Mycoplasma genitalium: a cause of male urethritis?

Jensen, J S; Orsum, R; Dohn, Birthe; Uldum, Søren A.; Worm, Anne‐Marie; Lind, K.

doi:10.1136/sti.69.4.265

Cited by 101 publications

(98 citation statements)

References 23 publications

(4 reference statements)

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“…For males, a low prevalence of 1.1% is also in line with other studies showing a prevalence of 1.1% in men attending a Department of Medicine for check-up 27 in Japan and prevalences of 0.8% to 8.5% among asymptomatic men seen in STD clinics. [2][3][4][5][6][7] The low coinfection rate with C trachomatis among both men and women is somewhat surprising, but in line with results found in other studies. 2 10 On the basis of the low prevalence in the general population, a widespread screening of the population between 21 and 24 years of age will not be feasible even if M genitalium at a later stage shown to be of importance in developing infertility.…”

Section: Discussionsupporting

confidence: 73%

“…1 Individuals attending sexually transmitted disease (STD) clinics have been the group most thoroughly studied and those with urethritis/cervicitis have been compared with asymptomatic STD clinic attendees. Men with urethritis had M genitalium prevalences of 9.4-29.2%, [2][3][4][5][6][7] whereas asymptomatic men in the same high-risk populations had prevalences of 0.8-8.5%. [2][3][4][5][6][7] The corresponding figures for women with cervicitis in two major studies were 10-11% 2 8 and for women without cervicitis it was 3-5%.…”

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confidence: 99%

“…Men with urethritis had M genitalium prevalences of 9.4-29.2%, [2][3][4][5][6][7] whereas asymptomatic men in the same high-risk populations had prevalences of 0.8-8.5%. [2][3][4][5][6][7] The corresponding figures for women with cervicitis in two major studies were 10-11% 2 8 and for women without cervicitis it was 3-5%. The concordance rate between partners is high, ranging from 45% to 58% of female partners to male index patients 2 9 whereas 38% and 56% of male partners to female index patients have been shown to be infected.…”

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confidence: 99%

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

Andersen¹,

Sokolowski²,

Østergaard

et al. 2006

Sexually Transmitted Infections

125

107

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Background: Mycoplasma genitalium has been shown to cause urethritis in men and cervicitis in women and may also be a causative agent in female infertility. Objective: To estimate the prevalence of urogenital M genitalium infection and identify sexual behavioural risk factors in the general population. Methods: Participating individuals were 731 men and 921 women aged 21-23 years and not seeking the healthcare system because of symptoms. They answered questionnaires on sexual behaviour and provided samples for M genitalium testing. Results: In women aged 21-23 years, the prevalence of infection was 2.3% (21/921) and in men of the same age it was 1.1% (8/731). For both sexes, an increasing number of partners was associated with a greater chance of being infected. Among women a shorter duration of a steady relationship and having a partner with symptoms was associated with being infected, and for men younger age at first intercourse was associated with M genitalium infection. Conclusions: We conclude that the prevalence of infection in the general population is too low for populationbased screening. However, the development of test algorithms based on behavioural risk factors is a promising alternative.

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Section: Discussionsupporting

confidence: 73%

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confidence: 99%

mentioning

confidence: 99%

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

Andersen¹,

Sokolowski²,

Østergaard

et al. 2006

Sexually Transmitted Infections

125

107

View full text Add to dashboard Cite

show abstract

“…Due to a lack of reliable culture and serological methods, the role of M. genitalium in NCNGU has been difficult to establish (Jensen et al, 1993;Taylor-Robinson, 1983), but the progress of molecular techniques like PCR has made it possible to detect the bacterium in urogenital specimens. PCR-based assays have been developed by several research groups but most of them are labour intensive and none is commercially available (Deguchi et al, 2002;Jensen et al, 1991;Taylor-Robinson, 1995).…”

Section: Introductionmentioning

confidence: 99%

Detection of Mycoplasma genitalium in urogenital specimens by real-time PCR and by conventional PCR assay

Jurstrand

Jensen

Fredlund

et al. 2005

Journal of Medical Microbiology

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A real-time LightCycler PCR (LC-PCR) with hybridization probes for detection of Mycoplasma genitalium in endocervical and first void urine specimens was developed and compared to a conventional PCR. The primers for both assays were identical and designed to amplify a 427 bp fragment of the 16S rRNA gene of M. genitalium. The LC-PCR assay had a detection limit of , 5 bacterial genomes per reaction when dilutions of genomic DNA from a type strain of M. genitalium were tested. First void urine from 398 men and first void urine and endocervical specimens from 301 women attending an STD clinic were analysed by LC-PCR and by the conventional PCR. Using the conventional PCR as reference, the LC-PCR had a specificity of 99 . 7 % and a sensitivity of 72 . 2 % for the detection of M. genitalium in first void urine samples from men. There was no significant difference in the performance of the LC-PCR assay compared to the conventional PCR when endocervical swabs were considered (58 and 65 %, respectively) or with a set of endocervical swab/urine specimens for which the LC-PCR assay detected 73 % of the infections (specificity ¼ 98 . 6 % and sensitivity ¼ 68 . 2 %) while the conventional PCR detected 85 % of the infections. With female urine specimens there was a significant difference between the two assays (38 and 73 %, respectively; P ¼ 0 . 01 McNemar's test). This illustrates the need to analyse both endocervical and urine specimens, because M. genitalium DNA was detected in only one of the two specimens in a great number of the M. genitalium-infected women. The lower sensitivity of the LC-PCR assay was probably caused by a combination of inhibition and limitations regarding the amount of template DNA. The LC-PCR assay was easy to perform and the simultaneous amplification and detection eliminated the need for further handling of PCR products. With improvement in sample preparation methods and increased volumes of the template DNA, the LC-PCR assay could be a useful routine diagnostic method.

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“…In the 1990s, the advent of PCR-based assays facilitated studies on the association of M. genitalium with acute nongonococcal urethritis (NGU) (9, 11). This mycoplasma has been detected significantly more often in patients with acute NGU, particularly in patients with nonchlamydial NGU, than in subjects without urethritis (6,8). In 2002 we developed a TaqMan assay for quantification of M. genitalium DNA and quantified M. genitalium in first-pass urine of men with urethritis and of asymptomatic men (17).…”

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confidence: 99%

Longitudinal Quantitative Detection by Real-Time PCR of Mycoplasma genitalium in First-Pass Urine of Men with Recurrent Nongonococcal Urethritis

et al. 2002

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By using a TaqMan assay we monitored longitudinal changes in Mycoplasma genitalium loads in five men with recurrent M. genitalium-positive nongonococcal urethritis. We observed regrowth of M. genitalium persisting in hosts after treatment and a possible association of the increase in the M. genitalium load with emergence of symptoms and signs of nongonococcal urethritis in four of these patients.In 1981, when Mycoplasma genitalium was initially identified, two strains were isolated from two urethral specimens in culture (16). Despite repeated attempts to isolate M. genitalium from the urogenital tract, however, culture of M. genitalium is still immensely difficult. In the 1990s, the advent of PCR-based assays facilitated studies on the association of M. genitalium with acute nongonococcal urethritis (NGU) (9, 11). This mycoplasma has been detected significantly more often in patients with acute NGU, particularly in patients with nonchlamydial NGU, than in subjects without urethritis (6,8). In 2002 we developed a TaqMan assay for quantification of M. genitalium DNA and quantified M. genitalium in first-pass urine of men with urethritis and of asymptomatic men (17). We reported that the M. genitalium load was significantly higher in men with acute nonchlamydial NGU than in asymptomatic men (17). The various results reported to date suggest that M. genitalium may be associated with the development of acute NGU independent of Chlamydia trachomatis (2, 13).For chronic NGU, it has been suggested that persistence of M. genitalium in the urethra after antimicrobial chemotherapy might be associated with this condition (5,7,10,15). However, quantitative analysis of M. genitalium has been not performed in cases of chronic NGU. In the present study, therefore, we used the TaqMan assay to monitor longitudinal changes in M. genitalium loads in patients with recurrent NGU and to examine those cases for association of the M. genitalium load with clinical findings and inflammatory responses.Five men with recurrent NGU, who had been included in a previous study (10), were enrolled in the present study. They attended the Department of Urology, Toyota Memorial Hospital, Toyota, Japan, between July 1999 and December 2001. Each of these patients had symptoms and signs consistent with acute urethritis at the first visit. For each patient, Gramstained urethral smears showed five or more polymorphonuclear leucocytes (PMNLs) per high-power (ϫ1,000) microscopic field in at least three fields. Urine specimens were subjected to AMPLICOR STD-1 assay (Roche Diagnostics, Indianapolis, Ind.) for detecting Neisseria gonorrhoeae and C. trachomatis and to a PCR-and phylogeny-based assay for detecting mycoplasmas and ureaplasmas. The AMPLICOR STD-1 assay was done according to the manufacturer's instructions. The PCR-and phylogeny-based assay, which could detect at least 10 copies of the 16S rRNA gene of M. genitalium, was done as described in our previous report (18). Two patients were positive for both C. trachomatis and M. genitalium, and three w...

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Mycoplasma genitalium: a cause of male urethritis?

Cited by 101 publications

References 23 publications

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

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

Detection of Mycoplasma genitalium in urogenital specimens by real-time PCR and by conventional PCR assay

Longitudinal Quantitative Detection by Real-Time PCR of Mycoplasma genitalium in First-Pass Urine of Men with Recurrent Nongonococcal Urethritis

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