Background The aetiology of mucopurulent cervicitis is not known in 50% of cases and cannot be attributed to the known cervical pathogens Neisseria gonorrhoeae, Chlamydia trachomatis, Genital Mycoplasmas are such organisms which can be easily overlooked as there is a lack of sufficient laboratory infrastructure for diagnosing them in developing countries. Also, there is the lack of awareness among physicians about M. genitalium infection. There is scarce literature showing the association of M. genitalium with cervicitis and no reports from India. The purpose of this study was hence to determine the frequency of detection of M. genitalium and to investigate causal relationship between M. genitalium and cervicitis.
Methods Two hundred women who attended gynecologic clinics were recruited. Mucopurulent cervicitis was defined as presence of either visible yellow mucopus or presence of > 30PMNL/1000 X microscopic field on gramme stain smear of cervical mucus. First void urine (FVU), three endocervical swabs (ECS) were collected from the study group and control group. All the samples were tested by PCR amplification for presence of M. genitalium by targeting MgPa gene as described previously. Samples were also subjected to culture for other genital Mycoplasmas and PCR amplification for Chlamydia trachomatis and Neisseria gonorrhoeae.
Results Mycoplasma genitalium was found in 6% from ECS and 5% from Urine of women with Cervicitis and overall M. genitalium was detected in 11% of women and 1% from Controls (P < 0.05). Disordered proliferative endometrium was observed in 4 of the M. genitalium positive cases. All the patients who were positive for Chlamydia trachomatis (5%) and Mycoplasma hominis(7%) and Ureaplasma urealyticum(4%) were excluded from the study. Prior miscarriage, menstrual cycle, whitish vaginal discharge and pelvic discomfort were positively associated with M. genitalium.
Conclusions The study suggests association of M. genitalium infection and Cervicitis and this microorganism should be routinely screened in patients of cervicitis.