Prevalence ofMycoplasma genitaliumin different population groups: systematic review and meta-analysis

Abstract

BackgroundMycoplasma genitalium is a common cause of non-gonococcal non-chlamydial urethritis and cervicitis. Testing of asymptomatic populations has been proposed, but prevalence rates in asymptomatic populations are not well established. We aimed to estimate the prevalence of M. genitalium in adults in the general population, in clinic-based samples, pregnant women, men who have sex with men (MSM) and female sex workers (FSW). without language restrictions. We included studies with 500 participants or more. We screened and selected studies and extracted data in duplicate. We examined eligible studies in forest plots and conducted random effects meta-analysis to estimate prevalence, if appropriate. Between study heterogeneity was examined using the I 2 statistic and meta-regression. ResultsOf 3,316 screened records, 63 were included. In randomly selected samples from the general population, the summary prevalence estimate was 1.3% (95% confidence intervals, CI 1.0 to 1.8%, I 2 41.5%, 3 studies) in countries with higher levels of development and 3.9% (95% CI 2.2 to 6.7, I 2 89.2%, 3 studies) in countries with lower levels. Prevalence estimates were similar in women and men (p=0.47). In clinic-based samples prevalence estimates were higher, except in asymptomatic patients (0.8%, 95% CI 0.4 to 1.4, I 2 0.0%, 3 studies). Summary prevalence estimates were: pregnant women 0.9% (95% CI 0.6 to 1.4%, I 2 0%, 4 studies); MSM in the community 3.2% (95% CI 2.1 to 5.1, I 2 78.3%, 5 studies); FSW in the community 15.9% (95% CI 13.5 to 18.9, I 2 =79.9%, 4 studies). DiscussionThis systematic review can inform testing guidelines for M. genitalium infection. The low estimated prevalence of M. genitalium in the general population, pregnant women and asymptomatic attenders at clinics does not support expansion of testing to asymptomatic people in these groups.

Mycoplasma genitaliumincidence, persistence, concordance between partners and progression: systematic review and meta-analysis

“…[18 19] A review of the prevalence of M. genitalium has been published. [8] We report our findings according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA, online supplementary file 1). [20]…”

“…[7] In sex workers, men who have sex with men (MSM) and clinic-based populations prevalence was higher and more variable. [8] The increasing availability of nucleic acid amplification tests (NAAT) that detect M. genitalium has resulted in calls for widespread testing of asymptomatic populations. [9] But increased testing and treatment is likely to exacerbate the already high proportion of antimicrobial resistant M. genitalium, since de novo resistance to macrolides emerges rapidly.…”

Mycoplasma genitalium: an important sexually transmitted infection comes into focus

“…The increase in NAAT diagnostics and antibiotic resistance have inspired greater M. genitalium epidemiology studies that are gathered in the systematic review and meta-analysis by Baumann et al 7. This systematic review pored over 3000 citations and identified 117 studies that examined the prevalence of M. genitalium.…”

Community‐based strategies to identify the unmet need for care of individuals with sexually transmitted infection‐associated symptoms in rural South Africa

“…Estimated annual incidence rates of 12.0 million infections for Chlamydia trachomatis, 11.4 million for Neisseria gonorrhoeae and 37.4 million for Trichomonas vaginalis are reported for the African region [2]. Also, prevalence of Mycoplasma genitalium of up to 10% has been reported in studies from various countries in this region [3,4]. Adequate treatment for STIs is important, since untreated STIs can lead to pelvic inflammatory disease, adverse pregnancy outcomes and an increased risk of transmitting and acquiring human immunodeficiency virus (HIV) [5,6].…”