title: Associations between Mycoplasma genitalium, Chlamydia trachomatis and pelvic inflammatory disease.
abstract: OBJECTIVE
  To evaluate the association between Mycoplasma genitalium, Chlamydia trachomatis, and pelvic inflammatory disease (PID) METHODS: A case-control methodology was used. Swab eluates were processed using the QIAamp DNA mini kit. Polymerase chain reaction (PCR) for M genitalium was carried out using a real time in-house 16S based assay. An endocervical swab was taken and tested for the presence of C trachomatis (ligase chain reaction, Abbott Laboratories), and a high vaginal swab was taken and tested for the presence of Neisseria gonorrhoeae and bacterial vaginosis.
  
  
  RESULTS
  Of the PID cases 13% (6/45) had evidence of M genitalium infection compared to none of the controls (0/37); 27% (12/45) of the cases had C trachomatis infection compared to none of the controls; and 16% (7/45) of cases only had serological evidence of C trachomatis infection compared to 5% (2/37) of controls. Cases were more likely to present with M genitalium and/or C trachomatis than controls (p<0.001).
  
  
  CONCLUSIONS
  This study indicates that there may be an association between M genitalium and PID, and that this relation is largely independent of C trachomatis. Future studies need to investigate the pathological basis of the relation between M genitalium and PID using samples from women with PID diagnosed using laparoscopy and endometrial biopsy. Little is known about the epidemiology of M genitalium: large scale epidemiological investigations are needed to determine the prevalence, incidence, and factors associated with this emerging infection.
authors.affiliation: Communicable Disease Surveillance Centre, UK. isimms@phls.org.uk
authors.forename: I
authors.initials: I
authors.lastname: Simms
authors.forename: K
authors.initials: K
authors.lastname: Eastick
authors.forename: H
authors.initials: H
authors.lastname: Mallinson
authors.forename: K
authors.initials: K
authors.lastname: Thomas
authors.forename: R
authors.initials: R
authors.lastname: Gokhale
authors.forename: P
authors.initials: P
authors.lastname: Hay
authors.forename: A
authors.initials: A
authors.lastname: Herring
authors.forename: P A
authors.initials: PA
authors.lastname: Rogers
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002692:Chlamydia trachomatis / Q000302:isolation & purification*; D004269:DNA, Bacterial / Q000032:analysis*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009174:Mycoplasma / Q000235:genetics*; D009344:Neisseria gonorrhoeae / Q000302:isolation & purification; D000292:Pelvic Inflammatory Disease / Q000382:microbiology*; D016133:Polymerase Chain Reaction / Q000379:methods; D016585:Vaginosis, Bacterial / Q000175:diagnosis
chemical_list: D004269:DNA, Bacterial