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Increasing the evaluation of Mycoplasma and Ureaplasma infections in primary care: A quality improvement project

Volpert EM, Corniel B, Croghan A, Humphreys M, Moisa CR, Smith J

Journal of the American Association of Nurse Practitioners, 2026

519 participants

Abstract

BACKGROUND: Mycoplasma and Ureaplasma infections are frequently underdiagnosed and undertreated in primary care, contributing to adverse reproductive and genitourinary outcomes. Limited routine screening, diagnostic complexity, and variable provider awareness contribute to gaps in care.

LOCAL PROBLEM: In an academic primary care setting, patients presenting with genitourinary symptoms were infrequently evaluated for Mycoplasma and Ureaplasma.

METHODS: This quality improvement project was conducted in two academic family medicine clinics. Pre- and postintervention retrospective chart reviews assessed rates of testing and diagnosis among adult patients presenting with urethral or vaginal discharge, pelvic pain, and/or dysuria. Provider education and standardized evaluation and treatment algorithms were implemented.

INTERVENTIONS: An educational session was delivered and supported with emailed materials. Standardized algorithms outlining indications for testing and recommended treatments were integrated into clinical workflow.

RESULTS: During the study period, 519 patients presented with genitourinary symptoms. Recurrent symptoms consistent with Mycoplasma or Ureaplasma infection were identified in 205 patients (39.5%); however, 133 (64.9%) were not screened. Among the 72 patients (35.1%) who underwent diagnostic testing, 46 (63.9%) tested positive. Overall, 45 patients were diagnosed with Mycoplasma or Ureaplasma infections, including Mycoplasma hominis (26.7%), Ureaplasma…

How strong is the evidence?

Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 519 participants or records.

How the five levels of evidence work. The level is assigned automatically from the abstract and can be wrong, so check the paper.

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