Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia
Central Clinical School, Monash University, Melbourne, Victoria, Australia.
Sex Transm Infect. 2022 Jun;98(4):277-285. doi: 10.1136/sextrans-2020-054818. Epub 2021 Jul 1.
While the contribution of (MG) to symptoms in men is well described, less is known about its association with common genital symptoms in women. We aimed to determine the prevalence of MG and macrolide resistance, and its association with common genital symptoms in women attending a sexual health service, to inform indications for testing and clinical practice.
We undertook a cross-sectional study of symptomatic and asymptomatic women attending Melbourne Sexual Health Centre (MSHC), between April 2017 and April 2019. Women were tested for MG and macrolide resistance, (CT), , , bacterial vaginosis and vulvovaginal candidiasis. Women completed a questionnaire on symptoms, and symptomatic women underwent examination. The prevalence of MG (and macrolide resistance) and other genital infections was calculated with 95% CIs, and associations between these outcomes and specific genital symptoms were examined using logistic regression.
Of 1318 women, 83 (6%, 95% CI: 5% to 8%) had MG, of which 39 (48%, 95% CI: 36% to 59%) had macrolide-resistant MG; 103 (8%, 95% CI: 6% to 9%) women had CT. MG prevalence was similar in asymptomatic (10 of 195; 5%) and symptomatic (73 of 1108; 7%) women, p=0.506. MG was associated with mucopurulent cervicitis on examination (adjusted OR=4.38, 95% CI: 1.69 to 11.33, p=0.002), but was not associated with other specific genital symptoms or signs.
MG was as common as CT among women attending MSHC. MG was not associated with genital symptoms, but like CT, was significantly associated with cervicitis. These data provide evidence that routine testing for MG in women with common genital symptoms is not indicated. The presence of macrolide resistance in 48% of women supports use of resistance-guided therapy.
虽然 （MG） 对男性症状的贡献已有详细描述，但对其与女性常见生殖器症状的关联知之甚少。我们旨在确定 MG 和大环内酯类耐药的流行率，以及其与在性健康服务机构就诊的女性常见生殖器症状之间的关联，为检测和临床实践提供依据。
我们对 2017 年 4 月至 2019 年 4 月期间在墨尔本性健康中心（MSHC）就诊的有症状和无症状女性进行了横断面研究。女性接受了 MG 和大环内酯类耐药检测，以及 （CT）、淋病奈瑟菌、细菌性阴道病和外阴阴道念珠菌病检测。女性完成了关于症状的问卷，有症状的女性接受了检查。MG（和大环内酯类耐药）和其他生殖器感染的患病率用 95%置信区间（CI）计算，使用逻辑回归检查这些结果与特定生殖器症状之间的关联。
在 1318 名女性中，83 名（6%，95%CI：5%至 8%）患有 MG，其中 39 名（48%，95%CI：36%至 59%）患有耐大环内酯类的 MG；103 名（8%，95%CI：6%至 9%）女性患有 CT。无症状（195 名中的 10 名；5%）和有症状（1108 名中的 73 名；7%）女性的 MG 患病率相似，p=0.506。MG 与检查时的黏液脓性宫颈炎相关（调整后的 OR=4.38，95%CI：1.69 至 11.33，p=0.002），但与其他特定生殖器症状或体征无关。
MG 在 MSHC 就诊的女性中与 CT 一样常见。MG 与生殖器症状无关，但与 CT 一样，与宫颈炎显著相关。这些数据提供了证据，表明对有常见生殖器症状的女性进行 MG 常规检测是不合适的。48%的女性存在大环内酯类耐药，支持使用耐药指导的治疗。
