Failure to detect Mycoplasma genitalium in the pharynges of female sex workers in Japan

Deguchi, Takashi; Yasuda, Mitsuru; Yokoi, Shigeaki; Nakano, Masahiro; S, Itó; Ohkusu, Kiyofumi; Ezaki, Takayuki; Hoshina, Shinji

doi:10.1007/s10156-009-0726-4

Cited by 26 publications

(24 citation statements)

References 20 publications

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“…Lastly, because we relied on clinic-based data, we were unable to identify cases of NGNCU caused by pathogens such as Mycoplasma genitalium, herpes viruses and adenovirus, which can cause NGNCU, but which are not tested for routinely in our clinic. Although this is a limitation to our study, M. genitalium has not been detected in the oropharynx previously, 15 and our findings support the idea that oral sex is a likely source of infection for many cases of NGNCU.…”

Section: Discussionsupporting

confidence: 86%

An estimate of the proportion of symptomatic gonococcal, chlamydial and non-gonococcal non-chlamydial urethritis attributable to oral sex among men who have sex with men: a case–control study

et al. 2015

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Background Sexually transmitted infections of the pharynx are common among men who have sex with men (MSM); the degree to which these infections are transmitted through oral sex is unknown. Methods We conducted a case-control study of MSM attending Public Health – Seattle & King County STD Clinic between 2001 – 2013 to estimate the proportion of symptomatic urethritis cases attributable to oral sex using two methods. First, we categorized men into the following mutually exclusive behavioural categories based on their self-reported sexual history in the previous 60 days: 1) only received oral sex (IOS); 2) 100% condom usage with insertive anal sex plus oral sex (PIAI); 3) inconsistent condom usage with anal sex (UIAI); and 4) no sex. We then determined the proportion of cases in which men reported the oropharynx as their only urethral exposure (IOS and PIAI). Second, we calculated the population attributable risk percent (PAR%) associated with oral sex using Mantel-Haenszel odds ratio estimates. Results Based on our behavioural categorization method, men reported the oropharynx as their only urethral exposure in the past 60 days in 27.5% of gonococcal, 31.4% of chlamydial, and 35.9% non-gonococcal, non-chlamydial (NGNCU) urethritis cases. The PAR%s for symptomatic gonococcal, chlamydial and NGNCU urethritis attributed to oropharyngeal exposure were 33.8%, 2.7% and 27.1% respectively. Conclusions The pharynx is an important source of gonococcal transmission, and may be important in the transmission of chlamydia and other, unidentified pathogens that cause urethritis. Efforts to increase pharyngeal gonorrhoea screening among MSM could diminish STI transmission.

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Section: Discussionsupporting

confidence: 86%

An estimate of the proportion of symptomatic gonococcal, chlamydial and non-gonococcal non-chlamydial urethritis attributable to oral sex among men who have sex with men: a case–control study

et al. 2015

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“…Similarly, oral carriage and deposition through oral sex is also unlikely. M. genitalium has not been detected in any of the oropharyngeal specimens tested with molecular methods to date [28,30]. Thus, these other potential modes of transmission for M. genitalium are unlikely.…”

Section: Other Potential Modes Of Transmissionmentioning

confidence: 77%

Mycoplasma genitalium: Is It a Sexually Transmitted Pathogen?

Manhart

Kay

2010

Curr Infect Dis Rep

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Mycoplasma genitalium is an emerging pathogen that has been detected in the male and female reproductive tracts. It is an established cause of nongonococcal urethritis and evidence linking it to cervicitis, endometritis, and tubal factor infertility is accumulating. Whether a pathogen is sexually transmitted has important implications for clinical management because partner management strategies are an essential part of the treatment plan for sexually transmitted infections. However, mere detection in the genital tract and associations with reproductive tract disease are insufficient to conclude that an organism is sexually transmitted. Therefore, to assess whether M. genitalium is sexually transmitted, we evaluated the literature in terms of associations with established risk factors for other sexually transmitted infections, comparisons of sexually experienced individuals to nonsexually experienced individuals, consideration of other modes of transmission, assessment of concordant infection status among sexual partners, and examination of molecular strain typing in concordantly infected partners.

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“…M. genitalium has been detected in anorectal samples by culture and NAATs, and transmission from penile‐anal sexual contact has been established . Oral‐genital contact is less likely to contribute to any significant extent, as carriage of M. genitalium in the oro‐pharynx is low . Mother‐to‐child transmission at birth has not been systematically studied, but M. genitalium has been detected in the respiratory tract of newborn children .…”

Section: Transmissionmentioning

confidence: 99%

“…23 Oral-genital contact is less likely to contribute to any significant extent, as carriage of M. genitalium in the oro-pharynx is low. 24,25 Mother-to-child transmission at birth has not been systematically studied, but M. genitalium has been detected in the respiratory tract of newborn children. 26 The risk of contracting M. genitalium per sexual encounter has not been determined, but because M. genitalium is present in lower concentration in genital tract specimens than C. trachomatis, 27 it could be considered slightly less contagious than chlamydia.…”

Section: Transmissionmentioning

confidence: 99%

2016 European guideline on Mycoplasma genitalium infections

Jensen

Cusini

Gomberg

et al. 2016

Acad Dermatol Venereol

320

303

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Mycoplasma genitalium infection contributes to 10-35% of non-chlamydial non-gonococcal urethritis in men. In women, M. genitalium is associated with cervicitis and pelvic inflammatory disease (PID). Transmission of M. genitalium occurs through direct mucosal contact. Asymptomatic infections are frequent. In women, symptoms include vaginal discharge, dysuria or symptoms of PID -abdominal pain and dyspareunia. In men, urethritis, dysuria and discharge predominates.Besides symptoms, indication for laboratory test is a high-risk sexual behaviour. Diagnosis is achievable only through nucleic acid amplification testing (NAAT). If available, NAAT diagnosis should be followed with an assay for macrolide resistance. Therapy for M. genitalium is indicated if M. genitalium is detected or on an epidemiological basis. Doxycycline has a low cure rate of 30-40%, but does not increase resistance. Azithromycin has a cure rate of 85-95% in macrolide susceptible infections. An extended course appears to have a higher cure rate. An increasing prevalence of macrolide resistance, most likely due to widespread use of azithromycin 1 g single dose without test of cure, is drastically decreasing the cure rate. Moxifloxacin can be used as second-line therapy, but resistance is increasing. Uncomplicated M. genitalium infection should be treated with azithromycin 500 mg on day one, then 250 mg on days 2-5 (oral), or josamycin 500 mg three times daily for 10 days (oral). Second line treatment and treatment for uncomplicated macrolide resistant M. genitalium infection is moxifloxacin 400 mg od for 7-10 days (oral). For third line treatment of persistent M. genitalium infection after azithromycin and moxifloxacin doxycycline 100 mg two times daily for 14 days can be tried and may cure 30%. Pristinamycin 1 g four times daily for 10 days (oral) has a cure rate of app. 90%. Complicated M.genitalium infection (PID, epididymitis) is treated with moxifloxacin 400 mg od for 14 days.

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Failure to detect Mycoplasma genitalium in the pharynges of female sex workers in Japan

Cited by 26 publications

References 20 publications

An estimate of the proportion of symptomatic gonococcal, chlamydial and non-gonococcal non-chlamydial urethritis attributable to oral sex among men who have sex with men: a case–control study

An estimate of the proportion of symptomatic gonococcal, chlamydial and non-gonococcal non-chlamydial urethritis attributable to oral sex among men who have sex with men: a case–control study

Mycoplasma genitalium: Is It a Sexually Transmitted Pathogen?

2016 European guideline on Mycoplasma genitalium infections

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