Department of Medicine, Section of Infectious Diseases, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, Louisiana.
Department of Epidemiology, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana.
Clin Infect Dis. 2019 Jul 18;69(3):459-465. doi: 10.1093/cid/ciy922.
Mycoplasma genitalium has been significantly and nonsignificantly associated with cervicitis, urethritis, or vaginal discharge. This study examined the associations of M. genitalium with selected sexually transmitted infections (STIs) and demographic, behavioral, and clinical factors among women attending a sexually transmitted disease (STD) clinic in New Orleans.
Women aged ≥18 years who presented to the New Orleans STD clinic provided sociodemographic data and sexual behavior; STI, obstetric, and gynecologic history; and urine, vaginal, endocervical, and rectal specimens. Specimens were tested for M. genitalium, Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, Mycoplasma hominis, Ureaplasma species, and yeast. Bacterial vaginosis (BV) was diagnosed by Nugent score, and cervicitis was defined as ≥30 polymorphonuclear leukocytes per high-power microscopic field on a cervical Gram stain or yellow mucopus on an endocervical swab.
Among 400 women studied, M. genitalium was independently significantly associated with age <25 years (P < .03) and with ≥2 sexual partners in the last 12 months (P < .003). Neisseria gonorrhoeae (adjusted odds ratio [AOR], 1.75; P = .103), C. trachomatis (AOR, 1.43; P = .247), and T. vaginalis (AOR, 1.60; P = .120) independently increased the odds of infection with M. genitalium. Controlling for other STIs and BV, there was a positive trend for M. genitalium to predict cervicitis (AOR, 3.18 [95% confidence interval, .99-10.2]; P = .05).
Mycoplasma genitalium in our study displayed the clinical features of C. trachomatis and N. gonorrhoeae, the 2 organisms that drive research agendas in diagnosis, treatment, and prevention of bacterial STIs.
生殖支原体与宫颈炎、尿道炎或阴道分泌物明显相关，也与非明显相关。本研究在新奥尔良性传播疾病（STD）诊所就诊的女性中，检测了生殖支原体与选定的性传播感染（STI）以及人口统计学、行为和临床因素的相关性。
年龄≥18 岁并到新奥尔良 STD 诊所就诊的女性提供社会人口统计学数据和性行为；性传播感染、产科和妇科病史；以及尿液、阴道、宫颈和直肠标本。对标本进行生殖支原体、沙眼衣原体、淋病奈瑟菌、阴道毛滴虫、人型支原体、脲原体和酵母检测。细菌性阴道病（BV）通过 Nugent 评分诊断，宫颈炎定义为宫颈革兰氏染色每高倍镜视野下≥30 个多形核白细胞或宫颈拭子上出现黄色黏液脓性分泌物。
在 400 名研究女性中，生殖支原体与年龄<25 岁（P<0.03）和过去 12 个月内≥2 个性伴侣独立显著相关（P<0.003）。淋病奈瑟菌（调整后的优势比[OR]，1.75；P=0.103）、沙眼衣原体（OR，1.43；P=0.247）和阴道毛滴虫（OR，1.60；P=0.120）独立增加了感染生殖支原体的几率。控制其他 STI 和 BV 后，生殖支原体对宫颈炎有阳性预测趋势（OR，3.18[95%置信区间，0.99-10.2]；P=0.05）。
本研究中的生殖支原体具有沙眼衣原体和淋病奈瑟菌的临床特征，这两种病原体是推动细菌 STI 诊断、治疗和预防研究议程的主要病原体。
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