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Extragenital Mycoplasma genitalium infections among men who have sex with men.
Sex Transm Infect. 2020 02; 96(1):10-18.ST

Abstract

OBJECTIVES

There are limited data on the prevalence of Mycoplasma genitalium (Mgen) coinfection with rectal chlamydia (Chlamydia trachomatis (CT)) and rectal gonorrhoea (Neisseria gonorrhoeae (NG)) infections and few studies examining the prevalence of pharyngeal Mgen in men who have sex with men (MSM). Using transcription-mediated amplification assay, this study aimed to determine the proportion of rectal CT and rectal NG infections in MSM who are coinfected with rectal Mgen, and the proportion of MSM with Mgen detected in the pharynx in order to inform clinical practice.

METHODS

This was a cross-sectional study conducted at Melbourne Sexual Health Centre in Australia. Consecutively collected rectal swabs from MSM that tested positive for CT (n=212) or NG (n=212), and consecutively collected pharyngeal samples (n=480) from MSM were tested for Mgen using the Aptima Mycoplasma genitalium Assay (Hologic, San Diego). Samples were linked to demographic data and symptom status.

RESULTS

Rectal Mgen was codetected in 27 of 212 rectal CT (13%, 95% CI 9 to 18) and in 29 of 212 rectal NG (14%, 95% CI 9 to 19) samples, with no difference in the proportion positive for Mgen. MSM with rectal CT/Mgen coinfection had more sexual partners than those with rectal CT monoinfection (mean 6 vs 11, p=0.06). MSM with rectal NG/Mgen coinfection were more likely to be HIV-positive than those with rectal NG monoinfection (OR=2.96, 95% CI 1.21 to 7.26, p=0.023). MSM with rectal CT/Mgen coinfection were more likely to be using pre-exposure prophylaxis than MSM with rectal NG/Mgen coinfection (OR 0.25, 95% CI 0.10 to 0.65, p=0.002). Pharyngeal Mgen was uncommon and detected in 8 of 464 samples (2%, 95% CI 1% to 3%). Pharyngeal Mgen was associated with having a rectal STI (OR=10.61, 95% CI 2.30 to 48.87, p=0.002), and there was a borderline association with being HIV-positive (p=0.079).

CONCLUSION

These data indicate one in seven MSM treated for rectal CT or rectal NG will have undiagnosed Mgen that is potentially exposed to azithromycin during treatment of these STIs. Rectal Mgen coinfection was associated with specific risk factors which may inform testing practices. Pharyngeal Mgen was uncommon.

Authors+Show Affiliations

Central Clinical School, Monash University, Clayton, Victoria, Australia rlatimer@mshc.org.au. Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia.Central Clinical School, Monash University, Clayton, Victoria, Australia. Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia.Doherty Institute, Microbiological Diagnostic Unit Public Health Laboratory, University of Melbourne, Melbourne, Victoria, Australia.Central Clinical School, Monash University, Clayton, Victoria, Australia. Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia.Central Clinical School, Monash University, Clayton, Victoria, Australia. Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia.Doherty Institute, Microbiological Diagnostic Unit Public Health Laboratory, University of Melbourne, Melbourne, Victoria, Australia.Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia.Central Clinical School, Monash University, Clayton, Victoria, Australia. Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia.Central Clinical School, Monash University, Clayton, Victoria, Australia. Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

31217322

Citation

Latimer, Rosie Louise, et al. "Extragenital Mycoplasma Genitalium Infections Among Men Who Have Sex With Men." Sexually Transmitted Infections, vol. 96, no. 1, 2020, pp. 10-18.
Latimer RL, Vodstrcil L, De Petra V, et al. Extragenital Mycoplasma genitalium infections among men who have sex with men. Sex Transm Infect. 2020;96(1):10-18.
Latimer, R. L., Vodstrcil, L., De Petra, V., Fairley, C. K., Read, T. R., Williamson, D., Doyle, M., Chow, E. P., & Bradshaw, C. (2020). Extragenital Mycoplasma genitalium infections among men who have sex with men. Sexually Transmitted Infections, 96(1), 10-18. https://doi.org/10.1136/sextrans-2019-054058
Latimer RL, et al. Extragenital Mycoplasma Genitalium Infections Among Men Who Have Sex With Men. Sex Transm Infect. 2020;96(1):10-18. PubMed PMID: 31217322.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Extragenital Mycoplasma genitalium infections among men who have sex with men. AU - Latimer,Rosie Louise, AU - Vodstrcil,Lenka, AU - De Petra,Vesna, AU - Fairley,Christopher K, AU - Read,Tim Rh, AU - Williamson,Deborah, AU - Doyle,Michelle, AU - Chow,Eric Pf, AU - Bradshaw,Catriona, Y1 - 2019/06/19/ PY - 2019/03/26/received PY - 2019/05/24/revised PY - 2019/06/02/accepted PY - 2019/6/21/pubmed PY - 2020/4/29/medline PY - 2019/6/21/entrez KW - men who have sex with men KW - mycoplasma genitalium KW - pharynx KW - rectum SP - 10 EP - 18 JF - Sexually transmitted infections JO - Sex Transm Infect VL - 96 IS - 1 N2 - OBJECTIVES: There are limited data on the prevalence of Mycoplasma genitalium (Mgen) coinfection with rectal chlamydia (Chlamydia trachomatis (CT)) and rectal gonorrhoea (Neisseria gonorrhoeae (NG)) infections and few studies examining the prevalence of pharyngeal Mgen in men who have sex with men (MSM). Using transcription-mediated amplification assay, this study aimed to determine the proportion of rectal CT and rectal NG infections in MSM who are coinfected with rectal Mgen, and the proportion of MSM with Mgen detected in the pharynx in order to inform clinical practice. METHODS: This was a cross-sectional study conducted at Melbourne Sexual Health Centre in Australia. Consecutively collected rectal swabs from MSM that tested positive for CT (n=212) or NG (n=212), and consecutively collected pharyngeal samples (n=480) from MSM were tested for Mgen using the Aptima Mycoplasma genitalium Assay (Hologic, San Diego). Samples were linked to demographic data and symptom status. RESULTS: Rectal Mgen was codetected in 27 of 212 rectal CT (13%, 95% CI 9 to 18) and in 29 of 212 rectal NG (14%, 95% CI 9 to 19) samples, with no difference in the proportion positive for Mgen. MSM with rectal CT/Mgen coinfection had more sexual partners than those with rectal CT monoinfection (mean 6 vs 11, p=0.06). MSM with rectal NG/Mgen coinfection were more likely to be HIV-positive than those with rectal NG monoinfection (OR=2.96, 95% CI 1.21 to 7.26, p=0.023). MSM with rectal CT/Mgen coinfection were more likely to be using pre-exposure prophylaxis than MSM with rectal NG/Mgen coinfection (OR 0.25, 95% CI 0.10 to 0.65, p=0.002). Pharyngeal Mgen was uncommon and detected in 8 of 464 samples (2%, 95% CI 1% to 3%). Pharyngeal Mgen was associated with having a rectal STI (OR=10.61, 95% CI 2.30 to 48.87, p=0.002), and there was a borderline association with being HIV-positive (p=0.079). CONCLUSION: These data indicate one in seven MSM treated for rectal CT or rectal NG will have undiagnosed Mgen that is potentially exposed to azithromycin during treatment of these STIs. Rectal Mgen coinfection was associated with specific risk factors which may inform testing practices. Pharyngeal Mgen was uncommon. SN - 1472-3263 UR - https://www.unboundmedicine.com/medline/citation/31217322/Extragenital_Mycoplasma_genitalium_infections_among_men_who_have_sex_with_men_ L2 - https://sti.bmj.com/lookup/pmidlookup?view=long&pmid=31217322 DB - PRIME DP - Unbound Medicine ER -