Sexually Transmitted Diseases

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Sexually Transmitted Diseases:
doi: 10.1097/OLQ.0b013e31824b1cf3
Original Study

Clinical Characteristics Associated With Mycoplasma genitalium Infection Among Women at High Risk of HIV and Other STI in Uganda

Vandepitte, Judith MD, MSc*; Bukenya, Justine MD, MPH*; Hughes, Peter MSc*; Muller, Etienne PhD; Buvé, Anne PhD; Hayes, Richard DSc§; Weiss, Helen A. PhD§; Grosskurth, Heiner PhD*,§

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Abstract

Background: Mycoplasma genitalium is a common infection of the genitourinary tract, but its pathogenic effects have not been well described, especially in women. The increasing evidence that M. genitalium is associated with HIV infection calls for an urgent consensus on how best to control this infection. The aim of this study was to describe symptoms and signs associated with M. genitalium infection among high-risk women in Uganda.

Methods: A cohort of 1027 female sex workers was recruited in Kampala in 2008. At enrollment, HIV testing was performed, genital specimens were tested for other sexually transmitted infection, and urogenital symptoms and signs were recorded. Endocervical swabs were tested for M. genitalium using a commercial Real-TM PCR assay (Sacace Biotechnologies, Como, Italy). The associations of clinical signs and symptoms with prevalent M. genitalium were investigated using multivariable logistic regression models.

Results: Reported dysuria and presence of mucopurulent vaginal discharge were significantly associated with M. genitalium infection (OR: 1.85, 95% confidence interval: 1.13–3.03 and OR: 1.55, 95% confidence interval: 1.06–2.29, respectively). There was little evidence for an association with cervicitis or with pelvic inflammatory disease.

Conclusions: In this specific population, we found evidence that symptoms of urethritis and mucopurulent vaginal discharge were associated with M. genitalium infection. This supports earlier studies showing that M. genitalium may lead to clinically relevant genitourinary disorders and should be treated. In the absence of sensitive screening tests, further work is needed to validate clinical findings as possible indicators of M. genitalium infection to guide a possible syndromic approach for its control.

© Copyright 2012 American Sexually Transmitted Diseases Association

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