Large two-centre study into the prevalence of Mycoplasma genitalium and Trichomonas vaginalis in the Netherlands

Abstract

Mycoplasma genitalium and Trichomonas vaginalis are common sexually transmitted infections (STIs). In the Netherlands, testing for M. genitalium and T. vaginalis is not recommended for first-line STI screening. Recent reports about the increasing antimicrobial resistance in M. genitalium raise concern about the adequacy of current empirical treatment regimens. It is necessary to have insight in the prevalence of M. genitalium and T. vaginalis in order to evaluate current first-line STI screening and treatment protocols. During a five-month period, samples sent to two large medical microbiology diagnostic centres in the Netherlands for STI screening (Chlamydia trachomatis and Neisseria gonorrhoeae) were retrospectively tested for the prevalence of M. genitalium and T. vaginalis using the Diagenode S-DiaMGTV kit. A total of 1569 samples from 1188 unique patients (55.4% female) were tested. M. genitalium was the second most prevalent STI detected (4.5% of the patients), after C. trachomatis (8.3%). T. vaginalis was detected in 1.4% of the patients, comparable to the prevalence of N. gonorrhoeae (1.3%). Dual infections were only detected in a small number of patients (1.0%). Incorporation of M. genitalium into routine STI screening should be considered, because of its relatively high prevalence, the consequences of its detection for antibiotic treatment and because of the availability of easy-to-use molecular diagnostic tests. For T. vaginalis, routine screening may be considered, depending on local prevalence and (sub)population.

Mycoplasma genitalium and Trichomonas vaginalis in France: a point prevalence study in people screened for sexually transmitted diseases

“…gonorrhoeae screening in France. This prevalence is in accordance with the prevalence in the Netherlands, which ranges between 0.6 and 1.5% [5,19]. In contrast, the American T. vaginalis prevalence has been reported to be higher (8.7%) based on NAAT in women undergoing screening for C. trachomatis and N. gonorrhoeae [20].…”

“…However, the African and American continents are much more affected than Europe, with 42.8 million and 57.8 million adults infected in Africa and America, respectively, versus only 14.3 million adults infected in Europe in 2008 [3]. In Europe, the prevalence of T. vaginalis infection was recently evaluated to be between 0.5 and 1.4% in patients visiting general practitioners and STI clinics in the Netherlands [5,6], but additional European prevalence data are needed. The prevalence of M. genitalium infection ranges from 1 to 3% in the general population worldwide and rises to 38% in African sex workers and STI testing centres [7e9].…”

“…In Europe, the prevalence of M. genitalium infection was 1.2% in men and 1.3% in women in the British general population [7] and 0.8% in French pregnant women [10]. The prevalence was reported to be between 4 and 5% in patients visiting STI clinics and general practitioners in Europe [5,11,12]. In addition, recent reports showed increasing resistance of M. genitalium to macrolides in Europe, which is the class of antibiotics used as the first line treatment [11,13,14].…”

The Association between Mycoplasma Species Infection and Tubal Obstruction

“…In a large study from the Netherlands on 1188 patients screened for STDs, Mycoplasma was the second most common organism detected (4.5%) after chlamydia (8.3%) [19]. In vitro studies on mice have detected Mycoplasma in the genital tract causing structural changes in the ciliated epithelium of the fallopian tubes [20].…”

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

“…A newer generation assay allows for simultaneous detection of M. genitalium and T. vaginalis. This S-DiaMGTV kit (Diagenode) was subjected to a 1,569-specimen evaluation from STI clinic and general practice patients in the Netherlands (19 Fast-track diagnostics (Sliema, Malta) produces a number of CE-marked multiplex qualitative PCR assays for STI agents that allow for M. genitalium MgPa detection from first-void urine, genital, and rectal collections. The assays include an internal control and require additional instruments for DNA extraction and target amplification/detection.…”