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Prevalence of Chlamydia trachomatis and Mycoplasma genitalium coinfections and M. genitalium antimicrobial resistance in rectal specimens
  1. Rachel Pitt,
  2. Helen Fifer,
  3. Neil Woodford,
  4. Susan Hopkins,
  5. Michelle Jayne Cole
  1. National Infection Service, Public Health England, London, UK
  1. Correspondence to Rachel Pitt, National Infection Service, PHE, London NW9 5EQ, UK; Rachel.Pitt{at}

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To the Editor-in-Chief

It has recently been reported that 13% of men who have sex with men (MSM) attending a sexual health clinic were coinfected with Chlamydia trachomatis and Mycoplasma genitalium in the rectum,1 a site that has been described as a reservoir for asymptomatic M. genitalium infection.2

Public Health England’s (PHE) reference laboratory detects mutations associated with macrolide and fluoroquinolone resistance in M. genitalium and the lymphogranuloma venereum (LGV) genovars of C. trachomatis. In 2018, 2491 specimens were submitted to the reference laboratory for M. genitalium resistance testing where local assays were unavailable (488/2491 (19.6%) M. genitalium positive). Only 16 (0.6%) were documented from ano-rectal sites, probably because UK guidelines do not recommend asymptomatic screening for M. genitalium …

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  • Handling editor Anna Maria Geretti

  • Contributors RP was responsible for the first draft of the letter; all authors commented and edited subsequent versions.

  • Funding This study was funded by PHE to inform reference service development.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.