'The difference in determinants of Chlamydia trachomatis and Mycoplasma genitalium in a sample of young Australian women'.

Jennifer Walker,Nicole Taylor,Jane Gunn,Kathleen Mcnamee,Marcus Y Chen,Hudson Birden,Eve Urban,Marie Pirotta,Basil Donovan,Jimmy Twin,Sandra Walker,Jane S Hocking,Christopher K Fairley ,V Harindra ,John Kaldor ,Marian J Currie ,Suzanne M Garland ,Catriona Bradshaw ,Sepehr N Tabrizi ,Francis J Bowden ,Lyle C Gurrin

doi:10.1186/1471-2334-11-35

Abstract

BackgroundDifferences in the determinants of Chlamydia trachomatis ('chlamydia') and Mycoplasma genitalium (MG) genital infection in women are not well understood.MethodsA cohort study of 16 to 25 year old Australian women recruited from primary health care clinics, aimed to determine chlamydia and MG prevalence and incidence. Vaginal swabs collected at recruitment were used to measure chlamydia and MG prevalence, organism-load and chlamydia-serovar a cross-sectional analysis undertaken on the baseline results is presented here.ResultsOf 1116 participants, chlamydia prevalence was 4.9% (95% CI: 2.9, 7.0) (n = 55) and MG prevalence was 2.4% (95% CI: 1.5, 3.3) (n = 27). Differences in the determinants were found - chlamydia not MG, was associated with younger age [AOR:0.9 (95% CI: 0.8, 1.0)] and recent antibiotic use [AOR:0.4 (95% CI: 0.2, 1.0)], and MG not chlamydia was associated with symptoms [AOR:2.1 (95% CI: 1.1, 4.0)]. Having two or more partners in last 12 months was more strongly associated with chlamydia [AOR:6.4 (95% CI: 3.6, 11.3)] than MG [AOR:2.2 (95% CI: 1.0, 4.6)] but unprotected sex with three or more partners was less strongly associated with chlamydia [AOR:3.1 (95%CI: 1.0, 9.5)] than MG [AOR:16.6 (95%CI: 2.0, 138.0)]. Median organism load for MG was 100 times lower (5.7 × 104/swab) than chlamydia (5.6 × 106/swab) (p < 0.01) and not associated with age or symptoms for chlamydia or MG.ConclusionsThese results demonstrate significant chlamydia and MG prevalence in Australian women, and suggest that the differences in strengths of association between numbers of sexual partners and unprotected sex and chlamydia and MG might be due to differences in the transmission dynamics between these infections.

Highlights

Differences in the determinants of Chlamydia trachomatis (’chlamydia’) and Mycoplasma genitalium (MG) genital infection in women are not well understood
Prevalence estimates and associations A total of 55 women tested positive for chlamydia [prevalence: 4.9%] and 27 tested positive for MG [prevalence: 2.4%]
Two women were co-infected with both chlamydia and MG [0.2%]

Summary

Introduction

Differences in the determinants of Chlamydia trachomatis (’chlamydia’) and Mycoplasma genitalium (MG) genital infection in women are not well understood. Genital Chlamydia trachomatis (’chlamydia’) infection is a significant public health problem among young Australian women, with notification rates increasing from 74 per 100 000 people per year in 1997, to 287 per 100 000 people per year in 2009 [1]. Prevalence estimates among young Australian women range from 3% to 5% in community-based samples [2,3], but these estimates are based on small sample sizes with limited. Mycoplasma genitalium (MG) is another important sexually transmitted pathogen that is associated with urethritis [5], cervicitis, endometritis [6], pelvic inflammatory disease (PID), tubal factor infertility [7], and an increased risk of HIV transmission [8]. Understanding the burden of disease that might be attributable to MG in young Australian women is necessary to inform clinical practice and policy

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