Mycoplasma genitalium: prevalence and behavioural risk factors in the general population

Andersen, Berit; Sokolowski, Ineta; Østergaard, Lars; Frimodt‐Møller, Niels; Olesen, Frede; Jensen, Jørgen Skov

doi:10.1136/sti.2006.022970

Cited by 126 publications

(128 citation statements)

References 27 publications

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“…The negative association between consistent use of condom and N. gonorrhoeae infection was previously demonstrated in some studies on commercial sex workers and people living with HIV (17,(20)(21)(22) but not in other studies (13,16,18,23,24). The discrepancy in this respect among the above related studies indicate that the use of condoms is not very effective for protection against M. genitalium infections.…”

Section: Discussioncontrasting

confidence: 47%

An Epidemiological Study of Mycoplasma genitalium Infections among Males Attending a Sexually Transmitted Disease Clinic in Guangxi, China

et al. 2014

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SUMMARY:The objective of this study was to determine the prevalence of urethral Mycoplasma genitalium infections among male patients attending a sexually transmitted disease (STD) clinic in China and identify risk factors associated with this disease. A total of 423 patients were recruited in Hezhou City, Guangxi Province, China, and each was requested to complete a questionnaire regarding sociological and sexual behaviors. First-void urine samples were collected for M. genitalium analysis by polymerase chain reaction. Of the 406 urine samples collected, 114 were M. genitalium-positive, giving a prevalence rate of 28.1z. Univariate logistic regression analysis showed that M. genitalium infection was associated with younger age, having received at least senior high school education, and single marital status. In both univariate and multivariate logistic regression analyses, M. genitalium infection was found to be associated with lack of symptoms for STD in the past year (adjusted odds ratio [AOR] ＝ 2.839; 95z CI ＝ 1.495-5.392; P ＝ 0.001), no use of condoms with steady partners in the past year (AOR ＝ 2.830; 95z CI ＝ 1.468-5.455; P ＝ 0.002), and having sexual encounters with female sexual workers within the past 3 months (AOR ＝ 2.955; 95z CI ＝ 1.637-5.336; P º 0.0003). The observed high rate of M. genitalium infection among male STD patients in Hezhou City indicates an M. genitalium epidemic in the study population; thus, the national surveillance program and clinical health providers in China should more closely monitor this disease. INTROUDCTIONMycoplasma genitalium was first isolated from 2 of 13 men with non-gonococcal urethritis (NGU) in 1981 (1). By molecular assays, many studies have associated M. genitalium infection with acute NGU, particularly non-chlamydial NGU (NCNGU) in men (2-5), with a prevalence ranging from 5z to 42z (6). M. genitalium also plays an etiological role in both persistent and recurrent NGU with an estimated prevalence of 19z-41z in men with persistent or recurrent urethritis (4,6). Although M. genitalium is an emerging pathogen of NGU, a limited number of studies have observed an M. genitalium prevalence of 10z-24z among men with NGU in China (7-9). Moreover, the National Sentinel Surveillance Program of China reported that the prevalence of NGU since 2008 has been equivalent to that of genital Chlamydia trachomatis infection (10), without including the rate of M. genitalium-positive NGU. Thus, the actual rate of NGU in China may have been grossly underestimated. Furthermore, most healthcare providers often neglect M. genitalium-positive NGU; therefore, very little information is available regarding the disease burden of this pathogen. A study conducted by our group recently reported the prevalence of C. trachomatis and Neisseria gonorrhoeae infections among male patients attending a sexually transmitted disease (STD) clinic (MSP) in China (11); however, this study did not include M. genitalium infection. Therefore, as a supplementary study, our objective of the present study was to d...

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Section: Discussioncontrasting

confidence: 47%

An Epidemiological Study of Mycoplasma genitalium Infections among Males Attending a Sexually Transmitted Disease Clinic in Guangxi, China

et al. 2014

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“…Across many of these studies, a young age, little education, single marital status, and high numbers of sex partners remained consistently associated with infection (4,9,16,18,21,23,24). Findings are less consistent among the few studies that examined risk factors among FSWs.…”

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confidence: 57%

Clinical Characteristics Associated with Mycoplasma genitalium among Female Sex Workers in Nairobi, Kenya

et al. 2014

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eThe prevalence of Mycoplasma genitalium is high in vulnerable populations of women in low-resource settings. However, the epidemiology of infection in these populations is not well established. To determine the prevalence of Mycoplasma genitalium and its association with cervical cytology and other correlates, we recruited 350 female sex workers (FSW) who were 18 to 50 years old in Nairobi, Kenya, for a cross-sectional study. A questionnaire was administered at baseline to obtain information on sociodemographics and sexual behaviors. Women underwent a pelvic exam, during which a physician collected cervical-exfoliation samples for conventional cytology and sexually transmitted infection (STI) testing. Samples were tested for M. genitalium Mycoplasma genitalium is an emergent bacterium that is transmitted via sexual activity and has been associated with complications in the female genital tract, including endometritis, tubal-factor infertility, pelvic inflammatory disease (PID), cervicitis, and ectopic pregnancy (1-9). M. genitalium may also increase the risk of HIV transmission and associated shedding (10-13).Vulnerable populations of women in low-resource settings have a higher-than-average susceptibility to sexually transmitted infections (STIs) and subsequent complications of the reproductive tract, including those caused by M. genitalium, Chlamydia trachomatis, and Neisseria gonorrhoeae (14). In the case of female sex workers (FSWs), STI risk is increased due to a greater exposure to unsafe sexual behaviors, such as unprotected sexual intercourse and high numbers of clients/sexual partners (15).The prevalence and associated risk factors for M. genitalium have been investigated both in the general population and among populations at high risk for STIs in sub-Saharan Africa, Asia, the United Kingdom, and the United States (4, 16-23). Across many of these studies, a young age, little education, single marital status, and high numbers of sex partners remained consistently associated with infection (4,9,16,18,21,23,24). Findings are less consistent among the few studies that examined risk factors among FSWs. In the literature, studies have shown similar associations of M. genitalium infection with basic demographic factors, such as education and marital status. However, there is less agreement for sexual-behavioral and clinical correlates, such as condom use, duration of sex work, and history of STIs (16,18,23). Chinese sex workers who did not present STI symptoms in the year prior to the study were more likely to have infection with M. genitalium than those who did (23). In contrast, a study conducted in sub-Saharan Africa found that sex workers who presented clinical symptoms were more likely to have M. genitalium infection than those who were asymptomatic (18).In studies examining concurrent M. genitalium infection with other STIs in the general population, M. genitalium was found to be associated with urethritis, cervicitis, and PID (25-28). However, more-recent research indicates the role of M. genitalium ...

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“…A populationbased Danish screening program with subjects aged 21 to 23 years in 1997-98 assessed CT and MG prevalence rates of 8.4% and 2.3% in women, respectively (14). Data on the prevalence of NG infection in the general population do not seem to exist.…”

Section: ü1 Introductionmentioning

confidence: 99%

Prevalence and Determinants of Sexually Transmitted Infections in Women at Risk Undergoing Abortion in a Swiss Primary Care Setting

Wesbonk

Chmiel

Rosemann

et al. 2014

Praxis

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Background: Specific prevalence data are needed to assess the burden of sexually transmitted infections (STIs) in specific settings where data are scant, such as women seeking early termination of pregnancy (TOP). We aimed to investigate the prevalence of STIs and its determinants in women at risk (e.g. pathological cervical swab) undergoing TOP in a primary care setting in Switzerland.Methods: Cross-sectional study of 620 women seeking abortion counselling at a general practice in Zurich, Switzerland.. Patients' characteristics were assessed and in case of pathological cervical swab a PCR-based screening for Chlamydia trachomatis (CT), Mycoplasma genitalium (MG) and Neisseria gonorrhoeae (NG) was initiated to estimate STI prevalence. Bi-and multivariable analysis were used to investigate STI determinants.Results: 585 out of the 620 women presenting for counselling resulted in TOP. 581 (93.7%) cervical specimens were available with 272 having pathological signs (46.8%), thus were considered at risk for STIs. In 192 screened samples 28 STIs (14.6%) (95% CI: 10.3-20.3%) were detected, predominantly CT (17 cases) followed by MG (9 cases) and NG (2 cases).Compared to non-immigrants, immigrants were more likely to have a STI (adjusted OR 2.63; p=0.037) Non-screened women were significantly more often self-payers (31.3%) compared to screened women (8.3%) (p<0.001). Conclusion:We found a high STI prevalence in women presenting for TOP in a Swiss primary care setting. Women with a migration background seemed to be a vulnerable subgroup. Public health efforts are needed to implement cost-effective screening and case management programs in this population at risk for STIs. 2 Ü1 Abbreviations Ü1 IntroductionSexually transmitted infections (STI) are among the most common causes of illness in the world and have far-reaching health, social and economic consequences for many countries.Chlamydia trachomatis (CT), Mycoplasma genitalium (MG) and Neisseria gonorrhoeae (NG) are considered being common sexually transmitted pathogens and can cause genitourinary infections with a wide range of symptoms; in women MG and NG can cause cervicitis, urethritis and endometritis (1-5). The causal connection of MG with salpingitis as well as potentially resulting infertility remains controversial, whereas CT and NG are known to cause salpingitis and have an impact on infertility (1, 4,(6)(7)(8)(9)(10)). An untreated CT infection can also lead to peritonitis, perihepatitis, pelvic inflammatory disease (PID) and ectopic pregnancy (EP) (4, 6, 7). Genital CT and NG infections are asymptomatic or just show mild symptoms in up to 70% and 50% of cases, respectively (4, 11). As a consequence, these infections often remain undetected thus abetting further transmission. Similarly, asymptomatic MG infections have also been described, raising the question whether also asymptomatic subgroups, such as women presenting for early termination of pregnancy (TOP), should be screened for MG (12, 13).International prevalence rates of STIs vary, depe...

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Mycoplasma genitalium: prevalence and behavioural risk factors in the general population

Cited by 126 publications

References 27 publications

An Epidemiological Study of Mycoplasma genitalium Infections among Males Attending a Sexually Transmitted Disease Clinic in Guangxi, China

An Epidemiological Study of Mycoplasma genitalium Infections among Males Attending a Sexually Transmitted Disease Clinic in Guangxi, China

Clinical Characteristics Associated with Mycoplasma genitalium among Female Sex Workers in Nairobi, Kenya

Prevalence and Determinants of Sexually Transmitted Infections in Women at Risk Undergoing Abortion in a Swiss Primary Care Setting

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