RT Journal Article
SR Electronic
T1 The clinical indications for testing women for <em>Mycoplasma genitalium</em>
JF Sexually Transmitted Infections
JO Sex Transm Infect
FD BMJ Publishing Group Ltd
SP 277
OP 285
DO 10.1136/sextrans-2020-054818
VO 98
IS 4
A1 Rosie L Latimer
A1 Lenka A Vodstrcil
A1 Erica L Plummer
A1 Michelle Doyle
A1 Gerald L Murray
A1 Christopher K Fairley
A1 Kaveesha Bodiyabadu
A1 Tim R H Read
A1 Marti Kaiser
A1 Elisa Mokany
A1 Rebecca Guy
A1 Eric P F Chow
A1 Catriona Bradshaw
YR 2022
UL http://sti.bmj.com/content/98/4/277.abstract
AB Background While the contribution of Mycoplasma genitalium (MG) to symptoms in men is well described, less is known about its association with common genital symptoms in women. We aimed to determine the prevalence of MG and macrolide resistance, and its association with common genital symptoms in women attending a sexual health service, to inform indications for testing and clinical practice.Methods We undertook a cross-sectional study of symptomatic and asymptomatic women attending Melbourne Sexual Health Centre (MSHC), between April 2017 and April 2019. Women were tested for MG and macrolide resistance, Chlamydia trachomatis (CT), Neisseria gonorrhoeae, Trichomonas vaginalis, bacterial vaginosis and vulvovaginal candidiasis. Women completed a questionnaire on symptoms, and symptomatic women underwent examination. The prevalence of MG (and macrolide resistance) and other genital infections was calculated with 95% CIs, and associations between these outcomes and specific genital symptoms were examined using logistic regression.Results Of 1318 women, 83 (6%, 95% CI: 5% to 8%) had MG, of which 39 (48%, 95% CI: 36% to 59%) had macrolide-resistant MG; 103 (8%, 95% CI: 6% to 9%) women had CT. MG prevalence was similar in asymptomatic (10 of 195; 5%) and symptomatic (73 of 1108; 7%) women, p=0.506. MG was associated with mucopurulent cervicitis on examination (adjusted OR=4.38, 95% CI: 1.69 to 11.33, p=0.002), but was not associated with other specific genital symptoms or signs.Conclusions MG was as common as CT among women attending MSHC. MG was not associated with genital symptoms, but like CT, was significantly associated with cervicitis. These data provide evidence that routine testing for MG in women with common genital symptoms is not indicated. The presence of macrolide resistance in 48% of women supports use of resistance-guided therapy.No data are available. Data generated are confidential as they relate to patients at MSHC.