Abstract
Data on the likelihood of Mycoplasma genitalium infection in sexual contacts, particularly for men who have sex with men (MSM), are needed to form an evidence base for guidelines. We conducted a cross-sectional analysis of patients attending a sexual health clinic in Melbourne, Victoria, Australia, during 2008–2016. We calculated the proportion of contacts with M. genitalium infection and determined factors associated with infection. Among those patients reporting sexual contact with an M. genitalium–infected person, 48.2% of women, 31.0% of heterosexual men, and 41.7% of MSM were infected. Among heterosexual contacts, women were twice as likely to be infected; among MSM, rectal infection was more common than urethral infection; and among persons within heterosexual partnerships, concordance of infection was high. High positivity among female and MSM contacts and high concordance in heterosexual partnerships provide some justification for presumptive treatment; however, clinicians should consider antimicrobial drug resistance and toxicity of quinolones.
Highlights
Mycoplasma genitalium is an established sexually transmitted pathogen that causes nongonococcal urethritis, and recent evidence indicates that it increases the risk for cervicitis, pelvic inflammatory disease, preterm delivery, and spontaneous abortion [1,2]
During the study period, a total of 441 presentations to the clinic were made by patients reporting sexual contact with a person with M. genitalium infection (Figure)
These findings will inform guidelines for the management of sexual contacts of M. genitalium–infected patients and provide an evidence base for informed discussion between clinicians and their patients regarding the appropriateness of presumptive treatment for contacts of infected patients or recommending testing and return for treatment
Summary
Mycoplasma genitalium is an established sexually transmitted pathogen that causes nongonococcal urethritis, and recent evidence indicates that it increases the risk for cervicitis, pelvic inflammatory disease, preterm delivery, and spontaneous abortion [1,2]. The estimated prevalence of M. genitalium infection is 1%–3% in men and women, according to community-based studies from the United Kingdom, United States, Australia, and Scandinavia [3,4,5,6,7]. Published data are limited regarding the likelihood of transmission of M. genitalium and the proportion of persons who are likely to be infected after contact with an infected sex partner. Presumptive treatment for chlamydial infection, a sexually transmitted infection with similar characteristics to M. genitalium infection, is recommended based on prevalence estimates of 36%–68% among contacts of sex partners with confirmed chlamydial infection [23,24,25,26]. We performed a retrospective analysis of clinical records of patients attending a large urban sexual health service in Melbourne, Victoria, Australia, who reported sexual contact with a partner with diagnosed M. genitalium infection. We aimed to determine the proportion of cases with M. genitalium and the factors associated with infection in women, heterosexual men, and MSM
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