Evidence of emerging sexually transmitted Mycoplasma genitalium infection among women detected using multiplex and uniplex PCR

Abstract

Background The Centre for Disease Control has recognised Mycoplasma genitalium as an emerging sexually transmitted infection. Sparse literature is available in India regarding Mycoplasma genitalium infection. Aims To evaluate the prevalence of Mycoplasma genitalium, its detection from samples obtained from various sites, evaluate co-infections and follow up after treatment. Methods A prospective study was conducted among 341 sexually active women presenting with the complaints of lower genital tract infection to the Municipal STD clinic and ART Centre. Endocervical swabs, vaginal swabs and urine samples were tested for Mycoplasma genitalium using uniplex and multiplex real-time PCR kits. Gram stain was used for diagnosing bacterial vaginosis and candidiasis. Data on HIV, RPR, TPHA, Hepatitis C and HBsAg were also collected. Results The mean age of the participants was 33.4 ± 5.7 years. Mycoplasma genitalium was found in 23 (6.7%) patients, while Neisseria gonorrhoeae and Chlamydia trachomatis were detected in 8 (2.3%) of the participants. The highest Mycoplasma genitalium positivity was in the endocervical swab sample at 6 (26%), followed by the urine sample at 4 (17.3%). The most common coinfection was HCV (33.3%), followed by syphilis (14.3%). The uniplex and multiplex kits showed 47.8% concordance for Mycoplasma genitalium in endocervical swab samples. Tobacco addiction was a significant risk factor for the Mycoplasma genitalium infection. Out of the 6 women who attended the follow up visit at the end of three months, a positive test for cure was seen in 4 (66.6%). Limitations Significant numbers of patients were lost to follow up. Also, the presence of anti-microbial resistance was not evaluated. Conclusion Mycoplasma genitalium is prevalent among women with high-risk behaviours, highlighting the need for further studies are needed among other high-risk populations.