Mycoplasma genitalium is associated with cervicitis and HIV infection in an urban Australian STI clinic population.
OBJECTIVE
To investigate the prevalence of the genital mollicutes, Mycoplasma genitalium (MG), Mycoplasma hominis (MH), Ureaplasma urealyticum (UU) and Ureaplasma parvum (UP), and their associations with cervicitis in a sexually transmitted infection (STI) clinic population. Clinical correlates of MG infection were also assessed.


METHODS
527 women were enrolled in a cross-sectional study at two STI clinics in Sydney between June 2006 and January 2010. Genital mollicutes were detected by multiplex PCR testing of cervical swabs, and associations with cervicitis were analysed. Cervicitis was defined as >30 polymorphonuclear cells per high-power field in at least three non-adjacent fields of cervical mucus on Gram stain.


RESULTS
MG was found in 4.0% of women, MH in 17.1%, UU in 14.1%, and UP in 51.8%. MG was the only mollicute associated with cervicitis (unadjusted prevalence ratio (PR) 1.85, 95% CI 1.52 to 2.26, p<0.0001), and this association remained after adjustment for Chlamydia trachomatis (CT) infection (adjusted PR 1.24 (95% CI 1.04 to 1.48), p=0.02). MG was significantly associated with women being HIV positive (p=0.03), but not with age, vaginal discharge, commercial sex work, being of culturally and linguistically diverse background, or concurrent CT infection. Two of the 21 women with MG had ectopic pregnancies.


CONCLUSIONS
The authors recommend wider application of PCR testing for MG in STI services, particularly in high-risk women and those with cervicitis or HIV infection.
Short Street Centre, Department of Immunology & Infectious Diseases, St George Clinical School, University of New South Wales Faculty of Medicine, St George Hospital, Kogarah, Sydney, NSW 2217, Australia. luskjo@bigpond.com
M J
MJ
Lusk
P
P
Konecny
Z W
ZW
Naing
F L
FL
Garden
R G
RG
Cumming
W D
WD
Rawlinson
D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D009175:Mycoplasma Infections / Q000453:epidemiology*; D045704:Mycoplasma genitalium; D009517:New South Wales / Q000453:epidemiology; D015995:Prevalence; D014504:Urban Health; D014509:Ureaplasma; D016869:Ureaplasma Infections / Q000453:epidemiology*; D016990:Ureaplasma urealyticum; D002575:Uterine Cervicitis / Q000453:epidemiology* / Q000382:microbiology