Chlamydia trachomatisandMycoplasma genitaliumprevalence and associated factors among women presenting to a pregnancy termination and contraception clinic, 2009–2019

Abstract

BackgroundRisk of pelvic inflammatory disease associated with Chlamydia trachomatis and Mycoplasma genitalium is increased after termination of pregnancy (TOP) and may be increased after insertion of intrauterine devices (IUDs). Screening prior to these procedures is recommended only for C. trachomatis. We examined C. trachomatis and M. genitalium prevalence and associated factors among women presenting to a pregnancy termination and contraception service over 10 years.MethodsRetrospective analysis of clinical data collected from 17 573 women aged 15–45 years in 2009–2019 and for 266 M. genitalium positive women tested for macrolide resistance-associated mutations in 2016–2019.ResultsC. trachomatis and M. genitalium prevalence was 3.7% and 3.4%, respectively. In multivariable analyses, shared risk factors were younger age (p<0.001, for both C. trachomatis and M. genitalium), socioeconomic disadvantage (p=0.045 and p=0.008, respectively) and coinfection (p<0.001, for both sexually transmitted infections), with 10.1% of C. trachomatis positive women also positive for M. genitalium. Additional risk factors were earlier year of visit (p=0.001) for C. trachomatis and for M. genitalium residing outside a major city (p=0.013). The proportion of M. genitalium infections tested between 2016 and 2019 with macrolide resistance-associated mutations was 32.7%.ConclusionsGiven the high level of antimicrobial resistance and the prevalence of coinfection, testing C. trachomatis positive women for M. genitalium could be considered in this setting to prevent further spread of resistant infections. Further research is required into the causal link between M. genitalium and pelvic inflammatory disease in women undergoing TOP and IUD insertion.

Low prevalence of macrolide resistance in Mycoplasma genitalium infections in a cohort of pregnant women living with human immunodeficiency virus

“…8,13 In women, young age, with a low education level, originating from sub-Saharan Africa, having ≥6 sexual partners in the last 6 months, onset of sexual activity after 20 years of age, HIV positivity, and co-infection with other STIs have been associated with a higher risk of having M. genitalium infection. 8,13,24 In our study having a partner experiencing symptoms of STIs was significantly associated with M. genitalium infection ( p < 0.05). Additionally, in the unadjusted analysis, having a partner who was experiencing symptoms of STIs increased the risk for infection by close to 4-fold (odds ratio (OR): 3.56, 95% confidence interval (CI): 1.14–10.59, p = 0:023) .…”

Chlamydia trachomatis infection in Cuban adolescent and young populations

“…24 Many authors report this symptom as one of the most frequent in active CT infection. 5,25,26 However, according to our findings, this symptom was not associated with positive serology, probably because the majority of patients with positive IgG did not have an acute CT infection. IgG positive results were more frequently detected in women who reported having two or more pregnancies, and they were also associated with symptoms and signs related to lower genital infections, such as lower abdominal pain, genital odour and cervicitis.…”

Mycoplasma genitalium infection in the female reproductive system: Diseases and treatment

“…In a retrospective study from 2009 to 2019, the detection rate of M. genitalium was 3.4% among 17,573 women who presented a pregnancy termination and contraception clinic, with the highest prevalence of 5.4% among 20–24 years. The prevalence fluctuated over time, from 4.4% in 2009 to 2.1% in 2013 and 4.8% in 2019 ( Shilling et al, 2022 ). A meta-analysis revealed that the prevalence of M. genitalium in the general population of developed countries was 1.3%, lower than 3.9% in underdeveloped countries, and the prevalence of sex workers was as high as 15.9% ( Baumann et al, 2018 ).…”

“…A study in California showed that the co-infection rate with M. genitalium and C. trachomatis was 3.1% in women and 9.7% in men ( Getman et al, 2016 ). A study of the prevalence of C. trachomatis and M. genitalium among women attending termination of pregnancy and contraception clinics during 2009–2019 showed a co-infection rate of 10.1% for C. trachomatis and M. genitalium ( Shilling et al, 2022 ). In a recent HIV pre-exposure prophylaxis (PrEP) demonstration trial involving 200 men, molecular testing for N. gonorrhoeae , C. trachomatis , and M. genitalium found significantly higher gonococcal bacterial loads in the presence of M. genitalium , suggesting that M. genitalium may be a cofactor for N. gonorrhoeae transmission.…”