Mycoplasma genitalium in men who have sex with men at male-only saunas.
OBJECTIVE
To determine the prevalence and clinical associations of Mycoplasma genitalium in urethral, rectal and pharyngeal specimens collected from men who have sex with men (MSM) attending male-only saunas.


METHODS
A cross-sectional study of 521 MSM attending six male-only saunas in Melbourne was conducted between October 2001 and September 2002. Stored urine and rectal and pharyngeal swabs were tested for M genitalium by real-time polymerase chain reaction. The prevalence of M genitalium and clinical associations were determined.


RESULTS
A high prevalence (12.9%; 95% CI 10.2% to 15.9%) of sexually transmitted infections (STIs) was found in MSM. M genitalium (2.1%; 95% CI 1.1% to 3.6%) was less common than Chlamydia trachomatis (8.1%; 95% CI 5.9% to 10.6%, p<0.001), and Neisseria gonorrhoeae (4.8%; 95% CI 3.2% to 6.9%, p = 0.02). M genitalium was most likely to be detected as an asymptomatic rectal (1.6%; 95% CI 0.8% to 3.0%) or urethral infection (0.6%; 95% CI 0.2% to 1.6%, p = 0.12), but was absent from the pharynx. In comparison, C trachomatis was more common in the rectum (6.2%; 95% CI 4.3% to 8.6%) than urethra (1.8%; 95% CI 0.9% to 3.2%, p = 0.004), and was uncommon in the pharynx (0.6%; 95% CI 0.1% to 1.6%). Urethral infection with N gonorrhoeae (0.2%; 95% CI 0.01% to 1.0%) was rare, but it was as common in the pharynx (2.5%; 95% CI 1.4% to 4.2%) as the rectum (2.2%; 95% CI 1.2% to 3.8%). No significant demographic or behavioural associations with M genitalium were identified.


CONCLUSIONS
M genitalium was less common than C trachomatis and N gonorrhoeae in MSM attending male-only saunas and was most often detected as an asymptomatic rectal or a urethral infection but was absent from the pharynx. To inform STI screening strategies in MSM, more data are needed to understand how common M genitalium infection is in urethral and non-urethral sites in MSM, and how it contributes to clinical symptoms.
Bradshaw
C S
CS
Department of Epidemiology and Preventive Medicine, Monash University, Carlton 3053, Victoria, Australia. cbradshaw@mshc.org.au
Fairley
C K
CK
Lister
N A
NA
Chen
S J
SJ
Garland
S M
SM
Tabrizi
S N
SN
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002692:Chlamydia trachomatis / Q000302:isolation & purification; D003430:Cross-Sectional Studies; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008875:Middle Aged; D009175:Mycoplasma Infections / Q000453:epidemiology / Q000382:microbiology*; D045704:Mycoplasma genitalium / Q000302:isolation & purification*; D009344:Neisseria gonorrhoeae / Q000302:isolation & purification; D010614:Pharynx / Q000382:microbiology; D016133:Polymerase Chain Reaction; D015995:Prevalence; D011998:Recreation; D012007:Rectum / Q000382:microbiology; D012307:Risk Factors; D012749:Sexually Transmitted Diseases / Q000453:epidemiology / Q000382:microbiology*; D029002:Steam Bath; D014521:Urethra / Q000382:microbiology; D014739:Victoria / Q000453:epidemiology; D055815:Young Adult