RT Journal Article
SR Electronic
T1 <em>Chlamydia trachomatis</em> and <em>Mycoplasma genitalium</em> prevalence and associated factors among women presenting to a pregnancy termination and contraception clinic, 2009–2019
JF Sexually Transmitted Infections
JO Sex Transm Infect
FD BMJ Publishing Group Ltd
SP 115
OP 120
DO 10.1136/sextrans-2020-054695
VO 98
IS 2
A1 Hannah S Shilling
A1 Suzanne M Garland
A1 Anna-Maria Costa
A1 Alex Marceglia
A1 Katherine Fethers
A1 Jennifer Danielewski
A1 Gerald Murray
A1 Catriona Bradshaw
A1 Lenka Vodstrcil
A1 Jane S Hocking
A1 John Kaldor
A1 Rebecca Guy
A1 Dorothy A Machalek
YR 2022
UL http://sti.bmj.com/content/98/2/115.abstract
AB Background Risk of pelvic inflammatory disease associated with Chlamydia trachomatis and Mycoplasma genitalium is increased after termination of pregnancy (TOP) and may be increased after insertion of intrauterine devices (IUDs). Screening prior to these procedures is recommended only for C. trachomatis. We examined C. trachomatis and M. genitalium prevalence and associated factors among women presenting to a pregnancy termination and contraception service over 10 years.Methods Retrospective analysis of clinical data collected from 17 573 women aged 15–45 years in 2009–2019 and for 266 M. genitalium positive women tested for macrolide resistance-associated mutations in 2016–2019.Results C. trachomatis and M. genitalium prevalence was 3.7% and 3.4%, respectively. In multivariable analyses, shared risk factors were younger age (p&lt;0.001, for both C. trachomatis and M. genitalium), socioeconomic disadvantage (p=0.045 and p=0.008, respectively) and coinfection (p&lt;0.001, for both sexually transmitted infections), with 10.1% of C. trachomatis positive women also positive for M. genitalium. Additional risk factors were earlier year of visit (p=0.001) for C. trachomatis and for M. genitalium residing outside a major city (p=0.013). The proportion of M. genitalium infections tested between 2016 and 2019 with macrolide resistance-associated mutations was 32.7%.Conclusions Given the high level of antimicrobial resistance and the prevalence of coinfection, testing C. trachomatis positive women for M. genitalium could be considered in this setting to prevent further spread of resistant infections. Further research is required into the causal link between M. genitalium and pelvic inflammatory disease in women undergoing TOP and IUD insertion.All data relevant to the study are included in the article or uploaded as supplementary information.