Mycoplasma genitalium: prevalence in men presenting with urethritis to a South Australian public sexual health clinic

Intern Med J. 2013 May;43(5):494-500. doi: 10.1111/imj.12103.

Abstract

Background/aim: This study aimed to determine the prevalence of Mycoplasma genitalium infection among male patients with dysuria and/or urethral discharge. An analysis of the clinical, demographic and microbiological factors associated with M. genitalium infection was also conducted.

Method: From May 2007 to June 2011, men presenting to the clinic with self-reported symptoms of dysuria and/or urethral discharge were identified and underwent urethral swab, which was microscopically assessed for objective non-gonococcal urethritis. A first-void urine sample was tested for Chlamydia trachomatis and Neisseria gonorrhoeae using the Aptima Combo-2 assay. A portion of the urine sample was sent for polymerase chain reaction analysis for M. genitalium.

Results: One thousand, one hundred and eighty-two men with dysuria and/or urethral discharge were tested for M. genitalium. Of those, 96 men (8.1%) were positive for M. genitalium. Men identifying as solely MSM (men who have sex with men) constituted 16.3% (n = 193) of the sample. Their infection rate was 3.1% (n = 6). The infection rate for heterosexual and bisexual men was 9.1%. For all men, the M. genitalium co-infection rate was 14.6% (n = 14) with C. trachomatis and 3.1% (n = 3) with N. gonorrhoeae. Factors associated with M. genitalium infection were analysed by univariate analysis. We determined that five investigated predictors were significantly associated with M. genitalium infection, urethral discharge, non-gonococcal urethritis on Gram stain of urethral smears, identification as heterosexual or bisexual, and absence of co-infection with C. trachomatis or N. gonorrhoeae.

Conclusion: In Adelaide, M. genitalium is an important sexually transmitted infection among men with dysuria and/or urethral discharge, and is primarily an infection of heterosexual and bisexual men.

MeSH terms

  • Adult
  • Ambulatory Care Facilities*
  • Humans
  • Male
  • Mycoplasma Infections / diagnosis
  • Mycoplasma Infections / epidemiology*
  • Mycoplasma Infections / therapy
  • Mycoplasma genitalium*
  • New South Wales / epidemiology
  • Prevalence
  • Prospective Studies
  • Public Health Practice
  • Sexual Behavior*
  • Sexually Transmitted Diseases / diagnosis
  • Sexually Transmitted Diseases / epidemiology*
  • Sexually Transmitted Diseases / therapy
  • Urethritis / diagnosis
  • Urethritis / epidemiology*
  • Urethritis / therapy