Is Mycoplasma genitalium in women the ‘new chlamydia’? A community-based prospective cohort study

A group of British and Danish investigators have studied the prevalence and predictors for Mycoplasma genitalium and its role in pelvic inflammatory disease (PID) in 2378 British, multi-enthnic, sexually active female students aged between 18 and 27 years.

The subjects, who were part of the Prevention of Pelvic Infection (POPI) trial, had to complete a questionnaire and provide duplicate self-taken vaginal samples—one for chlamydia testing, one for preparing a Gram stain and M genitalium testing. Follow-up samples were provided by 94% of women at 12 months. Two physicians (and a third in the event of disagreement), who were blinded to the bacterial test results, reviewed the follow-up questionnaires and/or medical records to identify women who had been treated for PID or who met the modified Hager's clinical criteria and Centres for Disease Control and Prevention guidelines for PID. Unlike the chlamydia tests, which were performed immediately, M genitalium tests were only performed at the end of the follow-up period and confirmed using PCR on different gene sequences.

The baseline prevalence of M genitalium was 3.3% (95% CI 2.6 to 4.1; n = 78/2378) compared …