The demographic, sexual health and behavioral correlates of Mycoplasma genitalium infection among women with clinically suspected pelvic inflammatory disease

Abstract

Objective: Mycoplasma genitalium (Mg) has been identified as a cause of pelvic inflammatory disease (PID), a clinical syndrome associated with the inflammation of the female upper genital tract and serious reproductive sequelae. As the demographic, behavioral and sexual risk profile of women with Mg-associated PID is not well understood, we investigated characteristics of Mg-infected women presenting with clinically suspected PID.

Methods: Data from 586 participants in the PID Evaluation and Clinical Health Study were analyzed. Demographic, sexual history, and behavioral characteristics including age, race, marital status, education level, sexual activity, number of sexual partners, history of sexually transmitted infection (STIs), bacterial vaginosis and PID, contraception use, oral and anal sex, age at sexual debut, douching practices, and drug, alcohol and tobacco use, were compared between 88 women testing positive and 498 women testing negative for Mg by PCR in the cervix and/or endometrium. Twenty-two women with Mg mono-infections were compared to 172 women who tested positive for N. gonorrhoeae by culture and/or C. trachomatis by PCR.

Results: Age <25 years (AOR 2.7, 95% CI 1.5-4.7) and smoking (AOR 2.0, 95% CI 1.3-3.3) were independently associated with Mg. Women with Mg mono-infections were significantly less likely to be African-American (59.1% vs. 86.0%, p=0.001) than women with N. gonorrhoeae and/or C. trachomatis.

Conclusions: Women infected with Mg had some characteristics that are commonly associated with PID and other STIs. The demographic, sexual and behavioral characteristics of Mg-positive women were similar to women with chlamydial and/or gonococcal-PID.