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Mycoplasma genitalium in cervicitis and pelvic inflammatory disease among women at a gynecologic outpatient service

Published:March 09, 2012DOI:https://doi.org/10.1016/j.ajog.2012.02.036

      Objective

      We sought to analyze the prevalence and clinical manifestations of Mycoplasma genitalium infection in a heterogeneous population of women.

      Study Design

      The study was designed as a cross-sectional case-control study. Women attending a gynecological outpatient service from 2003 through 2008 were invited to participate.

      Results

      The prevalence of M genitalium was 2.1% and of Chlamydia trachomatis was 2.8% among 5519 tested women. A total of 679 women were included. Both pelvic inflammatory disease (PID) and cervicitis were independently associated with M genitalium (odds ratio, 9.00; 95% confidence interval, 1.62–49.89 and odds ratio, 3.80; 95% confidence interval, 2.06–7.03, respectively). Women with C trachomatis had a higher frequency of both PID (18.3% vs 4.9%, P < .001) and cervicitis (33.4% vs 22.3%, P < .001) than women with M genitalium.

      Conclusion

      M genitalium was an independent and strong risk factor for both cervicitis and PID although, compared to C trachomatis, clinical manifestations were less frequent.

      Key words

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      References

        • Horner P.J.
        • Gilroy C.B.
        • Thomas B.J.
        • Naidoo R.O.
        • Taylor-Robinson D.
        Association of Mycoplasma genitalium with acute non-gonococcal urethritis.
        Lancet. 1993; 342: 582-585
        • Totten P.A.
        • Schwartz M.A.
        • Sjostrom K.E.
        • et al.
        Association of Mycoplasma genitalium with nongonococcal urethritis in heterosexual men.
        J Infect Dis. 2001; 183: 269-276
        • Jensen J.S.
        Mycoplasma genitalium: the etiological agent of urethritis and other sexually transmitted diseases.
        J Eur Acad Dermatol Venereol. 2004; 18: 1-11
        • Falk L.
        • Fredlund H.
        • Jensen J.S.
        Symptomatic urethritis is more prevalent in men infected with Mycoplasma genitalium than with Chlamydia trachomatis.
        Sex Transm Infect. 2004; 80: 289-293
        • Keane F.E.
        • Thomas B.J.
        • Gilroy C.B.
        • Renton A.
        • Taylor-Robinson D.
        The association of Chlamydia trachomatis and Mycoplasma genitalium with non-gonococcal urethritis: observations on heterosexual men and their female partners.
        Int J STD AIDS. 2000; 11: 435-439
        • Falk L.
        • Fredlund H.
        • Jensen J.S.
        Signs and symptoms of urethritis and cervicitis among women with or without Mycoplasma genitalium or Chlamydia trachomatis infection.
        Sex Transm Infect. 2005; 81: 73-78
        • Anagrius C.
        • Lore B.
        • Jensen J.S.
        Mycoplasma genitalium: prevalence, clinical significance, and transmission.
        Sex Transm Infect. 2005; 81: 458-462
        • Tosh A.K.
        • Van Der Pol B.
        • Fortenberry J.D.
        • et al.
        Mycoplasma genitalium among adolescent women and their partners.
        J Adolesc Health. 2007; 40: 412-417
        • Hjorth S.V.
        • Bjornelius E.
        • Lidbrink P.
        • et al.
        Sequence-based typing of Mycoplasma genitalium reveals sexual transmission.
        J Clin Microbiol. 2006; 44: 2078-2083
        • Ma L.
        • Taylor S.
        • Jensen J.S.
        • Myers L.
        • Lillis R.
        • Martin D.H.
        Short tandem repeat sequences in the Mycoplasma genitalium genome and their use in a multilocus genotyping system.
        BMC Microbiol. 2008; 8: 130
        • Musatovova O.
        • Baseman J.B.
        Analysis identifying common and distinct sequences among Texas clinical strains of Mycoplasma genitalium.
        J Clin Microbiol. 2009; 47: 1469-1475
        • Uno M.
        • Deguchi T.
        • Komeda H.
        • et al.
        Mycoplasma genitalium in the cervices of Japanese women.
        Sex Transm Dis. 1997; 24: 284-286
        • Anagrius C.
        • Lore B.
        Chlamydia-like symptoms can have another etiology: Mycoplasma genitalium–an important and common sexually transmitted disease [in Swedish].
        Lakartidningen. 2002; 99 (4858-9): 4854-4855
        • Manhart L.E.
        • Critchlow C.W.
        • Holmes K.K.
        • et al.
        Mucopurulent cervicitis and Mycoplasma genitalium.
        J Infect Dis. 2003; 187: 650-657
        • Pepin J.
        • Labbe A.C.
        • Khonde N.
        • et al.
        Mycoplasma genitalium: an organism commonly associated with cervicitis among west African sex workers.
        Sex Transm Infect. 2005; 81: 67-72
        • Arraiz R.N.
        • Colina Ch S.
        • Marcucci J.R.
        • et al.
        Mycoplasma genitalium detection and correlation with clinical manifestations in population of the Zulia State, Venezuela [in Spanish].
        Rev Chilena Infectol. 2008; 25: 256-261
        • Gaydos C.
        • Maldeis N.E.
        • Hardick A.
        • Hardick J.
        • Quinn T.C.
        Mycoplasma genitalium as a contributor to the multiple etiologies of cervicitis in women attending sexually transmitted disease clinics.
        Sex Transm Dis. 2009; 36: 598-606
        • Lusk M.J.
        • Konecny P.
        • Naing Z.W.
        • Garden F.L.
        • Cumming R.G.
        • Rawlinson W.D.
        Mycoplasma genitalium is associated with cervicitis and HIV infection in an urban Australian STI clinic population.
        Sex Transm Infect. 2011; 87: 107-109
        • Casin I.
        • Vexiau-Robert D.
        • De La Salmoniere P.
        • Eche A.
        • Grandry B.
        • Janier M.
        High prevalence of Mycoplasma genitalium in the lower genitourinary tract of women attending a sexually transmitted disease clinic in Paris, France.
        Sex Transm Dis. 2002; 29: 353-359
        • Cohen C.R.
        • Nosek M.
        • Meier A.
        • et al.
        Mycoplasma genitalium infection and persistence in a cohort of female sex workers in Nairobi, Kenya.
        Sex Transm Dis. 2007; 34: 274-279
        • Korte J.E.
        • Baseman J.B.
        • Cagle M.P.
        • et al.
        Cervicitis and genitourinary symptoms in women culture positive for Mycoplasma genitalium.
        Am J Reprod Immunol. 2006; 55: 265-275
        • Huppert J.S.
        • Mortensen J.E.
        • Reed J.L.
        • Kahn J.A.
        • Rich K.D.
        • Hobbs M.M.
        Mycoplasma genitalium detected by transcription-mediated amplification is associated with Chlamydia trachomatis in adolescent women.
        Sex Transm Dis. 2008; 35: 250-254
        • Cohen C.R.
        • Manhart L.E.
        • Bukusi E.A.
        • et al.
        Association between Mycoplasma genitalium and acute endometritis.
        Lancet. 2002; 359: 765-766
        • Haggerty C.L.
        • Totten P.A.
        • Astete S.G.
        • Ness R.B.
        Mycoplasma genitalium among women with nongonococcal, nonchlamydial pelvic inflammatory disease.
        Infect Dis Obstet Gynecol. 2006; 2006: 30184
        • Cohen C.R.
        • Mugo N.R.
        • Astete S.G.
        • et al.
        Detection of Mycoplasma genitalium in women with laparoscopically diagnosed acute salpingitis.
        Sex Transm Infect. 2005; 81: 463-466
        • Simms I.
        • Eastick K.
        • Mallinson H.
        • et al.
        Associations between Mycoplasma genitalium, Chlamydia trachomatis and pelvic inflammatory disease.
        J Clin Pathol. 2003; 56: 616-618
        • Bjartling C.
        • Osser S.
        • Persson K.
        The association between Mycoplasma genitalium and pelvic inflammatory disease after termination of pregnancy.
        BJOG. 2010; 117: 361-364
        • Oakeshott P.
        • Aghaizu A.
        • Hay P.
        • et al.
        Is Mycoplasma genitalium in women the “New Chlamydia?” A community-based prospective cohort study.
        Clin Infect Dis. 2010; 51: 1160-1166
        • Workowski K.A.
        • Berman S.M.
        • Centers for Disease Control and Prevention
        Sexually transmitted diseases treatment guidelines, 2006.
        MMWR Recomm Rep. 2006; 55: 1-94
        • Amsel R.
        • Totten P.A.
        • Spiegel C.A.
        • Chen K.C.
        • Eschenbach D.
        • Holmes K.K.
        Nonspecific vaginitis: diagnostic criteria and microbial and epidemiologic associations.
        Am J Med. 1983; 74: 14-22
        • Jensen J.S.
        • Uldum S.A.
        • Sondergard-Andersen J.
        • Vuust J.
        • Lind K.
        Polymerase chain reaction for detection of Mycoplasma genitalium in clinical samples.
        J Clin Microbiol. 1991; 29: 46-50
        • Jensen J.S.
        • Bjornelius E.
        • Dohn B.
        • Lidbrink P.
        Use of TaqMan 5' nuclease real-time PCR for quantitative detection of Mycoplasma genitalium DNA in males with and without urethritis who were attendees at a sexually transmitted disease clinic.
        J Clin Microbiol. 2004; 42: 683-692
        • Swedish Institute for Infectious Disease Control
        Statistik för sexuellt överförbara infektioner Swedish Institute for Infectious Disease Control, Solna, Sweden2011 ([In Swedish]) (Accessed Oct. 17, 2011)
        • Andersen B.
        • Sokolowski I.
        • Ostergaard L.
        • Kjolseth Moller J.
        • Olesen F.
        • Jensen J.S.
        Mycoplasma genitalium: prevalence and behavioral risk factors in the general population.
        Sex Transm Infect. 2007; 83: 237-241
        • Manhart L.E.
        • Holmes K.K.
        • Hughes J.P.
        • Houston L.S.
        • Totten P.A.
        Mycoplasma genitalium among young adults in the United States: an emerging sexually transmitted infection.
        Am J Public Health. 2007; 97: 1118-1125
        • Ross J.D.
        • Brown L.
        • Saunders P.
        • Alexander S.
        Mycoplasma genitalium in asymptomatic patients: implications for screening.
        Sex Transm Infect. 2009; 85: 436-437
        • Marrazzo J.M.
        • Handsfield H.H.
        • Whittington W.L.
        Predicting chlamydial and gonococcal cervical infection: implications for management of cervicitis.
        Obstet Gynecol. 2002; 100: 579-584
        • Napierala Mavedzenge S.
        • Weiss H.A.
        Association of Mycoplasma genitalium and HIV infection: a systematic review and meta-analysis.
        AIDS. 2009; 23: 611-620
        • Haggerty C.L.
        • Totten P.A.
        • Astete S.G.
        • et al.
        Failure of cefoxitin and doxycycline to eradicate endometrial Mycoplasma genitalium and the consequence for clinical cure of pelvic inflammatory disease.
        Sex Transm Infect. 2008; 84: 338-342
        • Burchell H.J.
        • Schoon M.G.
        The value of laparoscopy in the diagnosis of acute pelvic inflammatory disease.
        S Afr Med J. 1987; 72: 197-198
        • Munday P.E.
        Pelvic inflammatory disease–an evidence-based approach to diagnosis.
        J Infect. 2000; 40: 31-41

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