Objective Research exploring the clinical and sexual risk correlates is essential to define universal standards for screening and management for Mycoplasma genitalium (MG). The objective of this study is to determine the baseline prevalence of MG and associated clinical risks using cross-sectional data.
Methods Adolescent and young adult women 13–29 years were recruited during clinical visits during which biological specimens were collected for Neisseriagonorrhoeae (NG) and Chlamydia trachomatis (CT) testing to provide vaginal specimens for MG and Trichomonasvaginalis (TV) testing. Demographic, clinical and sexual risk data were collected after obtaining written consent. MG was tested using the Hologic Gen-Probe transcription-mediated amplification–MG analyte-specific reagent assay and TV by the Aptima TV assay. Bivariate analyses were used to evaluate differences in MG prevalence based on pregnancy status, demographic factors, clinical symptoms, concurrent STI and sexual risk behaviour quiz score (maximum score=10).
Results 483 patients with a mean age of 22.4 years (SD 3.6) were enrolled. Most participants were not pregnant (66%) and asymptomatic (59%). MG was the most common STI (MG 16%, TV 9%, CT 8%, NG 1%). Neither pregnancy nor symptoms were predictive of STI positivity. Thirty-five percent of non-pregnant and 45% of pregnant adolescents ≤19 years were positive for any STI. Participants with MG were 3.4 times more likely to be co-infected with other STIs compared with those with other STIs (OR 3.4, 95% CI 1.17 to 10.3, P=0.021). Mean risk quiz scores for STI positive women were six points higher than those who were STI negative (β=0.63, 95% CI 0.36 to 0.90, P<0.001). There were no differences in risk scores for MG-positive participants compared with other STI positivity.
Conclusion MG infection was common, associated with STI co-infection and often asymptomatic, and pregnancy status did not confer protection.
- sexual behaviour
- m genitalium
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Handling editor Jonathan Ross
Contributors Design: MT, CAG, JSC. Execution/data collection: MT, CAG, JSC, RF-W, LT, JR, SH. Analysis of data: JP. Laboratory analysis: JH, CAG. Interpretation of data: JP, MT, CAG, JSC, LT. Manuscript development/review: all.
Funding This protocol was funded through a non-restricted institutional grant from Hologic, Inc. with infrastructure support from the following grants (National Institute of Nursing Research NIH/NINR 5R01NR013507, U54EB007958, NIBIB, NIH; U-01068613, NIH, NIAID).
Competing interests MT reports grants from Hologic, Inc, grants from National Institutes of Health, during the conduct of the study; personal fees and other from Church & Dwight, Inc, outside the submitted work. CAG reports grants from Hologic, Inc, grants from National Institutes of Health, during the conduct of the study.
Patient consent Obtained.
Ethics approval Johns Hopkins Medicine Institutional Review Board.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement We continue to collect data for the Women’s BioHealth Study as part of an extended timeline of funding. These data may be available upon publication of final analyses as part of a collaboration with other researchers.
Author note The abstract with associated table reprinted from the Journal of Paediatric and Adolescent Gynaecology (Trent M, Coleman J, Hardick J, Perin J, Tabacco L, Huettner S, Ronda J, Kysiak R, Gaydos C. Bio-Health study: clinical and sexual risk correlates of Mycoplasma genitalium in urban pregnant and non-pregnant young women, volume 30, issue 2 , 329–330, 2017) with permission from Elsevier.
Presented at The preliminary findings from this research were presented at the 2017 North American Society for Paediatric and Adolescent Gynaecology.