Background Mycoplasma genitalium (MG) causes non-gonococcal urethritis as well as asymptomatic infections although most data on the incidence and natural history of MG is from adults.
Methods Participants were 14–17 year old men in a longitudinal study of STI and the urethral microbiome. Urine samples were collected monthly and batch tested retrospectively for MG DNA using PCR. Urine samples were tested in real-time for chlamydia, gonorrhoea, trichomonas and white blood cells (WBC): infections by these organisms were treated. White blood cell count (WBC) was measured by automated cell count of fresh urine. Dysuria and urethral discharge were self-reported on cell phone diaries.
Results Among 75 participants (mean age 16.0 at enrollment), 6 (8.0%) men have at least one MG positive sample, with a total of 14 MG positive monthly urine samples. The prevalence of Chlamydia or gonorrhoea infection was 19/75 (25.3%) and 1/75 (1.3%), respectively. All but one participant was positive for at least two consecutive months, and one participant was positive for 4 consecutive months. One participant was positive only once, was co-infected with chlamydia, but treatment could not be confirmed. No other MG positive visits occurred simultaneously with other STI. None of the participants reported symptoms or sexual behaviours within a 15 day window of the positive visit. Average urine WBC was 21.8 WBC/ml urine although only 3/14 MG positive samples were associated with urine WBC > 28.5/ml (commonly used as a diagnostic threshold for pyuria).
Conclusions MG in adolescent men is more common than gonorrhoea, persistent without treatment for up to 120 days, and is typically not associated with symptoms or pyuria. These data add to emerging understanding of the prevalence and natural history of sexually transmitted MG and support the importance of more detailed understanding of sexual and reproductive health morbidity associated with these infections.
- Mycoplasma genitalium
- Natural History
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