Master’s Thesis Investigates the Prevalence of Genital Mycoplasmas among Pregnant Women with Sterile Pyuria

A Master’s thesis defense was held on Wednesday, September 2, 2026, for Nibras Zamil Abadi, a Master’s student in the Department of Medical Microbiology, College of Medicine, Al-Nahrain University. The thesis was entitled:

“Prevalence of Mycoplasma genitalium, Mycoplasma hominis, and Ureaplasma urealyticum in Pregnant Women with Sterile Pyuria.”

The study aimed to determine the incidence and prevalence of genital mycoplasma species, namely Mycoplasma genitalium, Mycoplasma hominis, and Ureaplasma urealyticum, among pregnant women with sterile pyuria. It also investigated their association with clinical symptoms, obstetric outcomes, and neonatal outcomes, and evaluated the effectiveness of polymerase chain reaction (PCR) for detecting these bacteria in cases where no bacterial growth was observed in urine cultures.

The cross-sectional study included 250 pregnant women who attended the antenatal care clinic at Al-Imamain Al-Kadhimain Teaching Hospital in Baghdad, Iraq, from October 2025 to January 2026. Midstream clean-catch urine samples were collected and subjected to microscopic examination and conventional culture. PCR testing was performed on 65 selected cases to detect Mycoplasma genitalium, Mycoplasma hominis, and Ureaplasma urealyticum using species-specific primers targeting the MgPa adhesin gene, 16S rDNA gene, and urease gene, respectively. Clinical, obstetric, and neonatal data were also collected. Statistical analysis was performed using SPSS version 26, with Fisher’s exact test applied and statistical significance set at P < 0.05.

The results showed that, among the 65 pregnant women who underwent PCR testing for genital mycoplasmas, 45 cases (69.2%) tested positive, while 20 cases (30.8%) tested negative.

Mycoplasma genitalium was the most frequently detected species, identified in 34 cases (52.3%), while 31 cases (47.7%) tested negative. Ureaplasma urealyticum was detected in 20 cases (30.8%), whereas 45 cases (69.2%) tested negative. Mycoplasma hominis was detected in 14 cases, representing 21.5% of the total tested cases.

The study demonstrated significant associations between genital mycoplasma infection and several clinical symptoms, including dysuria, urinary frequency/urgency, pelvic pain, and vaginal discharge. However, no significant association was observed between infection and hematuria.

The findings also revealed significant associations between genital mycoplasma infection and several adverse obstetric outcomes, including preterm contractions, chorioamnionitis, preterm premature rupture of membranes (PPROM), and cesarean section delivery.

In contrast, no significant associations were observed between genital mycoplasma infection and low birth weight, very low birth weight, neonatal intensive care unit (NICU) admission, respiratory distress, stillbirth, or neonatal mortality.

The study concluded that a high prevalence of genital mycoplasmas, particularly Mycoplasma genitalium and Ureaplasma urealyticum, was recorded among pregnant women with sterile pyuria. The findings also demonstrated significant associations between genital mycoplasma infection and certain adverse obstetric outcomes, highlighting the potential importance of these infections during pregnancy.

The study further demonstrated that PCR using urine samples was an effective non-invasive diagnostic method for detecting these bacteria, particularly in cases where conventional urine cultures showed no bacterial growth.

The discussion committee consisted of:

• Prof. Dr. Thanaa Rashid Abdul-Rahman – Chair

• Prof. Dr. Raghad Hussein Hassan – Member

• Prof. Dr. Sahar Hisham Abdul-Razzaq – Member

• Prof. Dr. Jabbar Salman Hassan – Member and Supervisor

• Prof. Dr. Sarah Abdul-Ridha Mohammed – Member and Supervisor

The thesis was successfully approved with a grade of Excellent.

Media and Government Communication Division
College of Medicine – Al-Nahrain University