title: Diagnostic assessment of Mycoplasma genitalium in culture-positive women.
abstract: Detection of Mycoplasma genitalium-mediated, chlamydia-negative nongonococcal urethritis and other M. genitalium-linked infectious etiologies has been very challenging. Although M. genitalium is considered a leading cause of genitourinary symptoms in men and women, extreme difficulties in its cultivation due to its highly fastidious nature and the lack of routine and effective diagnostic tests have slowed the generation of clinical data which directly implicate the presence of M. genitalium in disease pathogenesis. In this study, we compared enzyme-linked immunosorbent assays (ELISAs) and immunoblot and PCR assays in M. genitalium culture-positive women over 1 to 3 years of clinical visits to determine the usefulness of independent diagnostic strategies. Furthermore, the value of combinatorial diagnostic assessments is described, which provides insights into the dynamics of M. genitalium-host interactions. Overall, we show that neither ELISA nor PCR, alone or in combination, provides the sensitivity required to confidently predict the existence of viable M. genitalium organisms in cervical and vaginal samples. Additionally, culture-positive women exhibited a range of antibody responsiveness to M. genitalium based upon ELISA and immunoblot assessments, indicating immune diversity among this high-risk population.
authors.affiliation: Department of Microbiology and Immunology, University of Texas Health Science Center, San Antonio, Texas 78229-3900, USA. baseman@uthscsa.edu
authors.forename: Joel B
authors.initials: JB
authors.lastname: Baseman
authors.forename: Marianna
authors.initials: M
authors.lastname: Cagle
authors.forename: Jeffrey E
authors.initials: JE
authors.lastname: Korte
authors.forename: Caleb
authors.initials: C
authors.lastname: Herrera
authors.forename: Wanda G
authors.initials: WG
authors.lastname: Rasmussen
authors.forename: Janet G
authors.initials: JG
authors.lastname: Baseman
authors.forename: Rochelle
authors.initials: R
authors.lastname: Shain
authors.forename: Jeanna M
authors.initials: JM
authors.lastname: Piper
mesh_terms: D002584:Cervix Uteri / Q000382:microbiology*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D015151:Immunoblotting; D045704:Mycoplasma genitalium / Q000302:isolation & purification*; D016133:Polymerase Chain Reaction; D014621:Vagina / Q000382:microbiology*