Signs and symptoms of urethritis and cervicitis among women with or without Mycoplasma genitalium or Chlamydia trachomatis infection

Abstract

Objectives: To study the prevalence, symptoms, and signs of Mycoplasma genitalium and Chlamydia trachomatis infections in women attending a Swedish STD clinic, accessible for both sexes, and in a group of young women called in the cervical cancer screening programme. Methods: A cross sectional study among female STD clinic attendees in Ö rebro and a study among women called for Papanicolaou smear screening. Attendees were examined for urethritis and cervicitis. First void urine and endocervical samples were tested for M genitalium and C trachomatis. Results: The prevalence of C trachomatis and M genitalium in the STD clinic population was 10% (45/465) and 6% (26/461), respectively. Dual infection was diagnosed in four women. In the cancer screening group of women the corresponding prevalence was 2% (1/59) and 0%, respectively. Among the STD clinic attendees there were no significant differences in symptoms (32% v 23%, RR 1.4, 95% CI 0.6 to 3.4) or signs (71% v 50%, RR 1.4, 95% CI 0.9 to 2.3) between C trachomatis and M genitalium infections. Microscopic signs of cervicitis were significantly more common among M genitalium and C trachomatis infected women than in the cancer screening group of women. 56% (15/27) of male partners of M genitalium infected women were infected with M genitalium compared to 59% of male partners of C trachomatis infected women who were infected with C trachomatis (p = 0.80). Conclusions: M genitalium is a common infection associated with cervicitis and with a high prevalence of infected sexual partners supporting its role as a cause of sexually transmitted infection. M ycoplasma genitalium was isolated originally from the urethra of two men with non-gonococcal urethritis (NGU) in 1980.1 2 Isolation of this bacterium is very difficult, but the use of polymerase chain reaction (PCR) technology has consistently shown M genitalium to be a major cause of non-chlamydial non-gonococcal urethritis (NCNGU) among men. [2][3][4][5][6][7][8] There is also increasing evidence that M genitalium causes mucopurulent cervicitis in women 9 and that it may cause endometritis 10 11 and possibly tubal infection with sequelae in the form of ectopic pregnancy or tubal infertility.12 Only one published study has failed to show an association between urogenital tract disease and the presence of M genitalium in the female genital tract. 13 However, no asymptomatic patients were included in that study and surprisingly, as many as 38% of the women were positive compared with a C trachomatis prevalence of 8%, raising concern about the specificity of the M genitalium assay. Most M genitalium studies in STD clinic outpatients have focused on symptomatic patients with urethritis and have used nonsymptomatic patients as controls. These studies demonstrate that M genitalium, C trachomatis, and Neisseria gonorrhoeae are significantly more frequently detected among symptomatic patients than among asymptomatic controls, thus indicating that these bacteria are pathogens of the genital tract. This is emphasised by the fact t...

Analysis Identifying Common and Distinct Sequences among Texas Clinical Strains of Mycoplasma genitalium

“…Overall, 16.8% of women and 15.1% of men were found M. genitalium positive. These numbers are higher than results of similar studies of STD clinic attendees (1,3,10,29,38), which could be explained by the facts that our specimen collection was conducted over a rather short time period and the patient population consisted of women (and their partners) who were recruited after being diagnosed with nonviral STDs (36).…”

Mycoplasma genitalium among Adolescent Women and their Partners

“…Point prevalence ranged from 0.8-4.1%. Previous cross-sectional studies that included some adolescents found a point prevalence between 3.5-7% [10,17,18]. The difference in point prevalence found here may be attributable to the target population for this project as the young women were not recruited from STD or family planning clinics.…”

“…A prevalence study using STI clinic patients failed to find an association with clinical symptoms, but did find that microscopic evidence of infection was associated with M. genitalium detection [20]. A study using female subjects with active STI did find an association between M. genitalium detection and symptoms [21]; while, no association between microscopic signs and M. genitalium was found in a cross-sectional study using female STI clinic subjects [17]. Our data is among the first to present M. genitalium signs and symptoms data using a primary care, non-STI clinic, patient population.…”

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

“…In other studies, different populations with an expected low risk of STIs have been defined as control groups. In a Swedish study 10 none of 59 women aged 22-26 years attending a clinic for a pap-smear were infected, in two Japanese studies pregnant women 24 25 had prevalences of 0% (0/ 80) and 1% (1/90), and in a study from the United Kingdom 26 none of 37 women aged 21-45 years undergoing tubal ligation had M genitalium. In asymptomatic women attending STD clinics, the prevalence was 3% 2 and 5%.…”