Ureaplasma and Mycoplasma in kidney allograft recipients-A case series and review of the literature

Transpl Infect Dis. 2018 Oct;20(5):e12937. doi: 10.1111/tid.12937. Epub 2018 Jun 15.

Abstract

Ureaplasma urealyticum and Mycoplasma hominis are common inhabitants of the human genital tract. Increasingly, serious and sometimes fatal infections in immunocompromised hosts have been reported, highlighting their pathogenic potential. We reviewed the clinical impact of positive Ureaplasma spp. and Mycoplasma spp. urine cultures in 10 renal allograft recipients who presented with sterile leukocyturia. Five recipients remained asymptomatic. Five patients were symptomatic with dysuria or pain at the graft site. Three patients developed biopsy-proven acute graft pyelonephritis with graft dysfunction. One of these patients additionally showed a renal abscess as demonstrated by magnetic resonance imaging (MRI). All were successfully treated. A literature search revealed a substantial number of case reports with severe and sometimes fatal Ureaplasma spp. or Mycoplasma spp. infections in immunocompromised patients. Colonization rate is high in renal transplant patients. A subset of patients is at risk for invasive disease.

Keywords: Mycoplasma hominis; Ureaplasma urealyticum; abscess; graft dysfunction; infection; kidney allograft recipient.

Publication types

  • Review

MeSH terms

  • Adult
  • Allografts / immunology
  • Allografts / microbiology
  • Allografts / pathology
  • Biopsy
  • Female
  • Graft Rejection / immunology
  • Graft Rejection / microbiology
  • Graft Rejection / pathology
  • Graft Rejection / prevention & control
  • Humans
  • Immunocompromised Host
  • Immunosuppression Therapy / adverse effects
  • Kidney Transplantation / adverse effects*
  • Male
  • Middle Aged
  • Mycoplasma Infections / epidemiology*
  • Mycoplasma Infections / microbiology
  • Mycoplasma hominis / isolation & purification*
  • Mycoplasma hominis / pathogenicity
  • Ureaplasma Infections / epidemiology*
  • Ureaplasma Infections / microbiology
  • Ureaplasma urealyticum / isolation & purification*
  • Ureaplasma urealyticum / pathogenicity
  • Urinary Tract Infections / epidemiology*
  • Urinary Tract Infections / microbiology
  • Young Adult