Mycoplasma genitalium Prevalence, Coinfection, and Macrolide Antibiotic Resistance Frequency in a Multicenter Clinical Study Cohort in the United States

Abstract

The prevalence rates of Mycoplasma genitalium infections and coinfections with other sexually transmitted organisms and the frequency of a macrolide antibiotic resistance phenotype were determined in urogenital specimens collected from female and male subjects enrolled in a multicenter clinical study in the United States. Specimens from 946 subjects seeking care from seven geographically diverse clinical sites were tested for M. genitalium and for Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis. Sequencing was used to assess macrolide antibiotic resistance among M. genitalium-positive subjects. M. genitalium prevalence rates were 16.1% for females and 17.2% for males. Significant risk factors for M. genitalium infections were black race, younger age, non-Hispanic ethnicity, and female symptomatic status. Female M. genitalium infections were significantly more prevalent than C. trachomatis and N. gonorrhoeae infections, while the M. genitalium infection rate in males was significantly higher than the N. gonorrhoeae and T. vaginalis infection rates. The macrolide-resistant phenotype was found in 50.8% of females and 42% of males. These results show a high prevalence of M. genitalium single infections, a lower prevalence of coinfections with other sexually transmitted organisms, and high rates of macrolide antibiotic resistance in a diverse sample of subjects seeking care across a wide geographic area of the United States.

Mycoplasma genitalium on the Loose: Time to Sound the Alarm

“…Irrespective of the specimen type used, M. genitalium was more common than any of the four other STIs (15.3% with meatal swab and 12.6% in urine) and self-sampling using a meatal swab yielded higher prevalence of all five STIs. Although assays to detect mutations in the QRDR were not performed, MRMM were detected in 55.9% of urine specimens with readable 23S rRNA sequences, consistent with an earlier report of 50% in US men and women [6]. …”

Risk factors for Mycoplasma genitalium endometritis and incident infection: a secondary data analysis of the T cell Response Against Chlamydia (TRAC) Study

“…This is due to recruitment of women with or at high risk for C. trachomatis within a single geographic location. In a general population of low-risk and high-risk clinics/hospitals, Getman et al 10 reported that 68.7% of females with M. genitalium had monoinfection (absence of C. trachomatis , N. gonorrhoeae and T. vaginalis ). After treatment, the C. trachomatis coinfection rate for incident M. genitalium was 6.8%.…”

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

“…Moreover, a recent report suggests that inclusion of multiple analytes and specimen source collections significantly increases detection of STI carrier status (33). Further investigations may be necessary to indicate targeted demographics (20,(28)(29)(30) should a fully comprehensive screening approach not be advocated in a given locale. Consideration of M. genitalium molecular diagnostics within an STI screening algorithm may ultimately realize public health benefits and improved clinical management.…”