From the Center for Training and Research on Substance Abuse - HIV, Hanoi Medical University, Vietnam.
Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, CA.
Sex Transm Dis. 2024 Nov 1;51(11):750-755. doi: 10.1097/OLQ.0000000000002056. Epub 2024 Jul 16.
Mycoplasma genitalium causes a sexually transmitted infection and is also emerging as an important antimicrobial resistant pathogen. Data on M. genitalium infections among men who have sex with men (MSM) in low-resource settings are sparse.
From January to December 2022, participants in an HIV pre-exposure prophylaxis (PrEP) program in Hanoi, Vietnam were enrolled into the study. Demographic, behavioral, and clinical characteristics were collected. Self-collected urine, rectal, and pharyngeal specimens were tested for M. genitalium using the Alinity m STI Assay (Abbott Molecular, USA). Univariate and multivariate logistic regression were performed to assess for factors associated with infections.
Among 477 participants, the median age was 25.3 years (21.7-29.6) and 92.2% (n = 440) identified as MSM; 48.6% had ≥2 sex partners and 38.1% reported condomless anal sex in the prior month. The overall prevalence of M. genitalium infection was 10.9% (52/477); 7.3% (34/464) rectal, 3.2% (15/476) urethral, and 1.9% (9/476) pharyngeal. Infections were asymptomatic in 71.2% (37/52). Among those with M. genitalium , 30.7% (16/52) were co-infected with either Neisseria gonorrhoeae or Chlamydia trachomatis. Among those reporting rectal (n = 51) or urethral (n = 35) symptoms, but without C. trachomatis or N. gonorrhoeae co-infections, five (9.8%) had rectal infections and one (2.9%) had urethral infection. Participants with M. genitalium were more likely to be asymptomatic than participants without M. genitalium (adjusted odds ratio, 1.93; 95% confidence interval, 1.01-3.71).
Mycoplasma genitalium infections were common among primarily MSM engaged in an HIV PrEP program in Vietnam. The prevalence was highest in rectal specimens and nearly three quarters of M. genitalium infections were asymptomatic. Testing for M. genitalium infections among those with symptoms is important to enable pathogen-directed therapy. Additional research on antimicrobial resistance and treatment strategies for M. genitalium in low-resource settings is needed.
生殖支原体引起性传播感染，并且也正在成为一种重要的抗微生物药物耐药病原体。在资源匮乏环境中，男男性行为者（MSM）中生殖支原体感染的数据很少。
2022 年 1 月至 12 月，越南河内的一项 HIV 暴露前预防 (PrEP) 项目的参与者被纳入该研究。收集人口统计学、行为和临床特征。使用 Alinity m STI 检测试剂盒（雅培分子，美国）检测自我采集的尿液、直肠和咽部标本是否存在生殖支原体。采用单变量和多变量逻辑回归评估与感染相关的因素。
在 477 名参与者中，中位年龄为 25.3 岁（21.7-29.6），92.2%（n=440）为 MSM；48.6%的人有≥2 个性伴侣，38.1%的人在过去一个月内报告有肛交时未使用安全套。生殖支原体感染的总体患病率为 10.9%（52/477）；直肠 7.3%（34/464），尿道 3.2%（15/476），咽部 1.9%（9/476）。无症状感染者占 71.2%（37/52）。在患有生殖支原体的人群中，30.7%（16/52）合并感染淋病奈瑟菌或沙眼衣原体。在报告直肠（n=51）或尿道（n=35）症状但无沙眼衣原体或淋病奈瑟菌合并感染的人群中，5 人（9.8%）直肠感染，1 人（2.9%）尿道感染。与无生殖支原体感染的参与者相比，有生殖支原体感染的参与者更可能无症状（调整优势比，1.93；95%置信区间，1.01-3.71）。
在越南主要从事 HIV PrEP 项目的 MSM 中，生殖支原体感染较为常见。直肠标本的患病率最高，近四分之三的生殖支原体感染无症状。对有症状者进行生殖支原体感染检测，以进行针对病原体的治疗非常重要。在资源匮乏环境中，需要进一步开展生殖支原体抗微生物药物耐药性和治疗策略的研究。
