Detection of Mycoplasma genitalium from male primary urine specimens: an epidemiologic dichotomy with Trichomonas vaginalis

Napierala, Maureen; Munson, Erik; Wenten, David; Phipps, Paula; Gremminger, Roger; Schuknecht, Mary Kay; Munson, Kimber L.; Boyd, Vivian; Hamer, Deb; Schell, Ronald F.; Hryciuk, Jeanne E.

doi:10.1016/j.diagmicrobio.2015.03.016

Cited by 23 publications

(23 citation statements)

References 30 publications

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“…Data from Tables 1 and 2 confirm the representative nature of the study set. Past reports from our laboratory have summarized diagnostic assay performance within high-prevalence STI cohorts (16,20). Subsequent to these reports, our laboratory has extended its testing scope to locales outside the Milwaukee-Waukesha-West Allis MSA.…”

Section: Discussionmentioning

confidence: 99%

“…The other four arbitrary health care classifications did not experience this phenomenon. Napierala et al (16) previously described a M. genitalium/T. vaginalis dichotomy within a 2,750-male cohort in which the STI phenotypes of STI clinic attendees and patients seeking outpatient clinic care consisted predominately of M. genitalium and T. vaginalis, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…We recently demonstrated the utility of TMA-based M. genitalium detection in male specimens originating from both STI and community outpatient clinics (16). In contrast, previous studies of M. genitalium TMA in females have largely focused on high-risk demographics (14,15,(17)(18)(19).…”

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confidence: 99%

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Clinical Laboratory Assessment of Mycoplasma genitalium Transcription-Mediated Amplification Using Primary Female Urogenital Specimens

et al. 2016

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Following analysis of primary cervix, vagina, and first-void female urine specimens for Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis via commercial transcription-mediated amplification (TMA), residual material was subjected to Mycoplasma genitalium research-use-only TMA. Representation within a 2,478-specimen retrospective study set was established by comparison to a 6-month audit of clinical C. trachomatis TMA (12,999 specimens) on the basis of the C. trachomatis detection rate, specimen source distribution, clinic location, and age. M. genitalium was detected in 282 (11.4%) patients. This rate was higher than those seen with T. vaginalis (9.0%; P ‫؍‬ 0.005), C. trachomatis (6.2%), and N. gonorrhoeae (1.4%). Positive M. genitalium results were confirmed by repeat testing or alternative-target TMA at a rate of 98.7%. The mean age of the M. genitalium-infected females (24.7 years) was lower than that of the T. vaginalis-infected females (mean, 30.1 years; P < 0.0001) and higher than that of the C. trachomatis-infected females (mean, 23.8 years; P ‫؍‬ 0.003). Of 566 patient encounters positive for at least one sexually transmitted infection (STI), 35.9% exhibited sole detection of M. genitalium (P < 0.0004 versus sole detection of other STI agents) and 26.1% were solely positive for T. vaginalis (P < 0.0002 versus C. trachomatis). The M. genitalium and T. vaginalis detection rates among 755 patients at urban emergency departments were 14.6% and 13.0%, respectively (P ‫؍‬ 0.37). A 10.0% M. genitalium detection rate from other facilities exceeded that of T. vaginalis (7.2%; P ‫؍‬ 0.004). Incorporation of M. genitalium TMA into comprehensive testing programs would detect M. genitalium in a significant proportion of females, particularly those in outpatient obstetrics and gynecology (OB/GYN) settings. T he sexually transmitted infection (STI) agentMycoplasma genitalium has historically had a role of pathogenicity in male nongonococcal urethritis (1). Recent evidence has implicated the bacterium in clinically significant disease in females (2, 3). Additional studies suggest that M. genitalium infection promotes HIV acquisition (4-6) and virus shedding (7,8). Moreover, in a recent meta-analysis, Lis et al. (9) reported significant associations between M. genitalium infection and cervicitis, pelvic inflammatory disease, preterm birth, and spontaneous abortion.Until recently, a lack of reliable testing options has curtailed laboratory diagnosis of M. genitalium infection. Culture and serologic modalities have been limited by sensitivity and/or cross-reactivity with other mycoplasmas (1) and are becoming supplanted by molecular diagnostics, largely on a research basis. PCR-based assays have correlated M. genitalium DNA burden with clinical condition (10, 11) and treatment efficacy (12) in males. Quantitative molecular analysis has sought to study progression of genital disease in females (13). In the realm of laboratory diagnosis, initial studies of target capture-based transcription-mediated amp...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Clinical Laboratory Assessment of Mycoplasma genitalium Transcription-Mediated Amplification Using Primary Female Urogenital Specimens

et al. 2016

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“…This measure essentially denotes the probability that a given agent is the etiology of the STI diagnosed during that encounter. In the aforementioned study (28), a dichotomy of STI prevalence emerged when comparing STI phenotypes involving M. genitalium and T. vaginalis (Table 1). Sole detection of M. genitalium was documented in 36.5% of STI clinic visits that yielded at least one STI; this frequency was 22.0% within community care encounters (P ϭ 0.0007).…”

Section: Commercially Developed Rna Amplification Assaysmentioning

confidence: 99%

Molecular Diagnostics Update for the Emerging (If Not Already Widespread) Sexually Transmitted Infection Agent Mycoplasma genitalium: Just About Ready for Prime Time

Munson

2017

J Clin Microbiol

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Mycoplasma genitalium is an important and emerging agent of sexually transmitted infection in females and males, carrying the potential for postinfection genital tract sequelae. Past efforts to identify this organism on a routine basis, which were problematic due to the fastidious nature of the bacterium and its antigenic intricacies, have recently become supplemented by molecular diagnostics. A number of these assays are available commercially. This minireview describes the format and performance indices of a number of M. genitalium DNA-and RNA-based amplification assays; many of these assays have contributed to an improved clinical and epidemiologic understanding of this organism.

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“…TMA-based detection of other STI agents has been documented from male urogenital (T. vaginalis, M. genitalium) and pharyngeal (T. vaginalis) specimens (12,13,15,16). C. trachomatis and N. gonorrhoeae screening from both urine and extraurogenital sources in this study resulted in 228 instances of STI (15.3% incidence rate) (Fig.…”

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Expansion of Comprehensive Screening of Male Sexually Transmitted Infection Clinic Attendees with Mycoplasma genitalium and Trichomonas vaginalis Molecular Assessment: a Retrospective Analysis

Munson

Wenten²,

Jhansale³

et al. 2017

J Clin Microbiol

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Of 1,493 encounters of males at a sexually transmitted infection (STI) clinic in a community with a high prevalence of STI, Chlamydia trachomatis was detected in 8.7% and Neisseria gonorrhoeae was detected in 6.6%. Additional Trichomonas vaginalis and Mycoplasma genitalium screening found 17.4% and 23.9% of the encounters, respectively, to be positive for STI. STI agents were detected in 13.7% of urine specimens; addition of pharyngeal and rectal collections to the analysis resulted in detection of STI agents in 19.0% and 23.9% of encounters, respectively. A total of 101 (23.8%) encounters of identified STI involved sole detection of M. genitalium. Expansion of the STI analyte panel (including M. genitalium) and additional specimen source sampling within a comprehensive STI screening program increase identification of male STI carriers. KEYWORDS Mycoplasma genitalium, transcription-mediated amplification,Trichomonas vaginalis E xtraurogenital screening for agents of sexually transmitted infection (STI) has been advocated in a number of clinical and public health scenarios (1). Studies have reported increased rates of Chlamydia trachomatis and Neisseria gonorrhoeae detection from pharyngeal and rectal specimens via nucleic acid amplification testing compared to rates found with culture (2-7). Moreover, differences in clinical and in vitro detection rates yielded by transcription-mediated amplification (TMA) versus DNA amplification modalities have been demonstrated (4-9), likely owing to target capture-based removal of endogenous inhibitors (10, 11). Detection of Trichomonas vaginalis RNA from pharyngeal specimens (12) and Mycoplasma genitalium RNA from urine specimens (13) of male STI clinic attendees has recently been reported on the basis of commercial TMA assays. The purpose of this investigation was to assess both the capacity of TMA for detection of M. genitalium from pharyngeal and rectal specimens and the potential for multispecimen analysis in the overall identification of male carriers of STI agents.(Results of this work were presented in part at ASM Microbe, Boston, MA, 16 to 20 June 2016.)With an Institutional Review Board-approved protocol, screening practices for male attendees of a Milwaukee, WI, STI clinic were audited from March 2014 through December 2015. The high-STI-prevalence nature of this community was noted previously (14). Aliquots of first-void urine were dispensed into Aptima urine specimen transport tubes (Hologic, San Diego, CA). Pharyngeal and rectal swab specimens were obtained using the Aptima unisex swab specimen collection kit (Hologic).

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Detection of Mycoplasma genitalium from male primary urine specimens: an epidemiologic dichotomy with Trichomonas vaginalis

Cited by 23 publications

References 30 publications

Clinical Laboratory Assessment of Mycoplasma genitalium Transcription-Mediated Amplification Using Primary Female Urogenital Specimens

Clinical Laboratory Assessment of Mycoplasma genitalium Transcription-Mediated Amplification Using Primary Female Urogenital Specimens

Molecular Diagnostics Update for the Emerging (If Not Already Widespread) Sexually Transmitted Infection Agent Mycoplasma genitalium: Just About Ready for Prime Time

Expansion of Comprehensive Screening of Male Sexually Transmitted Infection Clinic Attendees with Mycoplasma genitalium and Trichomonas vaginalis Molecular Assessment: a Retrospective Analysis

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