Table 2.
Prevalence and Association of Macrolide Resistance With Sociodemographic and Clinical Characteristics Among 286 Mycoplasma genitalium–Positive Patients Attending Urban Sexual Health Clinics, September–December 2020
| Characteristic | Macrolide Resistance | ||||
|---|---|---|---|---|---|
| MRM+/Total Tested | Prevalence, % (95% CI)a | aPRb | 95% CI | P | |
| Overall | 169/286 | 59.1 (53.1–64.8) | … | … | |
| Sitec | |||||
| Denver, CO | 34/65 | 52.3 (39.5–64.9) | 1.0 | .69–1.52 | .91 |
| Greensboro, NC | 36/51 | 70.6 (56.2–82.5) | 1.6 | 1.06–2.31 | .02 |
| Indianapolis, IN | … | … | … | … | |
| New York NY | 20/39 | 51.3 (34.8–67.6) | .9 | .55–1.36 | .53 |
| Seattle, WA | 20/38 | 52.6 (35.8–69.0) | 1.0 | ref | |
| St Louis, MO | 57/91 | 62.6 (51.9–72.6) | 1.3 | .91–1.99 | .14 |
| Sociodemographic characteristics | |||||
| Sexd | |||||
| Male | 94/155 | 60.6 (52.5–68.4) | 1.0 | ref | |
| Female | 75/131 | 57.3 (48.3–65.9) | 1.0 | .74–1.40 | .93 |
| Age | |||||
| Age continuous (per year) | 169/286 | … | 1.0 | .976–1.001 | .08 |
| Age categories | |||||
| <18 y | 5/7 | 71.4 (29.0–96.3) | 1.0 | ref | |
| 18–24 y | 66/103 | 64.1 (54.0–73.3) | .8 | .54–1.33 | .47 |
| 25–29 y | 46/76 | 60.5 (48.6–71.6) | .8 | .51–1.29 | .38 |
| 30–39 y | 39/77 | 50.6 (39.0–62.2) | .7 | .42–1.12 | .13 |
| ≥40y | 13/23 | 56.5 (34.5–76.8) | .7 | .41–1.34 | .33 |
| Race/ethnicitye | |||||
| NH Black | 97/165 | 58.8 (50.9–66.4) | 1.0 | ref | |
| NH White | 26/48 | 54.2 (39.2–68.6) | .9 | .70–1.25 | .64 |
| NH Other | 11/16 | 68.8 (41.3–89.0) | 1.2 | .83–1.78 | .32 |
| Hispanic/Latinx | 20/36 | 55.6 (38.1–72.1) | .9 | .69–1.29 | .70 |
| Unknown/missing | 15/21 | 71.4 (47.8–88.7) | 1.2 | .89–1.66 | .23 |
| Gender identityf | |||||
| Cisgender male | 94/154 | 61.0 (52.9–68.8) | 1.0 | ref | |
| Cisgender female | 75/130 | 57.7 (48.7–66.3) | .8 | .05–14.03 | .90 |
| Another | 0/2 | 0 (0) | … | … | |
| Sex/gender of sex partnersg | |||||
| Males | |||||
| MSM any | 21/41 | 51.2 (35.1–67.1) | 1.0 | ref | |
| MSW only | 68/107 | 63.6 (53.7–72.6) | 1.1 | .78–1.58 | .56 |
| Females | |||||
| WSW any | 6/10 | 60.0 (26.2–87.8) | 1.0 | ref | |
| WSM only | 66/117 | 56.4 (46.9–65.6) | 1.0 | .56–1.64 | .88 |
| Unknown | 7/10 | 70.0 (34.8–93.3) | … | … | |
| No sex in past year | 1/1 | 100.0 (25.0–100.0) | … | … | |
| Clinical characteristics | |||||
| Symptom statush | |||||
| Males | |||||
| Asymptomatic | 23/42 | 54.8 (38.7–70.2) | 1.0 | ref | |
| Symptomatic | 71/113 | 62.8 (53.2–71.7) | 1.1 | .81–1.43 | .63 |
| Females | |||||
| Asymptomatic | 22/44 | 50.0 (34.6–65.4) | 1.0 | ref | |
| Symptomatic | 53/87 | 60.9 (49.9–71.2) | 1.2 | .87–1.73 | .24 |
| Diagnosisi | |||||
| Males | |||||
| No diagnosis | 38/64 | 59.4 (46.4–71.5) | 1.0 | ref | |
| Male urethritis | 39/62 | 62.9 (49.7–74.8) | .9 | .63–1.16 | .33 |
| Females | |||||
| No diagnosis | 32/64 | 50.0 (37.2–62.8) | 1.0 | ref | |
| Vaginitis | 36/55 | 65.5 (51.4–77.8) | 1.8 | 1.14–2.85 | .01 |
| Cervicitis | 2/2 | 100.0 (15.8–100.0) | 3.5 | 1.69–7.30 | .001 |
| PID | 2/2 | 100.0 (15.8–100.0) | 1.8 | 1.09–3.08 | .02 |
| Chlamydiaj | |||||
| Chlamydia negative | 62/118 | 52.5 (43.1–61.8) | 1.0 | ref | |
| Chlamydia positive | 25/41 | 61.0 (44.5–75.8) | .9 | .56–1.41 | .62 |
| Gonorrheaj | |||||
| Gonorrhea negative | 66/121 | 54.5 (45.2–63.6) | 1.0 | ref | |
| Gonorrhea positive | 13/29 | 44.8 (26.4–64.3) | .6 | .34–1.23 | .19 |
Bolded values are statistically significant at P < .05.
Abbreviations: aPR, adjusted prevalence ratio; CI, confidence interval; MRM, macrolide-resistance mutation; MSM, men who have sex with men; MSW, men who have sex with women; NH, non-Hispanic; PID, pelvic inflammatory disease; ref, reference; WSM, women who have sex with men; WSW, women who have sex with women.
aBinomial exact 95% CIs.
bAll prevalence ratios (PRs) adjusted for site, sex, and symptom status unless otherwise specified.
cPRs for site were adjusted for race-ethnicity, sex, and symptom status. Prevalence of MRM in Indianapolis was based on fewer than 5 specimens; the estimate and PR is suppressed, but data are included in the global estimate of MRM prevalence across sites.
dSpecimens were identified for surveillance based on recorded sex and the anatomic site from which the specimen was collected; sex does not account for gender identity.
ePRs for race-ethnicity adjusted for sex and symptom status but not site due to collinearity.
fDue to concerns about potential deductive disclosure, transgender, gender-diverse, and gender nonconforming persons in Denver were not included.
gMSM include male sex (index) who report sex with any male sex/gender partner either alone or in combination with other gender partners (eg, cis-female, trans male/female, nonbinary, or other gender identity); n = 43 MSM who identified as men who have sex with women and men (MSWM). MSW include male sex (index) who only report sex with female partners. WSM include female sex (index) who only had sex with male partners. WSW include female sex (index) who report sex with any female sex/gender either alone or in combination with other gender partners (eg, cis-female, trans male/female, nonbinary, other gender identity); n = 69 identified as women who have sex with women and men (WSWM). The unknown/another category includes 62 persons with missing information on sex/gender of sex partner.
hPRs for symptom status by sex adjusted for site only.
iDiagnoses are not mutually exclusive; therefore, summed counts may exceed the total population.
jGonorrhea and chlamydia status documented in only 4 sites (Denver, New York City, Seattle, St Louis).