Bradshaw C S, Fairley C K, Lister N A, Chen S J, Garland S M, Tabrizi S N
Department of Epidemiology and Preventive Medicine, Monash University, Carlton 3053, Victoria, Australia.
Sex Transm Infect. 2009 Oct;85(6):432-5. doi: 10.1136/sti.2008.035535. Epub 2009 Mar 1.
To determine the prevalence and clinical associations of Mycoplasma genitalium in urethral, rectal and pharyngeal specimens collected from men who have sex with men (MSM) attending male-only saunas.
A cross-sectional study of 521 MSM attending six male-only saunas in Melbourne was conducted between October 2001 and September 2002. Stored urine and rectal and pharyngeal swabs were tested for M genitalium by real-time polymerase chain reaction. The prevalence of M genitalium and clinical associations were determined.
A high prevalence (12.9%; 95% CI 10.2% to 15.9%) of sexually transmitted infections (STIs) was found in MSM. M genitalium (2.1%; 95% CI 1.1% to 3.6%) was less common than Chlamydia trachomatis (8.1%; 95% CI 5.9% to 10.6%, p<0.001), and Neisseria gonorrhoeae (4.8%; 95% CI 3.2% to 6.9%, p = 0.02). M genitalium was most likely to be detected as an asymptomatic rectal (1.6%; 95% CI 0.8% to 3.0%) or urethral infection (0.6%; 95% CI 0.2% to 1.6%, p = 0.12), but was absent from the pharynx. In comparison, C trachomatis was more common in the rectum (6.2%; 95% CI 4.3% to 8.6%) than urethra (1.8%; 95% CI 0.9% to 3.2%, p = 0.004), and was uncommon in the pharynx (0.6%; 95% CI 0.1% to 1.6%). Urethral infection with N gonorrhoeae (0.2%; 95% CI 0.01% to 1.0%) was rare, but it was as common in the pharynx (2.5%; 95% CI 1.4% to 4.2%) as the rectum (2.2%; 95% CI 1.2% to 3.8%). No significant demographic or behavioural associations with M genitalium were identified.
M genitalium was less common than C trachomatis and N gonorrhoeae in MSM attending male-only saunas and was most often detected as an asymptomatic rectal or a urethral infection but was absent from the pharynx. To inform STI screening strategies in MSM, more data are needed to understand how common M genitalium infection is in urethral and non-urethral sites in MSM, and how it contributes to clinical symptoms.
确定在仅接待男性顾客的桑拿浴室接受服务的男男性行为者（MSM）的尿道、直肠和咽部样本中生殖支原体的流行情况及其临床关联。
2001年10月至2002年9月，对墨尔本六家仅接待男性顾客的桑拿浴室中的521名MSM进行了一项横断面研究。通过实时聚合酶链反应检测储存的尿液、直肠拭子和咽部拭子中的生殖支原体。确定生殖支原体的流行情况及其临床关联。
在MSM中发现性传播感染（STI）的高流行率（12.9%；95%可信区间10.2%至15.9%）。生殖支原体（2.1%；95%可信区间1.1%至3.6%）比沙眼衣原体（8.1%；95%可信区间5.9%至10.6%，p<0.001）和淋病奈瑟菌（4.8%；95%可信区间3.2%至6.9%，p = 0.02）少见。生殖支原体最有可能在无症状的直肠（1.6%；95%可信区间0.8%至3.0%）或尿道感染中被检测到（0.6%；95%可信区间0.2%至1.6%，p = 0.12），但在咽部未检测到。相比之下，沙眼衣原体在直肠（6.2%；95%可信区间4.3%至8.6%）比尿道（1.8%；95%可信区间0.9%至3.2%，p = 0.004）更常见，在咽部不常见（0.6%；95%可信区间0.1%至1.6%）。尿道淋病奈瑟菌感染（0.2%；95%可信区间0.01%至1.0%）很少见，但在咽部（2.5%；95%可信区间1.4%至4.2%）和直肠（2.2%；95%可信区间,1.2%至3.8%）中同样常见。未发现与生殖支原体有显著的人口统计学或行为学关联。
在仅接待男性顾客的桑拿浴室接受服务的MSM中，生殖支原体比沙眼衣原体和淋病奈瑟菌少见，最常被检测为无症状的直肠或尿道感染，但在咽部未检测到。为了指导MSM的性传播感染筛查策略，需要更多数据来了解生殖支原体感染在MSM尿道和非尿道部位的常见程度，以及它如何导致临床症状。
