Abstract

Garland SM1, Marceglia AH2, Tabrizi SN1Costa AM1 1 Microbiology Infectious Diseases, 2 Choices and Sexual Health Service, Royal Women's Hospital, Parkville, Victoria, Australia The Royal Women's Hospital is the largest public provider of therapeutic abortions in Victoria, Australia. Prior to their medical or surgical termination, all women presenting to the Pregnancy Advisory Service (PAS) have been screened for Mycoplasma genitalium utilising an in-house PCR assay 1 in addition to Chlamydia trachomatis using a commercial PCR and bacterial vaginosis (BV) by Gram stained smear of posterior fornix secretions. From August 2009 to December 2010, the prevalence for M genitalium was 4.6% (CI 3.5% to 5.6%), C trachomatis 5.3% (CI 4.2% to 6.4%) and BV 16.2% (CI 14.4% to 18.0%). Most women had a normal genital tract on clinical examination. Of the women infected with C trachomatis and M genitalium, 42% and 34% respectively had abnormal genital tract signs. The average age of women attending the PAS clinic was 26.4 years, with 45.3% of the women being under 25. The average age for women with M genitalium was 24.6 years, whilst for those with C trachomatis it was 22.4 years. The 50 test of cures completed after treatment for M genitalium to date have all been negative. This is in contrast to local treatment failure rates in similar aged males (symptomatic with nonspecific urethritis in a sexual health clinic) and females (screening within a general practitioner setting) of 28% and a population treatment failure rate of 12%. We are uncertain what role our direct observed patient treatment plays in this low failure rate. This presentation will report on the first 17 months of screening for M genitalium in the PAS clinic and its implications for service provision within The Women's. Given the role of M genitalium in cervicitis, and the increasing evidence for its role in upper genital tract disease, screening for this bacterium should be considered, particularly with a surgical procedure such as termination of pregnancy, although the lack of a commercial test is problematic.