scholarly journals Mycoplasma genitalium Antimicrobial Resistance in Community and Sexual Health Clinic Patients, Auckland, New Zealand

2020 ◽  
Vol 26 (2) ◽  
pp. 332-335
Author(s):  
Anna Vesty ◽  
Gary McAuliffe ◽  
Sally Roberts ◽  
Gillian Henderson ◽  
Indira Basu
Keyword(s):  
New Zealand ◽  
Antimicrobial Resistance ◽  
Sexual Health ◽  
Mycoplasma Genitalium ◽  
Health Clinic

scholarly journals Antimicrobial resistance in Mycoplasma genitalium sampled from the British general population

2020 ◽  
Vol 96 (6) ◽  
pp. 464-468 ◽  
Author(s):  
Rachel Pitt ◽  
Magnus Unemo ◽  
Pam Sonnenberg ◽  
Sarah Alexander ◽  
Simon Beddows ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
General Population ◽  
Sexual Health ◽  
Treatment Guidelines ◽  
Mycoplasma Genitalium ◽  
Macrolide Resistance ◽  
Sample Survey ◽  
23S Rrna ◽  
Health Clinic ◽  
Rrna Gene

BackgroundMycoplasma genitalium is a common sexually transmitted infection. Treatment guidelines focus on those with symptoms and sexual contacts, generally with regimens including doxycycline and/or azithromycin as first-line and moxifloxacin as second-line treatment. We investigated the prevalence of antimicrobial resistance (AMR)-conferring mutations in M. genitalium among the sexually-active British general population.MethodsThe third national survey of sexual attitudes and lifestyles (Natsal-3) is a probability sample survey of 15 162 men and women aged 16–74 years in Britain conducted during 2010–12. Urine test results for M. genitalium were available for 4507 participants aged 16–44 years reporting >1 lifetime sexual partner. In this study, we sequenced regions of the 23S rRNA and parC genes to detect known genotypic determinants for resistance to macrolides and fluoroquinolones respectively.Results94% (66/70) of specimens were re-confirmed as M. genitalium positive, with successful sequencing in 85% (56/66) for 23S rRNA and 92% (61/66) for parC genes. Mutations in 23S rRNA gene (position A2058/A2059) were detected in 16.1% (95%CI: 8.6% to 27.8%) and in parC (encoding ParC D87N/D87Y) in 3.3% (0.9%–11.2%). Macrolide resistance was more likely in participants reporting STI diagnoses (past 5 years) (44.4% (18.9%–73.3%) vs 10.6% (4.6%–22.6%); p=0.029) or sexual health clinic attendance (past year) (43.8% (23.1%–66.8%) vs 5.0% (1.4%–16.5%); p=0.001). All 11 participants with AMR-conferring mutations had attended sexual health clinics (past 5 years), but none reported recent symptoms.ConclusionsThis study highlights challenges in M. genitalium management and control. Macrolide resistance was present in one in six specimens from the general population in 2010–2012, but no participants with AMR M. genitalium reported symptoms. Given anticipated increases in diagnostic testing, new strategies including novel antimicrobials, AMR-guided therapy, and surveillance of AMR and treatment failure are recommended.

Mycoplasma genitalium: test positivity in syndromic presentations and clinicians’ adherence with treatment guidelines at Sydney Sexual Health Centre

2021 ◽  
pp. 095646242110225
Author(s):  
Calvin Cheung ◽  
Christopher Bourne ◽  
Rick Varma
Keyword(s):  
Decision Making ◽  
Antimicrobial Resistance ◽  
Sexual Health ◽  
Treatment Guidelines ◽  
Health Centre ◽  
Diagnostic Testing ◽  
Mycoplasma Genitalium ◽  
Macrolide Resistance ◽  
Adherence To Treatment ◽  
Real World Data

Mycoplasma genitalium ( M.genitalium) is associated with urethritis, cervicitis, pelvic inflammatory disease, proctitis and epididymitis. Its treatment is complicated by antimicrobial resistance. To assess clinicians’ adherence to M.genitalium diagnostic testing recommendations for syndromic presentations, as well as resistance-guided management of M.genitalium at Sydney Sexual Health Centre, we reviewed patients presenting between August and December 2018. 349/372 (94%) syndromic presentations were tested for M.genitalium with 16% M.genitalium test positivity and 81% macrolide resistance. 16/27 (59%) macrolide-sensitive infections and 65/77 (84%) macrolide-resistant infections received resistance-guided treatment. Tests of cure (TOCs) were unnecessarily ordered for 82% macrolide-sensitive cases, while 88% macrolide-resistant cases were correctly ordered TOCs. Co-existing STIs at the time of macrolide-sensitive ( p = 0.30) or macrolide-resistant M.genitalium ( p = 0.94) diagnosis did not significantly affect adherence to treatment guidelines. This study confirms the expected prevalence of M.genitalium and macrolide resistance in syndromic presentations while our real-world data highlight the decision-making challenges involved with managing M.genitalium, offering insights for further research.

Prevalence of co-infections with other sexually transmitted infections in patients newly diagnosed with anogenital warts in Guangzhou, China

2020 ◽  
Vol 31 (11) ◽  
pp. 1073-1081
Author(s):  
Liuyuan Wang ◽  
Bin Yang ◽  
Lai S Tso ◽  
Peizhen Zhao ◽  
Wujian Ke ◽  
...  
Keyword(s):  
Sexual Health ◽  
Sexually Transmitted Infections ◽  
Mycoplasma Genitalium ◽  
Risk Groups ◽  
Health Clinic ◽  
Surveillance Systems ◽  
Newly Diagnosed ◽  
Anogenital Warts ◽  
Sexually Transmitted ◽  
Medical Histories

Prevalence of co-infecting sexually transmitted infections (STIs) among patients newly diagnosed with anogenital warts is under-reported. Our objective is to determine the prevalence of six common STIs, Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Mycoplasma genitalium (MG), genital herpes (herpes simplex virus type 2 [HSV-2]), HIV, and syphilis for patients visiting a sexual health clinic in Guangzhou, China. Demographics, sexual health, and medical histories were collected at patient intake. Patients diagnosed with anogenital warts (N = 200) were invited to participate. We collected urine samples, and urethral, cervical, and rectal swabs to test for CT, NG, and MG, and blood samples for serological detection of HSV-2, syphilis, and HIV. Overall 49 (24.5%) had a co-infection (22.2% of men and 27.7% of women). All six STIs were observed among men: CT (6.8%), NG (3.4%), MG (5.1%), HIV (4.3%), HSV-2 (4.3%), and syphilis (1.7%). Women had fewer STIs, but at higher rates: CT (13.3%), MG (6.0%), and HSV-2 (8.4%). Individual men had up to two co-infections, while women had no more than one co-infection. Chlamydia was the most common STI. Patients aged 18–25 years (35.4%) had the highest prevalence. Although opportunistic screening is often applied for high-risk groups, expansion to patients with anogenital warts in all health-care settings would improve detection of problematic asymptomatic co-infections, thereby increasing China’s capacity to contribute toward global surveillance systems.

Pelvic inflammatory disease associated with Chlamydia trachomatis but not Mycoplasma genitalium in New Zealand

Sexual Health ◽  
2016 ◽  
Vol 13 (1) ◽  
pp. 43 ◽  
Author(s):  
Jeannie Oliphant ◽  
Sunita Azariah
Keyword(s):  
New Zealand ◽  
Chlamydia Trachomatis ◽  
Sexual Health ◽  
Pelvic Inflammatory Disease ◽  
Inflammatory Disease ◽  
Trichomonas Vaginalis ◽  
Mycoplasma Genitalium ◽  
Control Group ◽  
Sexual Health Service ◽  
Relevant Variables

Background There is a paucity of studies looking at associations between Mycoplasma genitalium and pelvic inflammatory disease (PID). The objectives of this study were to estimate the prevalence of M. genitalium in women attending a sexual health service in New Zealand and secondly to examine for an association of M. genitalium with PID. Methods: Women consecutively attending the service for a sexual health screen (Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis) were recruited to establish a baseline prevalence of M. genitalium. An extra cervical swab was taken for the detection of M. genitalium. Recruitment of additional women with a clinical diagnosis of PID continued until a sufficient sample size was obtained to examine the association of PID with M. genitalium. Women in the baseline sample without PID were used as the control group. Results: The control group included 250 women, with M. genitalium diagnosed in 8.7% (95% CI 5.8–12.9%) and C. trachomatis in 9.9% (95% CI 6.8–14.2%). Ninety-one women were recruited with PID; M. genitalium was diagnosed in 9.9% (95% CI 5.3–17.7%) and C. trachomatis in 27.5% (95% CI 19.4–37.4%). Multivariate analysis using clinically relevant variables showed that a diagnosis of C. trachomatis (OR 2.44, 95% CI 1.24–4.81) but not M. genitalium (OR 0.91, 95% CI 0.38–2.20) was significantly associated with a PID diagnosis. Conclusions: M. genitalium was almost as commonly diagnosed as C. trachomatis in this population. C. trachomatis was the only infection that was significantly associated with PID.

Cervicitis: limited clinical utility for the detection of Mycoplasma genitalium in a cross-sectional study of women attending a New Zealand sexual health clinic

Sexual Health ◽  
2013 ◽  
Vol 10 (3) ◽  
pp. 263 ◽  
Author(s):  
Jeannie Oliphant ◽  
Sunita Azariah
Keyword(s):  
Sexual Health ◽  
Trichomonas Vaginalis ◽  
Clinical Utility ◽  
Clinical Symptoms ◽  
Mycoplasma Genitalium ◽  
Cross Sectional Study ◽  
Health Clinic ◽  
Sectional Study ◽  
Cross Sectional ◽  
Sexually Transmissible Infections

Background Although multiple studies have confirmed Mycoplasma genitalium as a cause of nongonococcal urethritis in men, there is less evidence of its pathogenicity in women. Our aims were to determine the prevalence of M. genitalium in a sample of women attending a sexual health clinic and to assess whether there was any association between the detection of M. genitalium and a diagnosis of cervicitis in this population. Methods: A cross-sectional study recruited women who required screening for sexually transmissible infections. Endocervical swabs to detect the presence of M. genitalium were taken in addition to routine testing for Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis. Data were collected on demographics, sexual behaviour, clinical symptoms and the presence of clinical or microscopic cervicitis. Results: The prevalence of M. genitalium was 8.4% (n = 22, 95% confidence interval (CI): 5.4–12.5%) in the study sample of 261 women. There was an association between the finding of cervical contact bleeding (odds ratio OR): 5.45; 95% CI: 1.93–15.42, P = 0.001) and microscopic cervicitis (OR: 2.64; 95% CI: 0.95–7.34, P = 0.06) and the presence of M. genitalium when compared with women with no diagnosed infection; however, the latter finding was not statistically significant. Conclusions: Although the prevalence of M. genitalium was high at 8.4%, the overall lack of any association between the findings of cervicitis and the detection of M. genitalium support the conclusion that cervicitis has poor clinical utility as an indicator for the presence of M. genitalium infection.

scholarly journals Mycoplasma genitalium in Singapore is Associated with Chlamydia trachomatis Infection and Displays High Macrolide and Fluoroquinolone Resistance Rates

2020 ◽  
Author(s):  
Tim Hart ◽  
Wen Ying Tang ◽  
Siti Aminah Mansoor ◽  
Martin Tze-Wei Chio ◽  
Timothy Sebastian Barkham
Keyword(s):  
Antibiotic Resistance ◽  
Sexual Health ◽  
Mycoplasma Genitalium ◽  
Routine Screening ◽  
High Rate ◽  
Fluoroquinolone Resistance ◽  
Health Clinic ◽  
Resistance Mutations ◽  
Transmitted Infection ◽  
Sexually Transmitted

Abstract Background: Mycoplasma genitalium is an emerging sexually transmitted infection, with increasing rates of resistance to fluroquinolones and macrolides, the recommended treatments. Despite this, M. genitalium is not part of routine screening for Sexually Transmitted Infections (STIs) in many countries and the prevalence of infection and patterns of disease remain to be determined in many populations. Such data is of particular importance in light of the reported rise in antibiotic resistance in M. genitalium isolates. Methods : Urine and urethral swab samples were collected from the primary public sexual health clinic in Singapore and tested for C. trachomatis (CT) or N. gonorrhoeae (NG) infection and for the presence of M. genitalium . Antibiotic resistance in M. genitalium strains detected was determined by screening for genomic mutations associated with macrolide and fluroquinolone resistance. Results : We report the results of a study into M. genitalium prevalence at the national sexual health clinic in Singapore. M. genitalium was heavily associated with CT infection (8.1% of cases), but present in only of 2.4% in CT negative cases and not independently linked to NG infection. Furthermore, we found high rates of resistance mutations to both macrolides (25%) and fluoroquinolones (37.5%) with a majority of resistant strains being dual-resistant. Resistance mutations were only found in strains from patients with CT co-infection. Conclusions : Our results support targeted screening of CT positive patients for M. genitalium as a cost-effective strategy to reduce the incidence of M. genitalium in the absence of comprehensive routine screening. The high rate of dual resistance also highlights the need to ensure the availability of alternative antibiotics for the treatment of multi-drug resistant M. genitalium isolates.

scholarly journals Highlighting the clinical need for diagnosing Mycoplasma genitalium infection

2018 ◽  
Vol 29 (7) ◽  
pp. 680-686 ◽  
Author(s):  
Catherine A Ison ◽  
Helen Fifer ◽  
Simon Gwynn ◽  
Paddy Horner ◽  
Peter Muir ◽  
...  
Keyword(s):  
Sexual Health ◽  
Mycoplasma Genitalium ◽  
Health Clinic ◽  
Specific Patient ◽  
Laboratory Staff ◽  
Modified Delphi ◽  
Delphi Approach ◽  
Consensus Statements ◽  
Sexual Contacts ◽  
The Uk

Despite Mycoplasma genitalium (MG) being increasingly recognised as a genital pathogen in men and women, awareness and utility of commercially available MG-testing has been low. The opinion of UK sexual health clinicians and allied professionals was sought on how MG-testing should be used. Thirty-two consensus statements were developed by an expert group and circulated to clinicians and laboratory staff, who were asked to evaluate their level of agreement with each statement; 75% agreement was set as the threshold for defining consensus for each statement. A modified Delphi approach was used and high levels of agreement obviated the need to test the original statement set further. Of 201 individuals who received questionnaires, 60 responded, most (48) being sexual health consultants, more than 10% of the total in the UK. Twenty-seven (84.4%) of the statements exceeded the 75% threshold. Respondents strongly supported MG-testing of patients with urethritis, pelvic inflammatory disease or unexplained persistent vaginal discharge, or post-coital bleeding. Fewer favoured testing patients with proctitis and support was divided for routinely testing Chlamydia-positive patients. Testing of current sexual contacts of MG-positive patients was supported, as was a test of cure for MG-positive patients, although agreement fell below the 75% threshold. Respondents agreed that all consultant- or specialist-led services should have access to testing for MG (98.3%). There was strong agreement for having MG-testing available for specific patient groups, which may reflect concern over antibiotic resistance and the desire to comply with clinical guidelines that recommend MG-testing in sexual health clinic settings.

Unlinked anonymous HIV prevalence among New Zealand sexual health clinic attenders: 2005–2006

2008 ◽  
Vol 19 (11) ◽  
pp. 752-757 ◽  
Author(s):  
S M McAllister ◽  
N P Dickson ◽  
K Sharples ◽  
M R Reid ◽  
J M Morgan ◽  
...  
Keyword(s):  
New Zealand ◽  
Sexual Health ◽  
Health Clinic ◽  
Bisexual Men ◽  
Sexually Transmitted ◽  
Health Clinics ◽  
Undiagnosed Hiv ◽  
And Bisexual ◽  
Sex With Men ◽  
Sexual Health Clinics

This unlinked anonymous study aimed at determining the prevalence of HIV among sexual health clinic attenders having blood samples taken for syphilis and/or hepatitis B serology in six major New Zealand cities over a 12-month period in 2005–2006. Overall, seroprevalence was five per 1000 (47/9439). Among men who have sex with men (MSM), the overall prevalence and that of previously undiagnosed HIV were 44.1 and 20.1 per 1000, respectively. In heterosexual men, the overall prevalence was 1.2 per 1000 and in women 1.4 per 1000. HIV remains to be concentrated among homosexual and bisexual men. Comparison with a previous survey in 1996–1997 suggests an increase in the prevalence of undiagnosed HIV among MSM and also an increase in the number of MSM attending sexual health clinics. The low prevalence of HIV among heterosexuals suggests no extensive spread into the groups identified at risk of other sexually transmitted infections.

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