Natural history of Mycoplasma genitalium: incidence, persistence, transmissibility and progression to pelvic inflammatory disease: systematic review and meta-analysis

Author(s):  
Nicola Low
2018 ◽  
Author(s):  
Manuel Cina ◽  
Lukas Baumann ◽  
Dianne Egli-Gany ◽  
Florian S Halbeisen ◽  
Hammad Ali ◽  
...  

ABSTRACTBackgroundMycoplasma genitaliumis increasingly seen as an emerging sexually transmitted pathogen, and has been likened toChlamydia trachomatis, but its natural history is poorly understood. The objectives of this systematic review were to determineM. genitaliumincidence, persistence, concordance between sexual partners, and the risk of pelvic inflammatory disease (PID).MethodsWe searched Medline, EMBASE, LILACS, IndMed and African Index Medicus from 1 January 1981 until 17 March 2018. Two independent researchers screened studies for inclusion and extracted data. We examined results in forest plots, assessed heterogeneity and conducted meta-analysis where appropriate. Risk of bias was assessed for all studies.ResultsWe screened 4634 records and included 17 studies; five (4100 women) reported on incidence, five (636 women) on persistence, 10 (1346 women and men) on concordance and three (5139 women) on PID. Incidence in women in two very highly developed countries was 1.07 per 100 person-years (95% CI, 0.61 to 1.53, I2 0%). Median persistence ofM. genitaliumwas estimated from one to three months in four studies but 15 months in one study. In ten studies measuringM. genitaliuminfection status in couples, 39-50% of male or female sexual partners of infected participants also hadM. genitaliumdetected. In prospective studies, the incidence of PID was higher in women withM. genitaliumthan those without (RR 1.68, 95% CI 0.59 to 2.77, I20%, 2 studies).DiscussionBased on findings from this and our linked review of prevalence, concordantM. genitaliummight be less common than forC. trachomatisand the age distributions of the infections differ. The synthesised data about prevalence, incidence and persistence ofM. genitaliuminfection are inconsistent. Taken together with evidence about antimicrobial resistance in the two infections,M. genitaliumis not the new chlamydia.Registration NumbersPROSPERO: CRD42015020420, CRD42015020405KEY MESSAGESThere are calls for widespread screening forMycoplasma genitalium, but the natural history of this emerging sexually transmitted pathogen is poorly understood.M. genitaliumincidence was 1.07 (95% confidence intervals, CI 0.61 to 1.53) per 100-person years in women in highly developed countries, 39-50% of infected individuals had a heterosexual partner withM. genitaliumand the risk ratio for pelvic inflammatory disease was 1.68 (95% CI 0.59 to 2.77).The duration of untreatedM. genitaliuminfection is probably longer than persistent detection ofM. genitalium, as measured in most cohort studies, in which inadvertent treatment cannot be ruled out.The results of this systematic review and other evidence sources show important differences in the epidemiology and dynamics ofM. genitaliumandChlamydia trachomatisinfection.


2016 ◽  
Vol 92 (Suppl 1) ◽  
pp. A65.1-A65 ◽  
Author(s):  
Manuel Cina ◽  
Lukas Baumann ◽  
Myrofora Goutaki ◽  
Florian Halbeisen ◽  
Hammad Ali ◽  
...  

2018 ◽  
Author(s):  
Yasir Elhassan ◽  
Fares Alahdab ◽  
Alessandro Prete ◽  
Danae Delivanis ◽  
Aakanksha Khanna ◽  
...  

2010 ◽  
Vol 2010 ◽  
pp. 1-8 ◽  
Author(s):  
Vanessa L. Short ◽  
Jørgen S. Jensen ◽  
Deborah B. Nelson ◽  
Pamela J. Murray ◽  
Roberta B. Ness ◽  
...  

Objective. As the consequences ofMycoplasma genitaliumin pregnant women are unknown, we examined the relationship between prenatalM. genitaliuminfection and SAB.Methods. The presence ofM. genitaliumwas determined by PCR in urine from 82 women who subsequently experienced a SAB and 134 women who maintained their pregnancies past 22 weeks gestation. The relationships betweenM. genitaliumand subsequent SAB, demographic, current pregnancy, and reproductive health history characteristics were evaluated.Results. Compared to women withoutM. genitalium, women withM. genitaliumwere more likely to report nulliparity (41.7% versus 17.4%,P=.04), history of pelvic inflammatory disease (27.3% versus 8.8%,P=.08), priorC. trachomatisinfection (63.6% versus 36.9%,P=.11,) and problems getting pregnant (18.2% versus 4.4%,P=.10).M. genitaliumwas not associated with SAB (AOR 0.9, 95% CI 0.2–3.8).Conclusions. Pregnant women who test positive forM. genitaliumdo not have an increased risk of SAB but report a history of reproductive morbidities.


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