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- Title
Mycoplasma genitalium in the US (MyGeniUS): Surveillance Data From Sexual Health Clinics in 4 US Regions.
- Authors
Manhart, Lisa E; Leipertz, Gina; Soge, Olusegun O; Jordan, Stephen J; McNeil, Candice; Pathela, Preeti; Reno, Hilary; Wendel, Karen; Parker, Anika; Geisler, William M; Getman, Damon; Golden, Matthew R; Team, for the MyGeniUS Study
- Abstract
Background Mycoplasma genitalium (MG) is on the CDC Watch List of Antimicrobial Resistance Threats, yet there is no systematic surveillance to monitor change. Methods We initiated surveillance in sexual health clinics in 6 cities, selecting a quota sample of urogenital specimens tested for gonorrhea and/or chlamydia. We abstracted patient data from medical records and detected MG and macrolide-resistance mutations (MRMs) by nucleic acid amplification testing. We used Poisson regression to estimate adjusted prevalence ratios (aPRs) and 95% CIs, adjusting for sampling criteria (site, birth sex, symptom status). Results From October–December 2020 we tested 1743 urogenital specimens: 57.0% from males, 46.1% from non-Hispanic Black persons, and 43.8% from symptomatic patients. MG prevalence was 16.6% (95% CI: 14.9–18.5%; site-specific range: 9.9–23.5%) and higher in St Louis (aPR: 1.9; 1.27–2.85), Greensboro (aPR: 1.8; 1.18–2.79), and Denver (aPR: 1.7; 1.12–2.44) than Seattle. Prevalence was highest in persons <18 years (30.4%) and declined 3% per each additional year of age (aPR:.97;.955–.982). MG was detected in 26.8%, 21.1%, 11.8%, and 15.4% of urethritis, vaginitis, cervicitis, and pelvic inflammatory disease (PID), respectively. It was present in 9% of asymptomatic males and 15.4% of asymptomatic females, and associated with male urethritis (aPR: 1.7; 1.22–2.50) and chlamydia (aPR: 1.7; 1.13–2.53). MRM prevalence was 59.1% (95% CI: 53.1–64.8%; site-specific range: 51.3–70.6%). MRMs were associated with vaginitis (aPR: 1.8; 1.14–2.85), cervicitis (aPR: 3.5; 1.69–7.30), and PID cervicitis (aPR: 1.8; 1.09–3.08). Conclusions MG infection is common in persons at high risk of sexually transmitted infections; testing symptomatic patients would facilitate appropriate therapy. Macrolide resistance is high and azithromycin should not be used without resistance testing.
- Subjects
UNITED States; PUBLIC health surveillance; MYCOPLASMA diseases; CONFIDENCE intervals; CLINICS; CENTERS for Disease Control &; Prevention (U.S.); DESCRIPTIVE statistics; DRUG resistance in microorganisms; DATA analysis software; SEXUAL health
- Publication
Clinical Infectious Diseases, 2023, Vol 77, Issue 10, p1449
- ISSN
1058-4838
- Publication type
Article
- DOI
10.1093/cid/ciad405