STIs
Ureaplasma urealyticum PCR (swab)
PCR test for Ureaplasma urealyticum in a vaginal swab; often present without symptoms, so a positive result says little.
What it measures
Ureaplasma urealyticum is a small bacterium without a cell wall that is present in the genital organs of many healthy people without causing symptoms (carriage). In adults, the bacterium is usually transmitted through sex, but it is not counted among the STIs. In a small share of men with urethritis (inflammation of the urethra), a large amount of this bacterium may possibly play a role. The PCR looks for genetic material of the bacterium in a self-collected vaginal swab and does not say whether the bacterium causes symptoms.
- Presence of Ureaplasma urealyticum in the vagina; this is usually carriage without symptoms
Positive
A positive result means that the bacterium is present. This is common in people without symptoms and usually does not mean disease. According to a position statement of the European STI Guidelines Editorial Board (IUSTI, 2018), in men with urethritis Ureaplasma urealyticum is in 40 to 80 percent of cases merely a bystander carrier and not the cause; in women there is no good evidence that the bacterium causes inflammation or infertility. According to this position statement, treatment of a positive result without symptoms is not needed; the bacterium is also hard to get rid of permanently.
Negative
A negative result means that the bacterium was not found. Because Ureaplasma urealyticum also occurs in healthy people and is not a proven cause of disease, a negative result has little meaning for your health. This result does not explain or rule out vaginal symptoms; tests for chlamydia, gonorrhea, trichomonas and bacterial vaginosis, among others, are intended for that.
If your result is abnormal
With a positive result without symptoms, according to the European recommendation, no treatment or follow-up is needed. With symptoms, the GP first looks for other causes, such as chlamydia, gonorrhea, Mycoplasma genitalium or trichomonas; only in men with urethritis and a large amount of Ureaplasma urealyticum can treatment be considered, although the evidence for this is weak. Ureaplasma is not notifiable.
Reliability
The PCR reliably detects the bacterium, but a positive result does not distinguish between carriage and an infection that causes symptoms. Ureaplasma urealyticum is not a proven cause of disease: the evidence that this bacterium causes urethritis or other symptoms is insufficient. As a result, a positive result says little, both in people without symptoms and in most people with symptoms.
Limitations
- A positive result does not say whether the bacterium causes symptoms; many women without symptoms also carry the bacterium.
- In women, the amount of this bacterium is associated with bacterial vaginosis and with real STIs, which can themselves be the cause of symptoms.
- Treatment with antibiotics often does not remove the bacterium permanently, and disappearance of the bacterium is not strongly linked to disappearance of symptoms.
- With self-collection, too little material may end up on the swab, for example if it was not inserted far enough or for too short a time; this can give a false negative result.
How common is this
How common Ureaplasma urealyticum is in the Netherlands is not known, because it is not routinely tested for. In international studies using PCR, the bacterium was found in an estimated 5 to 15 percent of men aged 16 to 44 and in 5 to 20 percent of sexually active women who were not pregnant. Carriage is more common at a younger age and after a new sexual partner.
Who is this useful for
The result usually does not explain symptoms, because the bacterium also occurs in many healthy people. Vaginal symptoms more often fit bacterial vaginosis, chlamydia, gonorrhea or trichomonas. This test is not suitable for questions about pregnancy or fertility.
Downsides and risks
- A positive result can lead to unnecessary treatment with antibiotics, with a chance of side effects and of resistance in this bacterium and in other bacteria, including those that cause real STIs.
- A positive result can wrongly give the idea that you have an STI, leading to worry or tension in a relationship.
Sources
- Horner e.a. Should we be testing for urogenital Mycoplasma hominis, Ureaplasma parvum and Ureaplasma urealyticum in men and women? Standpunt van de European STI Guidelines Editorial Board (IUSTI), J Eur Acad Dermatol Venereol 2018
- Multidisciplinaire Richtlijn Seksueel overdraagbare aandoeningen (2024), module B1 Urethritis
- Thuisarts.nl: Ik wil een soa-test doen
Always discuss an abnormal result with your GP. If a result is strongly abnormal, we try to reach you as soon as possible. Read your result yourself as well and contact your GP if in doubt. A test does not make a diagnosis. Read more about risks and results