Ross J D C, Brown L, Saunders P, Alexander S
Whittall Street Clinic, Whittall Street, Birmingham B4 6DH, UK.
Sex Transm Infect. 2009 Oct;85(6):436-7. doi: 10.1136/sti.2009.036046. Epub 2009 Jul 8.
Mycoplasma genitalium is well established as a cause of urethritis and has also been associated with cervicitis, endometritis and pelvic infection. Low rates of infection suggest screening may be inappropriate in the general population, but it remains unclear whether asymptomatic patients attending a sexual-health clinic should be tested routinely. The objective of this study was to measure the positivity rate of M genitalium infection in asymptomatic individuals presenting to a sexual-health clinic to inform the need for screening in this population.
Asymptomatic patients were identified using a structured questionnaire and tested for M genitalium from genital swabs or urine using two separate polymerase chain reaction (PCR) assays incorporating different primer sequences.
1304 patients were approached over a 6-month period. 743 (57%) patients were symptomatic, and 168 (13%) refused consent, leaving 394 (30%) patients who entered the study. Residual samples were available for 308 (79%) patients, 168 (54%) men and 140 (46%) women. 14/308 (4.5%, 95% CI 2.2 to 6.9%) asymptomatic patients were infected with M genitalium, and an additional 2 (0.6%, 95% CI 0.2 to 2.3%) patients had discrepant PCR results. No significant associations were found between M genitalium infection and age, gender, ethnicity or isolation site.
The positivity rate of M genitalium infection in asymptomatic sexual-health clinic attendees is comparable with that of gonorrhoea or chlamydia, and, if evidence of pathogenicity continues to accumulate, a further assessment of the role of routine screening in this setting would be appropriate.
生殖支原体已被确认为尿道炎的病因，也与宫颈炎、子宫内膜炎和盆腔感染有关。感染率较低表明在普通人群中进行筛查可能不合适，但尚不清楚前往性健康诊所的无症状患者是否应进行常规检测。本研究的目的是测量前往性健康诊所的无症状个体中生殖支原体感染的阳性率，以确定该人群是否需要进行筛查。
使用结构化问卷识别无症状患者，并使用两种包含不同引物序列的单独聚合酶链反应（PCR）检测方法，对生殖器拭子或尿液中的生殖支原体进行检测。
在6个月的时间里，共接触了1304名患者。743名（57%）患者有症状，168名（13%）拒绝同意，剩下394名（30%）患者进入研究。308名（79%）患者有剩余样本，其中男性168名（54%），女性140名（46%）。14/308名（4.5%，95%可信区间2.2%至6.9%）无症状患者感染了生殖支原体，另外2名（0.6%，95%可信区间0.2%至2.3%）患者的PCR结果不一致。在生殖支原体感染与年龄、性别、种族或分离部位之间未发现显著关联。
前往性健康诊所的无症状患者中生殖支原体感染的阳性率与淋病或衣原体感染的阳性率相当，如果致病性证据继续积累，进一步评估在这种情况下常规筛查的作用将是合适的。
