Objectives To investigate the prevalence of the genital mollicutes, Mycoplasma genitalium (MG), Mycoplasma hominis (MH), Ureaplasma urealyticum (UU) and Ureaplasma parvum (UP), and their associations with cervicitis in a sexually transmitted infection (STI) clinic population. Clinical correlates of MG infection were also assessed.
Methods 527 women were enrolled in a cross-sectional study at two STI clinics in Sydney between June 2006 and January 2010. Genital mollicutes were detected by multiplex PCR testing of cervical swabs, and associations with cervicitis were analysed. Cervicitis was defined as >30 polymorphonuclear cells per high-power field in at least three non-adjacent fields of cervical mucus on Gram stain.
Results MG was found in 4.0% of women, MH in 17.1%, UU in 14.1%, and UP in 51.8%. MG was the only mollicute associated with cervicitis (unadjusted prevalence ratio (PR) 1.85, 95% CI 1.52 to 2.26, p<0.0001), and this association remained after adjustment for Chlamydia trachomatis (CT) infection (adjusted PR 1.24 (95% CI 1.04 to 1.48), p=0.02). MG was significantly associated with women being HIV positive (p=0.03), but not with age, vaginal discharge, commercial sex work, being of culturally and linguistically diverse background, or concurrent CT infection. Two of the 21 women with MG had ectopic pregnancies.
Conclusions The authors recommend wider application of PCR testing for MG in STI services, particularly in high-risk women and those with cervicitis or HIV infection.
- Mycoplasma genitalium, Cervicitis, HIV
- mycoplasmas, reproductive health
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Funding MJL was in part supported by a scholarship from Novartis, HIV and Related Projects (HARP) Unit, South East Sydney and Illawarra Area Health Service, Sydney, NSW, Australia.
Competing interests None.
Ethics approval This study was conducted with the approval of the South Eastern Sydney and Illawarra Area Health Service human research ethics committee and the Sydney South West Area Heath Service ethics review committee (Royal Prince Alfred Hospital Zone).
Provenance and peer review Not commissioned; externally peer reviewed.