A Silent Epidemic: The Prevalence, Incidence and Persistence of Mycoplasma genitalium Among Young, Asymptomatic High-Risk Women in the United States

Autor: Susan S. Philip, Jane R. Schwebke, Robert L. Cook, Marcia M. Hobbs, Jeannette Y. Lee, Arlene C. Seña, Harold C. Wiesenfeld, Anne M. Rompalo
Rok vydání: 2018
Předmět:
Adult
0301 basic medicine
Microbiology (medical)
medicine.medical_specialty
Adolescent
Sexual Behavior
030106 microbiology
Sexually Transmitted Diseases
Mycoplasma genitalium
urologic and male genital diseases
Asymptomatic
Young Adult
03 medical and health sciences
0302 clinical medicine
Risk Factors
Internal medicine
Pelvic inflammatory disease
Odds Ratio
Prevalence
Humans
Medicine
Mycoplasma Infections
Prospective Studies
030212 general & internal medicine
Prospective cohort study
Articles and Commentaries
Asymptomatic Infections
Pregnancy
biology
Coinfection
business.industry
Incidence
Incidence (epidemiology)
Odds ratio
bacterial infections and mycoses
biology.organism_classification
medicine.disease
United States
female genital diseases and pregnancy complications
Sexual Partners
Infectious Diseases
Vagina
Regression Analysis
Female
Bacterial vaginosis
medicine.symptom
business
Pelvic Inflammatory Disease
Zdroj: Clinical Infectious Diseases. 67:73-79
ISSN: 1537-6591
1058-4838
DOI: 10.1093/cid/ciy025
Popis: Background Mycoplasma genitalium can result in pelvic inflammatory disease and adverse pregnancy outcomes. We analyzed data collected from a prospective study of asymptomatic bacterial vaginosis (BV) to determine the natural history of M. genitalium. Methods Women aged 15-25 years, with asymptomatic BV and ≥2 risk factors for sexually transmitted infection were recruited from 10 sites throughout the United States. Vaginal swab samples were collected at enrollment and through home-based testing every 2 months over 12 months. M. genitalium nucleic acid amplification testing was performed for M. genitalium using transcription-mediated assays (Hologic). The prevalence, incidence, and persistence of M. genitalium, defined as all positive specimens during follow-up, were estimated with 95% confidence intervals (CIs). Adjusted odds ratios (AOR) were calculated using logistic and Poisson regression to evaluate participant characteristics associated with M. genitalium infection. Results Among 1139 women, 233 were M. genitalium positive, for a prevalence of 20.5% (95% CI, 18.2%-22.9%); 42 of 204 had persistent M. genitalium (20.6%). Among 801 M. genitalium-negative women at baseline, the M. genitalium incidence was 36.6 per 100 person-years (95% CI, 32.4-41.3). Black race (AOR, 1.92; 95% CI, 1.09-3.38), age ≤21 years (1.40; 1.03-1.91), and prior pregnancy (1.36; 1.00-1.85) were associated with prevalent M. genitalium; only black race was associated with incident M. genitalium (P = .03). Conclusions We identified high rates of prevalent, incident, and persistent M. genitalium infections among young, high-risk women with asymptomatic BV, supporting the need for clinical trials to evaluate the impact of M. genitalium screening on female reproductive health outcomes.
Databáze: OpenAIRE
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