High Prevalence of Genital Mycoplasmas among Sexually Active Young Adults with Urethritis or Cervicitis Symptoms in La Crosse, Wisconsin

Abstract

Sexually active young adults in the small college town of La Crosse, Wisconsin, were evaluated for conventional sexually transmitted pathogens and tested for infections with mycoplasmas. The prevalence in 65 symptomatic men or women and 137 healthy volunteers (67 men and 70 women) was compared. Urine specimens from both cohorts were tested by ligase chain reaction for Chlamydia trachomatis or Neisseria gonorrhoeae. In addition, the urethral or cervical swabs from the symptomatic subjects were tested by PCR for Mycoplasma genitalium and cultured for Mycoplasma hominis and the ureaplasmas. The results confirmed a relatively low prevalence of gonorrhea among symptomatic men (12%) and chlamydia among symptomatic men (15%) and normal women (3%). In contrast, infections with mycoplasmas, especially the ureaplasmas (57%), were common and the organisms were the only potential sexually transmitted pathogen detected in 40 (62%) symptomatic subjects. Because of the high prevalence, we also evaluated urethral swabs from an additional 25 normal female volunteers and recovered ureaplasmas from 4 (16%) subjects. Additionally, the participants rarely used protection during sexual intercourse and some symptomatic subjects apparently acquired their infections despite using condoms regularly. The findings demonstrate a strong association between abnormal urogenital findings and detection of myoplasmas, particularly ureaplasmas, and suggest the infections will remain common.Genitourinary infections, including sexually transmitted diseases (STDs), are caused by a large number of diverse microbial agents that cause considerable morbidity and mortality worldwide. While "classical" sexually transmitted pathogens such as Neisseria gonorrhoeae and Treponema pallidum continue to produce serious illnesses among certain (primarily urban) populations in the United States (6, 7), less urbanized communities have a proportionally higher incidence of urethritis and cervicitis caused by Chlamydia trachomatis. In addition, mycoplasmas commonly colonize the genital tracts of men and women (34), and the ability of some species to cause nongonococcal urethritis has been well established. However, the prevalence and complete pathogenic potential of this bacterial group is still being elucidated (2,4,34,35).La Crosse, Wisconsin, a small city with a relatively large number of college students, has a low incidence of gonorrhea and syphilis. In addition, the incidence of C. trachomatis infections declined until 1997, though it has increased in recent years. This may be due in part to the introduction of more sensitive DNA-based assays. The countywide annual incidence of Chlamydia was 247/100,000 in 2001 (La Crosse County Public Health data). More significantly, a large proportion of urethritis and cervicitis cases remain nongonococcal and nonchlamydial, and we hypothesized a significant contribution from genital mycoplasmas. Accordingly, we evaluated a cohort of sexually active young adults with clinical symptoms suggestive of STD (i.e., urethritis or cer...

Frequency of Mycoplasma hominis and Ureaplasma urealyticum in Females With Urogenital Infections and Habitual Abortion History in Ahvaz, Iran; Using Multiplex PCR

“…These results support previous reports on the presence of M. hominis and U. urealyticum in sexually active adults (10,11). Apparently, the level of colonization of genital mycoplasmas is highly affected by fluctuation of estrogen and progesterone hormones (19).…”

“…Apparently, the level of colonization of genital mycoplasmas is highly affected by fluctuation of estrogen and progesterone hormones (19). In addition, within this range; more sexual activity, desired condition of urogenital tract mucosa and utilization of contraceptive pills cause higher level of colonization of mycoplasmas in comparison with those of non-sexually active adults (11,20). In the current study, 25 out of 265 females with urogenital infections had history of habitual abortion.…”

“…Notably, these microorganisms colonize numerously in sexually active women, but they cannot be detected due to less sensitivity of microbiological cultivation methods unless an infection occurs (11). Based on the literature, diseases such as pelvic inflammatory disease, infertility (12), habitual abortion (13), bacterial vaginosis (14), cervicitis (15), non-gonococcal urethritis (7) and chorioamnionitis (5) have been reported to be associated with M. hominis and U. urealyticum infection.…”

Multiplex PCR Testing Detection of Higher-than-Expected Rates of Cervical Mycoplasma , Ureaplasma , and Trichomonas and Viral Agent Infections in Sexually Active Australian Women

“…Our detection rates of the four species of the Mollicutes putatively associated with genital infection are consistent with previous studies, with U. parvum being the commonest (26,45,49). Detection of M. genitalium is becoming increasingly important because of recent reports of a high prevalence of the organism in women with cervicitis (15,41,45).…”

“…However, the etiology of most cases is undetermined and could be multifactorial in nature (11,34,35,40). Studies undertaken in other epidemiologic settings indicate significant differences in the prevalences of other cervical infectious agents (1,41,44,45,58). An underappreciation of the prevalences of and roles played by these nongonococcal and nonchlamydial agents potentially jeopardizes the effectiveness of empirical treatments for cervicitis.…”