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Mycoplasma genitalium Detected by Transcription-Mediated Amplification Is Associated With Chlamydia trachomatis in Adolescent Women

Huppert, Jill S. MD, MPH*; Mortensen, Joel E. PhD; Reed, Jennifer L. MD; Kahn, Jessica A. MD, MPH*; Rich, Kimberly D. MPH§; Hobbs, Marcia M. PhD§‖

Sexually Transmitted Diseases: March 2008 - Volume 35 - Issue 3 - p 250-254
doi: 10.1097/OLQ.0b013e31815abac6

Objectives: The clinical significance of Mycoplasma genitalium (MG) infection in adolescent women is poorly understood. We compared the prevalence of MG with that of other sexually transmitted organisms such as Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and Trichomonas vaginalis (TV) and assessed the associations of MG with sexual behaviors, genitourinary symptoms, physical and laboratory findings.

Study Design: Women aged 14 to 21 years (n = 331) were recruited from an urban medical center. The subjects’ sexual behaviors, genitourinary symptoms, and physical findings were recorded. Endocervical swabs were collected for CT and NG testing and vaginal swabs for wet mount, Gram stain, TV and MG testing. MG infection was identified by nucleic acid amplification using a transcription-mediated amplification assay.

Results: MG was detected in 74 (22.4%), CT in 79 (24.4%), TV in 60 (18.2%), and NG in 35 (10.7%) subjects. MG infection was not associated with vaginal symptoms, physical evidence of cervicitis, or findings on wet mount or Gram stain. In logistic regression, variables positively associated with MG were current CT [odds ratio (OR), 2.3; 95% confidence interval (CI), 1.4–4.4] and recent sexual contact (≤7 days) (OR, 2.0; CI, 1.1–3.2). Dysuria (OR, 0.44; CI, 0.2–0.96) and use of hormonal contraception (OR, 0.55; CI, 0.3–1.0) were negatively associated with MG infection.

Conclusion: In adolescent women, MG infection was as common as chlamydial infection and trichomoniasis and more common than gonorrhea. MG was associated with CT and recent sexual contact but not with vaginal symptoms or signs of cervicitis.

In young women presenting for care in Cincinnati, Ohio, the prevalence of M. genitalium was high and was associated with chlamydial infections but not vaginal symptoms or cervicitis.

From the *Division of Adolescent Medicine, †Laboratory Medicine, and ‡Emergency Medicine, Cincinnati Children’s Hospital Medical Center and the University of Cincinnati College of Medicine, Cincinnati, Ohio; Departments of §Medicine and |Microbiology and Immunology, University of North Carolina, Chapel Hill, North Carolina

Grace Kim, Stephanie Schubert, and Jennifer Bishop performed subject recruitment and data management. We thank Melissa Miller and John Schmitz for accommodating research testing in the McLendon Clinical Laboratories at UNC Hospitals.

J.S.H. has received unrestricted research funds, in-kind test kits, and speaker’s honoraria from Genzyme Diagnostics. M.M.H. has received research funds for test evaluation, and in-kind test kits from Gen-Probe. Authors J.E.M., J.L.R., J.A.K., and K.D.R. report no conflict.

Supported by the National Institutes of Health/National Institute for Allergy and Infectious Disease grant 5K23AI63182 (Huppert, PI). Dr. Hobbs and Ms. Rich were supported by NIH/NIAID grant U19-AI-31496. Kits and reagents were provided by Genzyme Diagnostics and Gen-Probe. No funding entity participated in the design or conduct of the study, in the collection, analysis, and interpretation of the data, or in the preparation, review, or approval of the manuscript.

Correspondence: Jill S. Huppert, MD, MPH, Cincinnati Children’s Hospital Medical Center, Division of Adolescent Medicine, 3333 Burnet Avenue, ML 4000, Cincinnati, OH 45229-3039. E-mail:

Received for publication May 10, 2007, and accepted September 9, 2007.

© Copyright 2008 American Sexually Transmitted Diseases Association