Article Text
PDF
Abstract
Background Mycoplasma genitalium (MG) is a critical pathogen of sexually transmitted infections (STIs) in men, associated with high antibiotic resistance. Understanding the clinical characteristics of MG infections can improve testing and treatment guidelines.
Aims To investigate the clinical features and characteristics of asymptomatic, acute and chronic MG infections in heterosexual males.
Methods From January 2018 to September 2023, men diagnosed with urethral STIs using multiplex real-time PCR were enrolled into this cross-sectional study. Testing indications included males with urethritis, suspected STIs and asymptomatic screening. Based on clinical symptoms, participants were classified as acute, chronic or asymptomatic groups. An electronic-based survey was administered to assess demographic, behavioural and clinical information. Univariate and multivariate logistic regression were performed to assess for factors associated with the presence of symptoms.
Result Among the 2102 men who have sex with women and were tested for STI, 879 records met the eligibility criteria for further analysis; MG was detected in 14.6% of the 2102 cases. Most patients presented with acute urethral symptoms (75.6%). Among men infected with MG, mono-infection accounted for 52.8%, while Chlamydia trachomatis and Neisseria gonorrhoeae co-infections occurred in 39.3% and 21.3%, respectively. Co-infections were more prevalent among acute urethritis compared with chronic urethritis or asymptomatic groups. Multivariable analysis revealed associations between chronic symptoms with absence of urethral discharge (aOR 0.31; 95% CI 0.2 to 0.47), previous antibiotic use (aOR 6.83; 95% CI 4.47 to 10.4), marriage (aOR 1.66; 95% CI 1.09 to 2.51) and history of STIs (aOR 2.08; 95% CI 1.24 to 3.49).
Conclusion Our study revealed a 14.6% prevalence of MG among individuals tested for STIs. Most patients presented with acute urethral symptoms, while chronic symptoms were associated with marriage, antibiotic use history and previous STIs. Routine MG screening of asymptomatic patients is not recommended, but improved access to diagnostics and further research is needed for clinical practice in low-resource settings.
- Mycoplasma genitalium
- URETHRITIS
- Disease Transmission, Infectious
- Sexual Behavior
Data availability statement
Data are available upon reasonable request. The data that support the findings of this study are available from the corresponding author, BHN, on reasonable request.
Statistics from Altmetric.com
Data availability statement
Data are available upon reasonable request. The data that support the findings of this study are available from the corresponding author, BHN, on reasonable request.
Footnotes
Handling editor Eric PF Chow
Contributors Guarantor of the study: BHN. Conceptualisation: BHN. Data collection: TCN, KHDN. Formal analysis: TCN, PCA, BHN. Drafting of the article: TCN, QMP, KHDN. Critical revision and supervision: BHN, PCA. All authors agree to be accountable for all aspects of the work. ChatGPT was used to condense unnecessarily long sentences.
Funding P.C.A was supported by the National Institutes of Health, Fogarty International Center (#K01TW012170)
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.