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

Abstract

Objective Assess risk factors for incident and endometrial Mycoplasma genitalium infection and determine if M. genitalium is associated with histological endometritis, an indicator of pelvic inflammatory disease. Methods This study was a secondary data analysis within the T cell Response Against Chlamydia (TRAC) Study, a prospective evaluation of 246 women withor at risk for Chlamydia trachomatis from urban outpatient clinics, who were followed quarterly for12 months. Risk factors for incident M. genitalium infection were determined by Cox regression. Relative risks were estimated by Poisson regression withrobust error measurements for models examining the association between M. genitalium and endometritis (histological evidence of plasma cells in endometrial stroma and neutrophils in the endometrial epithelium) and for models examining risk factors for detection of endometrial M. genitalium infection. Results M. genitalium prevalence was 16.7%, incidence was 25.3 per 100 person-years and 23% had repeated positive tests. Black race (non-black HRadj 0.4, 95% CI 0.2 to 0.9), less education (HRadj 2.4, 95% CI 1.2 to 5.1) and a new sexual partner (HRadj 3.1, 95% CI 1.7 to 5.4) were associated with incident M. genitalium. M. genitalium was associated with endometritis (RRadj 2.0, 95% CI 1.1 to 3.7). Trichomonas vaginalis (RRadj 2.0, 95% CI 1.2 to 3.4) and endometrial C. trachomatis (RRadj 1.7, 95% CI 1.1 to 2.8) were associated with endometrial M. genitalium. Conclusions M. genitalium is prevalent in women at high risk for C. trachomatis, persists over multiple follow-up visits and is associated with histological endometritis. Studies are needed to determine if screening for M. genitalium will improve reproductive outcomes.

The Effectiveness of Single-Dose Azithromycin Versus its Combination With Moxifloxacin Based on the Treatment of Chlamydial Cervicitis: A Study Protocol for a Randomized Clinical Trial

“…Recent studies have revealed that inadequate antibiotic coverage against the associated bacteria in chlamydial cervicitis is one of the most prevalent causes of the failure of the treatment. Additionally, some studies indicated that mycoplasma genitalium is one of the most common bacteria associated with chlamydia trachomatis, and moxifloxacin is one of the most effective drugs for the treatment of mycoplasma genitalium (21)(22)(23)(24)48). Based on the reports of some studies, mycoplasma genitalium treatment failed with macrolides such as azithromycin.…”

“…Several recent studies have also reported azithromycin treatment failure (18)(19)(20)(21)(22)(23)(24). In trying to reduce these failures, diagnostic advances are made in relation to chlamydial cervicitis.…”

Management of a Case of Peritonitis Due to Neisseria gonorrhoeae Infection Following Pelvic Inflammatory Disease (PID)

“…Chlamydia trachomatis and Neisseria gonorrhoeae were considered the main pathogens in the etiology 43 of PID [1], even if other microorganisms such as Mycoplasma genitalium and anaerobic bacteria were also 44 involved [3,4]. Furthermore, polymicrobial infections were responsible of 30-40% of PID cases [5].…”

The association of Chlamydia trachomatis and Mycoplasma genitalium infection with the vaginal metabolome

“…CT is the most prevalent bacterial STI in the United States, and causes significant morbidity, including PID and infertility in young women 22 . Mycoplasma genitalium (MG) is an emerging, highly drug resistant STI, which appears to be more prevalent than gonorrhea, and has been linked to cervicitis and PID in women [23][24][25] , though current CDC guidelines recommend consideration for testing and treatment only in women with persistent cervicitis 26 .…”