Associations between Mycoplasma genitalium (MG) and clinical signs among symptomatic women*†
| Total women n=1023 | MG negative n=956 (%, 95% CI) | MG positive n=67 (%, 95% CI) | Adjusted OR (95% CI)‡ | P value§ | |
| Vaginal discharge | |||||
| No | 322 | 307 (35, 32 to 38) | 15 (25, 14 to 37) | 1 | |
| Yes | 611 | 565 (65, 62 to 68) | 46 (75, 63 to 86) | 1.56 (0.84 to 2.87) | 0.158 |
| Not assessed/missing | 90 | 84 | 6 | ||
| Abnormal odour¶ | |||||
| No | 707 | 663 (76, 73 to 79) | 44 (72, 59 to 83) | 1 | |
| Yes | 228 | 211 (24, 21 to 27) | 17 (28, 17 to 41) | 1.22 (0.67 to 2.22) | 0.517 |
| Not assessed/missing | 88 | 82 | 6 | ||
| Vulval redness | |||||
| No | 679 | 633 (73, 70 to 76) | 46 (75, 63 to 86) | 1 | |
| Yes | 248 | 233 (27, 24 to 30) | 15 (25, 14 to 37) | 0.83 (0.41 to 1.66) | 0.591 |
| Not assessed/missing | 96 | 90 | 6 | ||
| Mucopurulent cervicitis** | |||||
| Women with BV | |||||
| No | 208 | 188 (86, 81 to 90) | 20 (95, 76 to 100) | 1 | |
| Yes | 32 | 31 (14, 10 to 19) | 1 (5, 0 to 24) | 0.36 (0.05 to 2.85) | 0.336 |
| Women without BV | |||||
| No | 405 | 389 (91, 88 to 93) | 16 (70, 47 to 87) | 1 | |
| Yes | 46 | 39 (9, 7 to 12) | 7 (30, 13 to 53) | 4.38 (1.69 to 11.33) | 0.002 |
| Cervical or adnexal motion tenderness | |||||
| No | 476 | 445 (78, 75 to 82) | 31 (86, 71 to 95) | 1 | |
| Yes | 127 | 122 (22, 18 to 25) | 5 (14, 5 to 29) | 0.46 (0.16 to 1.34) | 0.155 |
| Not assessed/missing | 420 | 389 | 31 | ||
| Cervical contact bleeding | |||||
| No | 591 | 555 (86, 83 to 88) | 36 (84, 69 to 93) | 1 | |
| Yes | 101 | 94 (14, 12 to 17) | 7 (16, 7 to 31) | 1.29 (0.55 to 3.02) | 0.563 |
| Not assessed/missing | 331 | 307 | 24 | ||
| Vaginal pH | |||||
| ≤4.5 | 594 | 557 (61, 58 to 64) | 37 (56, 43 to 68) | 1 | |
| >4.5 | 381 | 352 (39, 36 to 42) | 29 (44, 32 to 57) | 1.29 (0.77 to 2.17) | 0.334 |
| Not assessed/missing | 48 | 47 | 1 | ||
| High vaginal polymorph count | |||||
| <5 | 589 | 554 (60, 57 to 63) | 35 (54, 41 to 66) | 1 | |
| ≥5 | 400 | 370 (40, 37 to 43) | 30 (46, 34 to 59) | 1.33 (0.77 to 2.29) | 0.307 |
| Not assessed/missing | 34 | 34 | 2 |
Bold values are statistically significant.
*Women with an unassessable MG result (n=15) or Chlamydia trachomatis were excluded from the analysis (n=100; includes eight coinfected women). In addition, asymptomatic women were not clinically assessed and have been excluded from the analysis (n=180).
†Clinical signs were elicited only in women with clinical indications for examination and in particular, cervical assessment and bimanual examination were undertaken in women with specific indications for a speculum and bimanual examination.
‡All analyses were adjusted for number of male partners, vulvovaginal candidiasis, Neisseria gonorrhoeae and concurrent BV, with the exception that we did not adjust for BV in models examining associations with individual Amsel criteria (ie, vaginal discharge, abnormal vaginal odour and vaginal pH).
§P value calculated using logistic regression and bold indicates significant findings p<0.05.
¶Abnormal vaginal odour refers to any odour, not specifically a fishy odour.
**We tested for interaction terms between MG and genital coinfections and the only significant interaction was between MG and BV for cervicitis (p=0.020). Therefore, the association between cervicitis and MG could not be adjusted for BV. To account for potential confounding by BV on the relationship between MG and cervicitis, data were then stratified by BV status, and the association between MG and cervicitis was investigated within each stratum.
BV, bacterial vaginosis; n, number.