Abstract
Objectives: To study the prevalence, symptoms, and signs of Mycoplasma genitalium and Chlamydia trachomatis infections in men attending a Swedish STD clinic and to study the criteria for urethritis.
Methods: A cross sectional study among STD clinic attendees in Örebro, Sweden. Attendees were examined for microscopic urethritis and first void urine (FVU) was tested for M genitalium and C trachomatis.
Results: The prevalence of M genitalium and C trachomatis was 7% (34/512) and 12% (61/512), respectively. Dual infection was diagnosed in four men. In both infections 90% of the patients had signs of microscopic urethritis. M genitalium positive men had symptomatic urethritis significantly more often than those infected with C trachomatis (73% v 40%, RR 1.8; 95% CI 1.2 to 2.7). 63% of female partners of men infected with M genitalium were infected with M genitalium compared with chlamydial infection in 67% of female partners of men infected with C trachomatis. Non-chlamydial non-gonococcal urethritis without evidence of M genitalium infection was diagnosed in 180 men (35%). Symptoms and/or visible discharge were reported in 49% in this group.
Conclusions: M genitalium is a common infection associated with symptomatic urethritis and with a high prevalence of infected sexual partners supporting its role as a sexually transmitted infection.
Full Text
The Full Text of this article is available as a PDF (76.6 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Anagrius Carin, Loré Britta. Klamydialiknande symtom kan ha annan bakgrund. Mycoplasma genitalium--en viktig och vanlig sexuellt överförd sjukdom. Lakartidningen. 2002 Nov 28;99(48):4854-5, 4858-9. [PubMed] [Google Scholar]
- Björnelius E., Lidbrink P., Jensen J. S. Mycoplasma genitalium in non-gonococcal urethritis--a study in Swedish male STD patients. Int J STD AIDS. 2000 May;11(5):292–296. doi: 10.1177/095646240001100504. [DOI] [PubMed] [Google Scholar]
- Clausen H. F., Fedder J., Drasbek M., Nielsen P. K., Toft B., Ingerslev H. J., Birkelund S., Christiansen G. Serological investigation of Mycoplasma genitalium in infertile women. Hum Reprod. 2001 Sep;16(9):1866–1874. doi: 10.1093/humrep/16.9.1866. [DOI] [PubMed] [Google Scholar]
- Cohen Craig R., Manhart Lisa E., Bukusi Elizabeth A., Astete Sabina, Brunham Robert C., Holmes King K., Sinei Samuel K., Bwayo Job J., Totten Patricia A. Association between Mycoplasma genitalium and acute endometritis. Lancet. 2002 Mar 2;359(9308):765–766. doi: 10.1016/S0140-6736(02)07848-0. [DOI] [PubMed] [Google Scholar]
- Deguchi T., Komeda H., Yasuda M., Tada K., Iwata H., Asano M., Ezaki T., Kawada Y. Mycoplasma genitalium in non-gonococcal urethritis. Int J STD AIDS. 1995 Mar-Apr;6(2):144–145. doi: 10.1177/095646249500600219. [DOI] [PubMed] [Google Scholar]
- Dupin Nicolas, Bijaoui Gérard, Schwarzinger Michaël, Ernault Pauline, Gerhardt Philippe, Jdid Randa, Hilab Salim, Pantoja Christina, Buffet Marc, Escande Jean-Paul. Detection and quantification of Mycoplasma genitalium in male patients with urethritis. Clin Infect Dis. 2003 Jul 30;37(4):602–605. doi: 10.1086/376990. [DOI] [PubMed] [Google Scholar]
- Falk L., Fredlund H., Jensen J. S. Tetracycline treatment does not eradicate Mycoplasma genitalium. Sex Transm Infect. 2003 Aug;79(4):318–319. doi: 10.1136/sti.79.4.318. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Gambini D., Decleva I., Lupica L., Ghislanzoni M., Cusini M., Alessi E. Mycoplasma genitalium in males with nongonococcal urethritis: prevalence and clinical efficacy of eradication. Sex Transm Dis. 2000 Apr;27(4):226–229. doi: 10.1097/00007435-200004000-00008. [DOI] [PubMed] [Google Scholar]
- Horner P. J., Gilroy C. B., Thomas B. J., Naidoo R. O., Taylor-Robinson D. Association of Mycoplasma genitalium with acute non-gonococcal urethritis. Lancet. 1993 Sep 4;342(8871):582–585. doi: 10.1016/0140-6736(93)91411-e. [DOI] [PubMed] [Google Scholar]
- Horner P. J., Thomas B., Gilroy C. B., Egger M., Taylor-Robinson D. Do all men attending departments of genitourinary medicine need to be screened for non-gonococcal urethritis? Int J STD AIDS. 2002 Oct;13(10):667–673. doi: 10.1258/095646202760326408. [DOI] [PubMed] [Google Scholar]
- Horner P., Thomas B., Gilroy C. B., Egger M., Taylor-Robinson D. Role of Mycoplasma genitalium and Ureaplasma urealyticum in acute and chronic nongonococcal urethritis. Clin Infect Dis. 2001 Mar 15;32(7):995–1003. doi: 10.1086/319594. [DOI] [PubMed] [Google Scholar]
- Jensen J. S., Orsum R., Dohn B., Uldum S., Worm A. M., Lind K. Mycoplasma genitalium: a cause of male urethritis? Genitourin Med. 1993 Aug;69(4):265–269. doi: 10.1136/sti.69.4.265. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Jensen J. S., Uldum S. A., Søndergård-Andersen J., Vuust J., Lind K. Polymerase chain reaction for detection of Mycoplasma genitalium in clinical samples. J Clin Microbiol. 1991 Jan;29(1):46–50. doi: 10.1128/jcm.29.1.46-50.1991. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Jensen Jørgen Skov, Borre Martin B., Dohn Birthe. Detection of Mycoplasma genitalium by PCR amplification of the 16S rRNA gene. J Clin Microbiol. 2003 Jan;41(1):261–266. doi: 10.1128/JCM.41.1.261-266.2003. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Johannisson G., Enström Y., Löwhagen G. B., Nagy V., Ryberg K., Seeberg S., Welinder-Olsson C. Occurrence and treatment of Mycoplasma genitalium in patients visiting STD clinics in Sweden. Int J STD AIDS. 2000 May;11(5):324–326. doi: 10.1177/095646240001100508. [DOI] [PubMed] [Google Scholar]
- Kamwendo F., Forslin L., Bodin L., Danielsson D. Programmes to reduce pelvic inflammatory disease--the Swedish experience. Lancet. 1998;351 (Suppl 3):25–28. doi: 10.1016/s0140-6736(98)90008-3. [DOI] [PubMed] [Google Scholar]
- Lind K., Lindhardt B. O., Schütten H. J., Blom J., Christiansen C. Serological cross-reactions between Mycoplasma genitalium and Mycoplasma pneumoniae. J Clin Microbiol. 1984 Dec;20(6):1036–1043. doi: 10.1128/jcm.20.6.1036-1043.1984. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Manhart Lisa E., Critchlow Cathy W., Holmes King K., Dutro Susan M., Eschenbach David A., Stevens Claire E., Totten Patricia A. Mucopurulent cervicitis and Mycoplasma genitalium. J Infect Dis. 2003 Jan 29;187(4):650–657. doi: 10.1086/367992. [DOI] [PubMed] [Google Scholar]
- Morency P., Dubois M. J., Grésenguet G., Frost E., Mâsse B., Deslandes S., Somsé P., Samory A., Mberyo-Yaah F., Pépin J. Aetiology of urethral discharge in Bangui, Central African Republic. Sex Transm Infect. 2001 Apr;77(2):125–129. doi: 10.1136/sti.77.2.125. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Pépin J., Sobéla F., Deslandes S., Alary M., Wegner K., Khonde N., Kintin F., Kamuragiye A., Sylla M., Zerbo P. J. Etiology of urethral discharge in West Africa: the role of Mycoplasma genitalium and Trichomonas vaginalis. Bull World Health Organ. 2001;79(2):118–126. [PMC free article] [PubMed] [Google Scholar]
- Simms I., Eastick K., Mallinson H., Thomas K., Gokhale R., Hay P., Herring A., Rogers P. A. Associations between Mycoplasma genitalium, Chlamydia trachomatis, and pelvic inflammatory disease. Sex Transm Infect. 2003 Apr;79(2):154–156. doi: 10.1136/sti.79.2.154. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Spence M. R. Gonorrhea. Clin Obstet Gynecol. 1983 Mar;26(1):111–124. doi: 10.1097/00003081-198303000-00016. [DOI] [PubMed] [Google Scholar]
- Swartz S. L., Kraus S. J., Herrmann K. L., Stargel M. D., Brown W. J., Allen S. D. Diagnosis and etiology of nongonococcal urethritis. J Infect Dis. 1978 Oct;138(4):445–454. doi: 10.1093/infdis/138.4.445. [DOI] [PubMed] [Google Scholar]
- Taylor-Robinson D., Horner P. J. The role of Mycoplasma genitalium in non-gonococcal urethritis. Sex Transm Infect. 2001 Aug;77(4):229–231. doi: 10.1136/sti.77.4.229. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Taylor-Robinson David. Mycoplasma genitalium -- an up-date. Int J STD AIDS. 2002 Mar;13(3):145–151. doi: 10.1258/0956462021924776. [DOI] [PubMed] [Google Scholar]
- Thompson S. E., 3rd, Hager W. D., Wong K. H., Lopez B., Ramsey C., Allen S. D., Stargel M. D., Thornsberry C., Benigno B. B., Thompson J. D. The microbiology and therapy of acute pelvic inflammatory disease in hospitalized patients. Am J Obstet Gynecol. 1980 Jan 15;136(2):179–186. doi: 10.1016/0002-9378(80)90592-x. [DOI] [PubMed] [Google Scholar]
- Totten P. A., Schwartz M. A., Sjöström K. E., Kenny G. E., Handsfield H. H., Weiss J. B., Whittington W. L. Association of Mycoplasma genitalium with nongonococcal urethritis in heterosexual men. J Infect Dis. 2000 Dec 21;183(2):269–276. doi: 10.1086/317942. [DOI] [PubMed] [Google Scholar]
- Tully J. G., Taylor-Robinson D., Cole R. M., Rose D. L. A newly discovered mycoplasma in the human urogenital tract. Lancet. 1981 Jun 13;1(8233):1288–1291. doi: 10.1016/s0140-6736(81)92461-2. [DOI] [PubMed] [Google Scholar]
- Tully J. G., Taylor-Robinson D., Rose D. L., Furr P. M., Graham C. E., Barile M. F. Urogenital challenge of primate species with Mycoplasma genitalium and characteristics of infection induced in chimpanzees. J Infect Dis. 1986 Jun;153(6):1046–1054. doi: 10.1093/infdis/153.6.1046. [DOI] [PubMed] [Google Scholar]
- Uusküla Anneli, Kohl Peter K. Genital mycoplasmas, including Mycoplasma genitalium, as sexually transmitted agents. Int J STD AIDS. 2002 Feb;13(2):79–85. doi: 10.1258/0956462021924695. [DOI] [PubMed] [Google Scholar]