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Clin Infect Dis. 2018 Jun 18;67(1):73-79. doi: 10.1093/cid/ciy025.

A Silent Epidemic: The Prevalence, Incidence and Persistence of Mycoplasma genitalium Among Young, Asymptomatic High-Risk Women in the United States.

Author information

1
Department of Medicine, Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill.
2
Department of Biostatistics, University of Arkansas for Medical Sciences, Little Rock.
3
Department of Medicine, University of Alabama at Birmingham.
4
San Francisco Department of Public Health, California.
5
Department of Obstetrics and Gynecology, Magee-Women's Hospital of University of Pittsburgh Medical Center, Pennsylvania.
6
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
7
Departments of Epidemiology and Medicine, University of Florida, Gainesville.

Abstract

Background:

Mycoplasma genitalium can result in pelvic inflammatory disease and adverse pregnancy outcomes. We analyzed data collected from a prospective study of asymptomatic bacterial vaginosis (BV) to determine the natural history of M. genitalium.

Methods:

Women aged 15-25 years, with asymptomatic BV and ≥2 risk factors for sexually transmitted infection were recruited from 10 sites throughout the United States. Vaginal swab samples were collected at enrollment and through home-based testing every 2 months over 12 months. M. genitalium nucleic acid amplification testing was performed for M. genitalium using transcription-mediated assays (Hologic). The prevalence, incidence, and persistence of M. genitalium, defined as all positive specimens during follow-up, were estimated with 95% confidence intervals (CIs). Adjusted odds ratios (AOR) were calculated using logistic and Poisson regression to evaluate participant characteristics associated with M. genitalium infection.

Results:

Among 1139 women, 233 were M. genitalium positive, for a prevalence of 20.5% (95% CI, 18.2%-22.9%); 42 of 204 had persistent M. genitalium (20.6%). Among 801 M. genitalium-negative women at baseline, the M. genitalium incidence was 36.6 per 100 person-years (95% CI, 32.4-41.3). Black race (AOR, 1.92; 95% CI, 1.09-3.38), age ≤21 years (1.40; 1.03-1.91), and prior pregnancy (1.36; 1.00-1.85) were associated with prevalent M. genitalium; only black race was associated with incident M. genitalium (P = .03).

Conclusions:

We identified high rates of prevalent, incident, and persistent M. genitalium infections among young, high-risk women with asymptomatic BV, supporting the need for clinical trials to evaluate the impact of M. genitalium screening on female reproductive health outcomes.

PMID:
29342269
PMCID:
PMC6005142
[Available on 2019-06-18]
DOI:
10.1093/cid/ciy025

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