y.
To evaluate the role of Ureaplasma urealyticum as a genital pathogen in women's health. Three aspects were analyzed: (1) preterm delivery (PTD); (2) female infertility; and (3) lower genital tract pathology including pelvic inflammatory disease (PID), cervicitis, and genital discomfort (discharge, burning).
A systematic review was performed. Searching PUBMED and EMBASE for published articles from January 2003 to September 2017 using the key word "Ureaplasma urealyticum" yielded 1835 manuscripts. These were further screened using defined inclusion criteria: (1) original peer-reviewed observational studies; (2) English language; (3) U. urealyticum was specifically isolated; (4) present "cases"/"exposed" and "controls"/"unexposed" to enable calculating an association between U. urealyticum and the outcome studied. Altogether, 32 studies were included that underwent quality scoring based on methodology, sample size, study population, and method of identification of U. urealyticum. The association of U. urealyticum and PTD was inconsistent between the studies. Eight of the ten prospective studies failed to show an association between U. urealyticum and PTD, yet four of the six case control studies found a positive association. Regarding female infertility and genital discomfort, five of the six studies for each of these topics failed to find an association. Only two studies met the inclusion criteria for cervicitis with conflicting conclusions. Unfortunately, none of the studies met the inclusion criteria for PID. It seems that U. urealyticum has a limited role as a pathogen in female infertility, cervicitis, PID, and genital discomfort. The role as a pathogen in PTD is unclear and future studies are needed to address this issue.
评估解脲脲原体作为一种生殖道病原体在女性健康中的作用。分析了三个方面：（1）早产（PTD）；（2）女性不孕症；（3）下生殖道病变，包括盆腔炎（PID）、宫颈炎和生殖器不适（白带、灼痛）。
进行了一项系统综述。使用关键词“解脲脲原体”在PUBMED和EMBASE中检索2003年1月至2017年9月发表的文章，共得到1835篇手稿。根据以下明确的纳入标准进一步筛选：（1）原始的同行评审观察性研究；（2）英文文献；（3）专门分离出解脲脲原体；（4）有“病例”/“暴露组”和“对照”/“非暴露组”，以便计算解脲脲原体与所研究结局之间的关联。总共纳入了32项研究，并根据方法学、样本量、研究人群和解脲脲原体的鉴定方法进行了质量评分。解脲脲原体与早产之间的关联在各项研究中并不一致。十项前瞻性研究中有八项未能显示解脲脲原体与早产之间存在关联，但六项病例对照研究中有四项发现了正相关。关于女性不孕症和生殖器不适，这两个主题的六项研究中有五项未能发现关联。只有两项研究符合宫颈炎的纳入标准，但结论相互矛盾。不幸的是，没有一项研究符合盆腔炎的纳入标准。解脲脲原体作为病原体在女性不孕症、宫颈炎、盆腔炎和生殖器不适中的作用似乎有限。其作为早产病原体的作用尚不清楚，需要未来的研究来解决这个问题。
