<i><scp>M</scp>ycoplasma genitalium:</i> prevalence in men presenting with urethritis to a <scp>S</scp>outh <scp>A</scp>ustralian public sexual health clinic

Mezzini, Tonia; Waddell, Russell; Douglas, R J W; Sadlon, Tania

doi:10.1111/imj.12103

Cited by 15 publications

(15 citation statements)

References 22 publications

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“…This result is similar to findings from previous studies among male STD patients [29,30]. This might be attributed to more unprotected vaginal and anal intercourses in this population than in MSMs who engaged in exclusively homosexual behaviors.…”

Section: Discussionsupporting

confidence: 91%

The prevalence of urethral and rectal Mycoplasma genitalium among men who have sex with men in China, a cross-sectional study

Zheng¹,

Yin²,

Han³

et al. 2014

BMC Public Health

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BackgroundAlthough Mycoplasma genitalium (MG) is a common sexually transmitted infection (STI), very little information regarding the prevalence of MG among MSM (men who have sex with men) is available in China. The objective of this study was to determine the prevalence of MG among MSM in the city of Shenzhen, Guangdong Province, China, and to identify the potential risk factors associated with MG infection in this population.MethodsBetween January and May 2010, a total of 409 MSM were recruited in Shenzhen, Guangdong Province, China. An anonymous questionnaire was used to collect information regarding their sociological and sexual behaviors. In addition, their first-void urine (FVU) samples and rectal swabs were collected for PCR-based MG testing.ResultsAmong the 406 FVU and 405 rectal swab samples were collected from 409 MSM, the overall MG prevalence was 8.1% (33/406, 95% CI 5.7%-10.6%), with a FVU positivity of 3.4% (95% CI 1.7%-5.4%) and a rectal positivity of 5.4% (95% CI 3.5%-7.7%). Using both univariate and multivariable logistic regression analyses, urethral MG infection was significantly associated with having more heterosexual behaviors (AOR 7.16, 95% CI 1.89-27.13), and with having unprotected anal intercourse in the past six months (AOR 4.80, 95% CI 1.40-16.47). Rectal MG infection was significantly associated with HIV infection based on univariate logistic regression analysis (OR = 4.49, 95% CI 1.18-17.12).ConclusionsIn this study, we investigated the prevalence of MG infection in the population of interest, as determined from both urethral and rectal specimen. We showed that MG was more prevalent in MSM who had bisexual behaviors compared to those who engaged only in homosexual behaviors. Further work is needed to establish the mode of MG transmission and to identify its role in HIV transmission. Meanwhile, more attention should be paid to MG infection among MSMs, and especially bisexual MSMs, which might have critical implications for effective HIV/STD control in China.

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Section: Discussionsupporting

confidence: 91%

The prevalence of urethral and rectal Mycoplasma genitalium among men who have sex with men in China, a cross-sectional study

Zheng¹,

Yin²,

Han³

et al. 2014

BMC Public Health

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“…genitalium infections reported here are similar to those reported previously in smaller studies of high-risk populations in the United States (6, 9, 10, 14, 15, 20) and in the European community (21, 22), Australia and New Zealand (23–25), Asia (26, 27), and Africa (28, 29). Age-related trends for M.…”

Section: Discussionsupporting

confidence: 90%

Mycoplasma genitalium Prevalence, Coinfection, and Macrolide Antibiotic Resistance Frequency in a Multicenter Clinical Study Cohort in the United States

et al. 2016

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The prevalence rates of Mycoplasma genitalium infections and coinfections with other sexually transmitted organisms and the frequency of a macrolide antibiotic resistance phenotype were determined in urogenital specimens collected from female and male subjects enrolled in a multicenter clinical study in the United States. Specimens from 946 subjects seeking care from seven geographically diverse clinical sites were tested for M. genitalium and for Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis. Sequencing was used to assess macrolide antibiotic resistance among M. genitalium-positive subjects. M. genitalium prevalence rates were 16.1% for females and 17.2% for males. Significant risk factors for M. genitalium infections were black race, younger age, non-Hispanic ethnicity, and female symptomatic status. Female M. genitalium infections were significantly more prevalent than C. trachomatis and N. gonorrhoeae infections, while the M. genitalium infection rate in males was significantly higher than the N. gonorrhoeae and T. vaginalis infection rates. The macrolide-resistant phenotype was found in 50.8% of females and 42% of males. These results show a high prevalence of M. genitalium single infections, a lower prevalence of coinfections with other sexually transmitted organisms, and high rates of macrolide antibiotic resistance in a diverse sample of subjects seeking care across a wide geographic area of the United States.

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“…The prevalence of pathogens identified in both studies is reassuringly similar, and these data confirm C. trachomatis and M. genitalium are less likely to be detected in MSM. The estimates for C. trachomatis and M. genitalium are also in keeping with other estimates from our service and region (17)(18)(19)(20). It was interesting to note that even in the presence of a bacterial pathogen, MSM reported more consistent condom use for anal sex than MSW for vaginal sex and that MSM with idiopathic NGU were also substantially more likely to report engaging in only nonpenetrative anal/ vaginal sexual activity with their partners in the prior 3 months.…”

Section: Discussionsupporting

confidence: 83%

Characteristics of Acute Nongonococcal Urethritis in Men Differ by Sexual Preference

et al. 2014

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N ucleic acid amplification techniques (NAAT) have allowed greater understanding of the variety of pathogens involved in acute nongonococcal urethritis (NGU) (1). This has included the recent recognition of Mycoplasma genitalium, herpes simplex virus (HSV), and adenoviruses as urethral pathogens (2-5), although in a significant proportion of cases no urethral pathogen is currently identified. The role of Ureaplasma urealyticum in NGU has been somewhat controversial, but recent evidence implicates specific biovars and possibly higher bacterial loads as causally associated with acute NGU (6-8). Sporadic case reports implicate other bacteria such as Haemophilus species (Haemophilus influenzae and Haemophilus parainfluenzae), Streptococcus species (Streptococcus pneumoniae and Streptococcus pyogenes), and Moraxella catarrhalis in acute NGU, following orogenital sex (9-11); however, their etiologic role has not been established in case-control studies.Diagnostic and management approaches to acute NGU do not differentiate between men who have sex with men (MSM) and men who have sex with women (MSW). Yet sexual behaviors differ considerably between these groups, and it is therefore likely that the spectrum of pathogens varies. In support of this, a previous case-control study of NGU in our service found that Chlamydia trachomatis or M. genitalium were more likely to be associated with female partners, while viruses, such as HSV and adenovirus, were associated with a recent history of male sexual partners (2). Further elucidation of the etiology of this common syndrome, and developing an understanding of how sexual practices influence the detection of urethral pathogens, could improve the management of men and their partners (1,12,13). In this study, we examined behavioral, demographic, and laboratory characteristics of a large series of MSW and MSM with acute urethral symptoms over a 6-year period. We aimed to determine if there were key differences between MSW and MSM with acute NGU in the spectrum of pathogens involved and whether there were differences in sexual behavior preceding the acquisition of NGU. MATERIALS AND METHODSStudy population. We retrospectively reviewed the electronic case record database of Melbourne Sexual Health Centre, the main public sexually transmitted diseases clinic in Melbourne, Australia, from January 2006 to December 2011. Patients were required to have the diagnosis of acute NGU entered into the electronic medical record, with one or more of the following acute urethral symptoms for less than 1 month's duration: urethral discharge and urethral irritation, discomfort, or itch; patients also needed to fulfill the conventional laboratory definition of urethritis, namely, 5 or more polymorphic neutrophilic lymphocytes/high-powered field (Ն5 polymorphonuclear leukocytes [PMNL]/high-powered field [HPF]) on urethral Gram stain. Importantly, only a single first episode of acute NGU per case over the study period was included. All subsequent

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Mycoplasma genitalium: prevalence in men presenting with urethritis to a South Australian public sexual health clinic

Abstract: In Adelaide, M. genitalium is an important sexually transmitted infection among men with dysuria and/or urethral discharge, and is primarily an infection of heterosexual and bisexual men.

Cited by 15 publications

References 22 publications

The prevalence of urethral and rectal Mycoplasma genitalium among men who have sex with men in China, a cross-sectional study

The prevalence of urethral and rectal Mycoplasma genitalium among men who have sex with men in China, a cross-sectional study

Mycoplasma genitalium Prevalence, Coinfection, and Macrolide Antibiotic Resistance Frequency in a Multicenter Clinical Study Cohort in the United States

Characteristics of Acute Nongonococcal Urethritis in Men Differ by Sexual Preference

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