A serological study of the role of Mycoplasma genitalium in pelvic inflammatory disease and ectopic pregnancy

Abstract

Objectives: Establishing a connection between the emerging urogenital tract pathogen Mycoplasma genitalium and upper genital tract infection in women would be of major importance. The aim of this study was to evaluate the association between M genitalium antibodies and pelvic inflammatory disease (PID) and ectopic pregnancy (EP) using a lipid-associated membrane protein-enzyme immunoassay (LAMP-EIA) method. Methods: The LAMP-EIA was used to analyse sera obtained from patients with clinical PID and EP collected in Sweden between February 1984 and April 1986. Sera from healthy pregnant women (Ctrl) collected during approximately the same period were used as controls. Evidence of chlamydial infection was investigated using a commercial anti-Chlamydia trachomatis EIA assay. Results: The LAMP-EIA was specific as determined by a lack of cross-reactivity with other Mycoplasma species. The LAMP-EIA showed that 17% (33/193) of the PID patients were M genitalium positive as compared to 18% (15/82) of the EP patients and 15% (36/246) of the Ctrl women. No significant association could be demonstrated between M genitalium antibodies and PID or EP in crude or adjusted logistic regression. Antibodies against C trachomatis were demonstrated in 54% of the PID and 57% of the EP patients, and also in 37% of the Ctrl women, showing a statistically significant association. Conclusion: No statistically significant association between PID or EP and M genitalium antibodies could be found using the LAMP-EIA, although a slight tendency toward association was found when focusing on younger individuals. P elvic inflammatory disease (PID) almost exclusively affects sexually active fertile women, who then face an increased risk of infertility, ectopic pregnancy (EP) and chronic pelvic pain. The best known causative agents of PID are Neisseria gonorrhoeae and Chlamydia trachomatis. Some studies have indicated that non-gonococcal rather than gonococcal infections of the upper genital tract are more likely to result in infertility and EP.1-3 Although many cases are caused by C trachomatis, some studies have also shown an association between Mycoplasma genitalium infection and PID and infertility. [4][5][6][7] M genitalium was discovered in 1981 when it was isolated from the urethra of two men with non-gonococcal urethritis. 8The infection is sexually transmitted, but the complete pattern of diseases caused by M genitalium has not yet been completely elucidated. The infections tend to run a chronic course and are often asymptomatic.9 10 Experiments with female monkeys where M genitalium was inoculated into the oviducts, resulted in salpingitis followed by a specific antibody response.11 The cross-reactions between M pneumoniae and M genitalium 12 13 have made it difficult to use serology for diagnosis and epidemiological studies, but Wang et al developed and evaluated a Triton X-114 extracted lipid-associated membrane protein (LAMP) assay and found no cross-reactions. 9 14 In the present study we have used sera obtained in the 1980s from women ...

Mycoplasma genitalium: from Chrysalis to Multicolored Butterfly

“…Further evidence for M. genitalium causing PID is (i) the ability of the organisms to adhere to Fallopian tube mucosal epithelial cells in organ culture (29) and to affect the cells and cause ciliary damage (5), (ii) the production of endometritis and salpingitis experimentally in several subhuman primate species (151,202,204) and hydrosalpinx formation in mice (143), (iii) the association of tubal factor infertility with a previous infection with M. genitalium (25), and (iv) the demonstration of M. genitalium antibody responses in one-third of women with acute PID (150), a finding disputed by some investigators (110,123). In summary, the overall supportive aspects have led to the conclusion that M. genitalium is one of the causes of PID (62).…”

“…As this disease damages Fallopian tubes (5), there is a small chance that such a prior mycoplasmal infection could be responsible for an ectopic pregnancy. However, a serological study provided no support for this (110).…”

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

“…ycoplasma 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)(2)(3)(4)(5)(6)(7)(8)(9). M. genitalium may also increase the risk of HIV transmission and associated shedding (10)(11)(12)(13).…”

Laparoscopy in pelvic inflammatory disease

“…Wiąże się to z utratą ochrony ze strony oksygenazy hydrogenowej produkowanej przez pałeczki Lactobacillus [3,4]. Spotykanymi patogenami są również cytomegalowirus (CMV), Mycoplasma hominis, Mycoplasma genitalium, Ureaplasma urealyticum [5][6][7].…”