Mycoplasma genitalium Infection Prevalence in Patients with Human Immunodeficiency Virus

Abstract

Objective: To determine the prevalence of Mycoplasma genitalium (M. genitalium) infection in HIV positive patients by PCR examination in Teratai Clinic of Dr. Hasan Sadikin General Hospital, Bandung in order to reduce sexually transmitted diseases, especially M. genitalium infection in HIV positive patients. Methods:This study was a cross-sectional study with consecutive sampling methods. Eighty one HIV positive patients attending the Teratai Clinic of Dr. Hasan Sadikin General Hospital, Bandung were recruited to be the subjects of this study. All subjects underwent history taking, physical examination, and PCR examination for M. genitalium. Specimens were taken from cervical smear in females and first void urine in male. Results:The prevalence of M. genitalium based on the PCR examination in HIV positive patients attended to Teratai Clinic Dr. Hasan Sadikin General Hospital Bandung was 9%. Conclusions:Mycoplasmal infection identification based on PCR examination should be considered for routine screening test to reduce the incidence of sexually transmitted diseases in HIV positive patients. IntroductionMycoplama genitalium (M. genitalium) is the smallest bacterium, with a genome size of 580 kb , of the Mollicutes Class (Mollis:soft, Cutis:skin, in Latin) that is mainly found in human genital tract.1,2 Several studies have already shown that M. genitalium is a sexually transmitted organism that causes asymptomatic or non-gonococcal urethritis (NGU) in males as well as cervicitis, endometritis, pelvic inflammatory disease in females. 3-7Mycoplama genitalium infection can be detected through culture, serological, and polymerase chain reaction (PCR) examinations. The culture examination may take several weeks or even months to grow M. genitalium.Hence, it cannot be used as a routine diagnostic tool in every day practice. In the serological examination, cross reactions may occur between M. genitalium and M. pneumoniae due to some similar structures, thereby decreasing the specificity of the test. The PCR examination can detect the microorganism in samples collected from the reproductive tracts in a highly sensitive, accurate, and specific manner. This leads to a situation where PCR is the only reliable diagnostic tool for M. genitalium infection.8 Currently, the PCR examination to detect M. genitalium is available for research only and not available comercially. MethodsThis study was an observational study with cross sectional design. The subjects were 81 HIV positive patients who visited Teratai Clinic of Dr. Hasan Sadikin General Hospital Bandung who were taken in consecutive admission in July 2012. The HIV serostatus of the study population had already been determined and confirmed based on National HIV guideline in Teratai Clinic before this study. The inclusion criteria for this study were male and female HIV patients inTeratai clinic who were sexually active. Female patients who were having her menstrual period were excluded from this study. The study design was approved by the Research Ethics Commit...