Rapid molecular detection, prevalence and antimicrobial resistance of Ureaplasma urealyticum in genital tract specimens: a study at a district general hospital in China.

BACKGROUND: Ureaplasma urealyticum (U. urealyticum, UU) infection in the genital tract can induce severe complications of adverse pregnancy outcomes and infertility. Therefore, the current study aimed to apply and evaluate a rapid SAT method for detecting U. urealyticum.

METHODS: This study enrolled 2,728 outpatients with genitourinary complaints. The inclusion criteria were: (1) presence of genitourinary symptoms, and (2) no antibiotic therapy within the 72 h preceding sample collection. Firstly, U. urealyticum identified by culture underwent broth microdilution antimicrobial susceptibility testing. Secondly, a total of 305 UU-positive and 301 UU-negative controls were randomly selected for assessing the sensitivity and specificity of the SAT method. Finally, we compared the sensitivity and specificity of the SAT method with those of real-time fluorescence qPCR.

RESULTS: Of the 2,728 samples tested, 1,158 (42.45%) were positive for U. urealyticum by culture assay. The resistance rates against MIN, DOX, JOS, CLA, ROX, AZI, LEV, OFL, and SPA were 1.38%, 2.07%, 5.44%, 12.18%, 17.74%, 17.70%, 16.23%, 27.03%. and 21.59%, respectively. The sensitivity and specificity of the SAT method were 96.39% and 99.00%, respectively. Compared to the real-time fluorescence qPCR, no statistically significant difference was observed in either sensitivity (96.39% vs 96.72%; χ² = 0.0493, p = 0.8243) or specificity (99.00% vs 99.67%; χ² = 0.2517, p = 0.6159).

CONCLUSIONS: Although SAT is not superior to qPCR in sensitivity or specificity, it offers comparable performance, along with rapid detection and potential cost-effectiveness. Therefore, SAT represents a promising diagnostic alternative, particularly for rapid detection of U. urealyticum infection.