MYCOPLASMA GENITALIUM

Detection of Mycoplasma genitalium in women with laparoscopically diagnosed acute salpingitis

C R Cohen^3,5, N R Mugo³, S G Astete², R Odondo⁴, L E Manhart², J A Kiehlbauch⁵, W E Stamm², P G Waiyaki⁵ and P A Totten²

¹ Department of Obstetrics and Gynecology, University of Washington, Seattle, WA, USA
² Department of Obstetrics and Medicine University of Washington, Seattle, WA, USA
³ Department of Obstetrics and Gynecology, University of Nairobi, Nairobi, Kenya
⁴ Department of Obstetrics and Medical Microbiology University of Nairobi, Nairobi, Kenya
⁵ Center for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya

Correspondence to:
Correspondence to:
Craig R Cohen
MD, MPH, 74 New Montgomery Street, Suite 600, UCSF, Box 0886, San Francisco, CA 94105, USA; ccohen{at}psg.ucsf.edu

Objectives: Mycoplasma genitalium has been associated with cervicitis, endometritis, and tubal factor infertility. Because the ability of this bacterium to ascend and infect the fallopian tube remains undefined, we performed an investigation to determine the prevalence of M genitalium in fallopian tube, endometrial, and cervical specimens from women laparoscopically diagnosed with acute salpingitis in Nairobi, Kenya.

Methods: Women presenting with pelvic inflammatory disease were laparoscopically diagnosed with salpingitis. Infection with M genitalium in genital specimens was determined by polymerase chain reaction (PCR).

Results: Of 123 subjects with acute salpingitis, M genitalium was detected by PCR in the cervix and/or endometrium in nine (7%) participants, and in a single fallopian tube specimen. In addition, those infected with M genitalium were more often HIV infected than women not infected by M genitalium (seven of nine (78%) v 42 of 114 (37%), p<0.03).

Conclusions: M genitalium is able to ascend into the fallopian tube, but its association with tubal pathology requires further investigation.

Abbreviations: CSS, clinical severity score; NGU, non-gonococcal urethritis; PCR, polymerase chain reaction; PID, pelvic inflammatory disease; TOA, tubo-ovarian abscess

Keywords: pelvic inflammatory disease; salpingitis; Mycoplasma genitalium; Africa

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