Abstract
During 2016–2017, we tested asymptomatic men who have sex with men (MSM) in Melbourne, Australia, for Mycoplasma genitalium and macrolide resistance mutations in urine and anorectal swab specimens by using PCR. We compared M. genitalium detection rates for those asymptomatic men to those for MSM with proctitis and nongonococcal urethritis (NGU) over the same period. Of 1,001 asymptomatic MSM, 95 had M. genitalium; 84.2% were macrolide resistant, and 17% were co-infected with Neisseria gonorrhoeae or Chlamydia trachomatis. Rectal positivity for M. genitalium was 7.0% and urine positivity was 2.7%. M. genitalium was not more commonly detected in the rectums of MSM (n = 355, 5.6%) with symptoms of proctitis over the same period but was more commonly detected in MSM (n = 1,019, 8.1%) with NGU. M. genitalium is common and predominantly macrolide-resistant in asymptomatic MSM. M. genitalium is not associated with proctitis in this population.
Highlights
During 2016–2017, we tested asymptomatic men who have sex with men (MSM) in Melbourne, Australia, for Mycoplasma genitalium and macrolide resistance mutations in urine and anorectal swab specimens by using PCR
We compared these data with the proportion of tests positive for M. genitalium in MSM with symptoms of proctitis and nongonococcal urethritis to further examine the contribution of M. genitalium to these syndromes in MSM
We compared associations between the detection of M. genitalium and that of C. trachomatis or N. gonorrhoeae in the rectum or urine in the asymptomatic study population using logistic regression, as we did with associations between M. genitalium and C. trachomatis in cases of nongonococcal urethritis diagnosed during the same period
Summary
During 2016–2017, we tested asymptomatic men who have sex with men (MSM) in Melbourne, Australia, for Mycoplasma genitalium and macrolide resistance mutations in urine and anorectal swab specimens by using PCR. Bissessor et al reported that bacterial load of rectal M. genitalium was higher in MSM with proctitis compared with those with asymptomatic infection, and detection was more common in HIV-positive than HIV-negative MSM (21% vs 8%; p = 0.006) [9]. We aimed to determine the proportion of asymptomatic MSM who had M. genitalium in the urethra or rectum and the prevalence of macrolide resistance and risk factors for infection. We compared these data with the proportion of tests positive for M. genitalium in MSM with symptoms of proctitis and nongonococcal urethritis to further examine the contribution of M. genitalium to these syndromes in MSM
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