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: An Emerging Cause of Sexually Transmitted Disease in Women


Mycoplasma genitalium is an emerging sexually transmitted pathogen implicated in urethritis in men and several inflammatory reproductive tract syndromes in women including cervicitis, pelvic inflammatory disease (PID), and infertility. This comprehensive review critically examines epidemiologic studies of M. genitalium infections in women with the goal of assessing the associations with reproductive tract disease and enhancing awareness of this emerging pathogen. Over 27,000 women from 48 published reports have been screened for M. genitalium urogenital infection in high- or low-risk populations worldwide with an overall prevalence of 7.3% and 2.0%, respectively. M. genitalium was present in the general population at rates between those of Chlamydia trachomatis and Neisseria gonorrhoeae. Considering more than 20 studies of lower tract inflammation, M. genitalium has been positively associated with urethritis, vaginal discharge, and microscopic signs of cervicitis and/or mucopurulent cervical discharge in seven of 14 studies. A consistent case definition of cervicitis is lacking and will be required for comprehensive understanding of these associations. Importantly, evidence for M. genitalium PID and infertility are quite convincing and indicate that a significant proportion of upper tract inflammation may be attributed to this elusive pathogen. Collectively, M. genitalium is highly prevalent in high- and low-risk populations, and should be considered an etiologic agent of select reproductive tract disease syndromes in women.


Vyšlo v časopise: : An Emerging Cause of Sexually Transmitted Disease in Women. PLoS Pathog 7(5): e32767. doi:10.1371/journal.ppat.1001324
Kategorie: Review
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.ppat.1001324

Souhrn

Mycoplasma genitalium is an emerging sexually transmitted pathogen implicated in urethritis in men and several inflammatory reproductive tract syndromes in women including cervicitis, pelvic inflammatory disease (PID), and infertility. This comprehensive review critically examines epidemiologic studies of M. genitalium infections in women with the goal of assessing the associations with reproductive tract disease and enhancing awareness of this emerging pathogen. Over 27,000 women from 48 published reports have been screened for M. genitalium urogenital infection in high- or low-risk populations worldwide with an overall prevalence of 7.3% and 2.0%, respectively. M. genitalium was present in the general population at rates between those of Chlamydia trachomatis and Neisseria gonorrhoeae. Considering more than 20 studies of lower tract inflammation, M. genitalium has been positively associated with urethritis, vaginal discharge, and microscopic signs of cervicitis and/or mucopurulent cervical discharge in seven of 14 studies. A consistent case definition of cervicitis is lacking and will be required for comprehensive understanding of these associations. Importantly, evidence for M. genitalium PID and infertility are quite convincing and indicate that a significant proportion of upper tract inflammation may be attributed to this elusive pathogen. Collectively, M. genitalium is highly prevalent in high- and low-risk populations, and should be considered an etiologic agent of select reproductive tract disease syndromes in women.


Zdroje

1. World Health Organization

2007

Sexually transmitted infections fact sheet.

Available: http://www.who.int/mediacentre/factsheets/fs110/en/. Accessed 22 April 2011

2. ManhartLE

HolmesKK

HughesJP

HoustonLS

TottenPA

2007

Mycoplasma genitalium among young adults in the United States: an emerging sexually transmitted infection.

Am J Public Health

97

1118

1125

3. TullyJG

Taylor-RobinsonD

ColeRM

RoseDL

1981

A newly discovered mycoplasma in the human urogenital tract.

Lancet

1

1288

1291

4. JensenJS

2004

Mycoplasma genitalium: the aetiological agent of urethritis and other sexually transmitted diseases.

J Eur Acad Dermatol Venereol

18

1

11

5. MartinDH

2008

Nongonococcal urethritis: new views through the prism of modern molecular microbiology.

Curr Infect Dis Rep

10

128

132

6. JensenJS

UldumSA

Sondergard-AndersenJ

VuustJ

LindK

1991

Polymerase chain reaction for detection of Mycoplasma genitalium in clinical samples.

J Clin Microbiol

29

46

50

7. PalmerHM

GilroyCB

ClaydonEJ

Taylor-RobinsonD

1991

Detection of Mycoplasma genitalium in the genitourinary tract of women by the polymerase chain reaction.

Int J STD AIDS

2

261

263

8. AnagriusC

LoreB

JensenJS

2005

Mycoplasma genitalium: prevalence, clinical significance, and transmission.

Sex Transm Infect

81

458

462

9. FalkL

FredlundH

JensenJS

2004

Symptomatic urethritis is more prevalent in men infected with Mycoplasma genitalium than with Chlamydia trachomatis.

Sex Transm Infect

80

289

293

10. FalkL

FredlundH

JensenJS

2005

Signs and symptoms of urethritis and cervicitis among women with or without Mycoplasma genitalium or Chlamydia trachomatis infection.

Sex Transm Infect

81

73

78

11. HjorthSV

BjorneliusE

LidbrinkP

FalkL

DohnB

2006

Sequence-based typing of Mycoplasma genitalium reveals sexual transmission.

J Clin Microbiol

44

2078

2083

12. KeaneFE

ThomasBJ

GilroyCB

RentonA

Taylor-RobinsonD

2000

The association of Chlamydia trachomatis and Mycoplasma genitalium with non-gonococcal urethritis: observations on heterosexual men and their female partners.

Int J STD AIDS

11

435

439

13. ThurmanAR

MusatovovaO

PerdueS

ShainRN

BasemanJG

2010

Mycoplasma genitalium symptoms, concordance and treatment in high-risk sexual dyads.

Int J STD AIDS

21

177

183

14. ToshAK

Van Der PolB

FortenberryJD

WilliamsJA

KatzBP

2007

Mycoplasma genitalium among adolescent women and their partners.

J Adolesc Health

40

412

417

15. MaL

TaylorS

JensenJS

MyersL

LillisR

2008

Short tandem repeat sequences in the Mycoplasma genitalium genome and their use in a multilocus genotyping system.

BMC Microbiol

8

130

16. AndersenB

SokolowskiI

OstergaardL

Kjolseth MollerJ

OlesenF

2007

Mycoplasma genitalium: prevalence and behavioural risk factors in the general population.

Sex Transm Infect

83

237

241

17. ClausenHF

FedderJ

DrasbekM

NielsenPK

ToftB

2001

Serological investigation of Mycoplasma genitalium in infertile women.

Hum Reprod

16

1866

1874

18. EdwardsRK

FergusonRJ

ReyesL

BrownM

TheriaqueDW

2006

Assessing the relationship between preterm delivery and various microorganisms recovered from the lower genital tract.

J Matern Fetal Neonatal Med

19

357

363

19. GhebremichaelM

PaintsilE

LarsenU

2009

Alcohol abuse, sexual risk behaviors, and sexually transmitted infections in women in Moshi urban district, northern Tanzania.

Sex Transm Dis

36

102

107

20. HittiJ

GarciaP

TottenP

PaulK

AsteteS

2010

Correlates of cervical Mycoplasma genitalium and risk of preterm birth among Peruvian women.

Sex Transm Dis

37

81

85

21. OakeshottP

HayP

Taylor-RobinsonD

HayS

DohnB

2004

Prevalence of Mycoplasma genitalium in early pregnancy and relationship between its presence and pregnancy outcome.

BJOG

111

1464

1467

22. OlsenB

LanPT

Stalsby LundborgC

KhangTH

UnemoM

2009

Population-based assessment of Mycoplasma genitalium in Vietnam–low prevalence among married women of reproductive age in a rural area.

J Eur Acad Dermatol Venereol

23

533

537

23. RahmanS

GarlandS

CurrieM

TabriziSN

RahmanM

2008

Prevalence of Mycoplasma genitalium in health clinic attendees complaining of vaginal discharge in Bangladesh.

Int J STD AIDS

19

772

774

24. SvenstrupHF

FedderJ

KristoffersenSE

TrolleB

BirkelundS

2008

Mycoplasma genitalium, Chlamydia trachomatis, and tubal factor infertility–a prospective study.

Fertil Steril

90

513

520

25. ArraizRN

Colina ChS

MarcucciJR

RondonGN

ReyesSF

2008

Mycoplasma genitalium detection and correlation with clinical manifestations in population of the Zulia State, Venezuela.

Rev Chilena Infectol

25

256

261

26. BaczynskaA

HvidM

LamyP

BirkelundS

ChristiansenG

2008

Prevalence of Mycoplasma genitalium, Mycoplasma hominis and Chlamydia trachomatis among Danish patients requesting abortion.

Syst Biol Reprod Med

54

127

134

27. BjartlingC

OsserS

PerssonK

2010

The association between Mycoplasma genitalium and pelvic inflammatory disease after termination of pregnancy.

BJOG

117

361

364

28. BlanchardA

HamrickW

DuffyL

BaldusK

CassellGH

1993

Use of the polymerase chain reaction for detection of Mycoplasma fermentans and Mycoplasma genitalium in the urogenital tract and amniotic fluid.

Clin Infect Dis

17

Suppl 1

S272

279

29. BradshawCS

ChenMY

FairleyCK

2008

Persistence of Mycoplasma genitalium following azithromycin therapy.

PLoS ONE

3

e3618

doi:10.1371/journal.pone.0003618

30. CasinI

Vexiau-RobertD

De La SalmoniereP

EcheA

GrandryB

2002

High prevalence of Mycoplasma genitalium in the lower genitourinary tract of women attending a sexually transmitted disease clinic in Paris, France.

Sex Transm Dis

29

353

359

31. CohenCR

ManhartLE

BukusiEA

AsteteS

BrunhamRC

2002

Association between Mycoplasma genitalium and acute endometritis.

Lancet

359

765

766

32. CohenCR

MugoNR

AsteteSG

OdondoR

ManhartLE

2005

Detection of Mycoplasma genitalium in women with laparoscopically diagnosed acute salpingitis.

Sex Transm Infect

81

463

466

33. CohenCR

NosekM

MeierA

AsteteSG

Iverson-CabralS

2007

Mycoplasma genitalium infection and persistence in a cohort of female sex workers in Nairobi, Kenya.

Sex Transm Dis

34

274

279

34. de BarbeyracB

Bernet-PoggiC

FebrerF

RenaudinH

DuponM

1993

Detection of Mycoplasma pneumoniae and Mycoplasma genitalium in clinical samples by polymerase chain reaction.

Clin Infect Dis

17

Suppl 1

S83

S89

35. EdbergA

JurstrandM

JohanssonE

WikanderE

HoogA

2008

A comparative study of three different PCR assays for detection of Mycoplasma genitalium in urogenital specimens from men and women.

J Med Microbiol

57

304

309

36. GaydosC

MaldeisNE

HardickA

HardickJ

QuinnTC

2009

Mycoplasma genitalium as a contributor to the multiple etiologies of cervicitis in women attending sexually transmitted disease clinics.

Sex Transm Dis

36

598

606

37. GrzeskoJ

EliasM

MaczynskaB

KasprzykowskaU

TlaczalaM

2009

Occurrence of Mycoplasma genitalium in fertile and infertile women.

Fertil Steril

91

2376

2380

38. HaggertyCL

TottenPA

AsteteSG

NessRB

2006

Mycoplasma genitalium among women with nongonococcal, nonchlamydial pelvic inflammatory disease.

Infect Dis Obstet Gynecol

2006

30184

39. HaggertyCL

TottenPA

AsteteSG

LeeS

HoferkaSL

2008

Failure of cefoxitin and doxycycline to eradicate endometrial Mycoplasma genitalium and the consequence for clinical cure of pelvic inflammatory disease.

Sex Transm Infect

84

338

342

40. HogdahlM

KihlstromE

2007

Leucocyte esterase testing of first-voided urine and urethral and cervical smears to identify Mycoplasma genitalium-infected men and women.

Int J STD AIDS

18

835

838

41. HuppertJS

MortensenJE

ReedJL

KahnJA

RichKD

2008

Mycoplasma genitalium detected by transcription-mediated amplification is associated with Chlamydia trachomatis in adolescent women.

Sex Transm Dis

35

250

254

42. JurstrandM

JensenJS

MagnusonA

KamwendoF

FredlundH

2007

A serological study of the role of Mycoplasma genitalium in pelvic inflammatory disease and ectopic pregnancy.

Sex Transm Infect

83

319

323

43. KorteJE

BasemanJB

CagleMP

HerreraC

PiperJM

2006

Cervicitis and genitourinary symptoms in women culture positive for Mycoplasma genitalium.

Am J Reprod Immunol

55

265

275

44. LabbeAC

FrostE

DeslandesS

MendoncaAP

AlvesAC

2002

Mycoplasma genitalium is not associated with adverse outcomes of pregnancy in Guinea-Bissau.

Sex Transm Infect

78

289

291

45. LawtonBA

RoseSB

BromheadC

GaitanosLA

MacDonaldEJ

2008

High prevalence of Mycoplasma genitalium in women presenting for termination of pregnancy.

Contraception

77

294

298

46. ManhartLE

CritchlowCW

HolmesKK

DutroSM

EschenbachDA

2003

Mucopurulent cervicitis and Mycoplasma genitalium.

J Infect Dis

187

650

657

47. ManhartLE

MostadSB

BaetenJM

AsteteSG

MandaliyaK

2008

High Mycoplasma genitalium organism burden is associated with shedding of HIV-1 DNA from the cervix.

J Infect Dis

197

733

736

48. MelleniusH

BomanJ

LundqvistEN

JensenJS

2005

Mycoplasma genitalium should be suspected in unspecific urethritis and cervicitis. A study from Vasterbotten confirms the high prevalence of the bacteria.

Lakartidningen

102

3538

3540–3531

49. MoiH

ReintonN

MoghaddamA

2009

Mycoplasma genitalium in women with lower genital tract inflammation.

Sex Transm Infect

85

10

14

50. MusatovovaO

BasemanJB

2009

Analysis identifying common and distinct sequences among Texas clinical strains of Mycoplasma genitalium.

J Clin Microbiol

47

1469

1475

51. PepinJ

LabbeAC

KhondeN

DeslandesS

AlaryM

2005

Mycoplasma genitalium: an organism commonly associated with cervicitis among west African sex workers.

Sex Transm Infect

81

67

72

52. RossJD

BrownL

SaundersP

AlexanderS

2009

Mycoplasma genitalium in asymptomatic patients: implications for screening.

Sex Transm Infect

85

436

437

53. ShortVL

JensenJS

NelsonDB

MurrayPJ

NessRB

2010

Mycoplasma genitalium among young, urban pregnant women.

Infect Dis Obstet Gynecol

2010

984760

54. SimmsI

EastickK

MallinsonH

ThomasK

GokhaleR

2003

Associations between Mycoplasma genitalium, Chlamydia trachomatis and pelvic inflammatory disease.

J Clin Pathol

56

616

618

55. TsunoeH

TanakaM

NakayamaH

SanoM

NakamuraG

2000

High prevalence of Chlamydia trachomatis, Neisseria gonorrhoeae and Mycoplasma genitalium in female commercial sex workers in Japan.

Int J STD AIDS

11

790

794

56. UnoM

DeguchiT

KomedaH

HayasakiM

IidaM

1997

Mycoplasma genitalium in the cervices of Japanese women.

Sex Transm Dis

24

284

286

57. SpenceD

MelvilleC

2007

Vaginal discharge.

BMJ

335

1147

1151

58. MarrazzoJM

MartinDH

2007

Management of women with cervicitis.

Clin Infect Dis

44

Suppl 3

S102

S110

59. MollerBR

Taylor-RobinsonD

FurrPM

1984

Serological evidence implicating Mycoplasma genitalium in pelvic inflammatory disease.

Lancet

1

1102

1103

60. WestromL

1975

Effect of acute pelvic inflammatory disease on fertility.

Am J Obstet Gynecol

121

707

713

61. McGowinCL

SpagnuoloRA

PylesRB

2010

Mycoplasma genitalium rapidly disseminates to the upper reproductive tracts and knees of female mice following vaginal inoculation.

Infect Immun

78

726

736

62. MollerBR

Taylor-RobinsonD

FurrPM

FreundtEA

1985

Acute upper genital-tract disease in female monkeys provoked experimentally by Mycoplasma genitalium.

Br J Exp Pathol

66

417

426

63. Taylor-RobinsonD

FurrPM

TullyJG

BarileMF

MollerBR

1987

Animal models of Mycoplasma genitalium urogenital infection.

Isr J Med Sci

23

561

564

64. MenaLA

MroczkowskiTF

NsuamiM

MartinDH

2009

A randomized comparison of azithromycin and doxycycline for the treatment of Mycoplasma genitalium-positive urethritis in men.

Clin Infect Dis

48

1649

1654

65. WorkowskiKA

BermanS

2010

Sexually transmitted diseases treatment guidelines, 2010.

MMWR Recomm Rep

59

1

110

66. NessRB

SoperDE

HolleyRL

PeipertJ

RandallH

2002

Effectiveness of inpatient and outpatient treatment strategies for women with pelvic inflammatory disease: results from the Pelvic Inflammatory Disease Evaluation and Clinical Health (PEACH) Randomized Trial.

Am J Obstet Gynecol

186

929

937

67. BjorneliusE

AnagriusC

BojsG

CarlbergH

JohannissonG

2008

Antibiotic treatment of symptomatic Mycoplasma genitalium infection in Scandinavia: a controlled clinical trial.

Sex Transm Infect

84

72

76

68. DeguchiT

YoshidaT

YokoiS

ItoM

TamakiM

2002

Longitudinal quantitative detection by real-time PCR of Mycoplasma genitalium in first-pass urine of men with recurrent nongonococcal urethritis.

J Clin Microbiol

40

3854

3856

69. FalkL

FredlundH

JensenJS

2003

Tetracycline treatment does not eradicate Mycoplasma genitalium.

Sex Transm Infect

79

318

319

70. HornerPJ

GilroyCB

ThomasBJ

NaidooRO

Taylor-RobinsonD

1993

Association of Mycoplasma genitalium with acute non-gonococcal urethritis.

Lancet

342

582

585

71. WikstromA

JensenJS

2006

Mycoplasma genitalium: a common cause of persistent urethritis among men treated with doxycycline.

Sex Transm Infect

82

276

279

72. MaedaSI

TamakiM

KojimaK

YoshidaT

IshikoH

2001

Association of Mycoplasma genitalium persistence in the urethra with recurrence of nongonococcal urethritis.

Sex Transm Dis

28

472

476

73. JernbergE

MoghaddamA

MoiH

2008

Azithromycin and moxifloxacin for microbiological cure of Mycoplasma genitalium infection: an open study.

Int J STD AIDS

19

676

679

74. QuayleAJ

2002

The innate and early immune response to pathogen challenge in the female genital tract and the pivotal role of epithelial cells.

J Reprod Immunol

57

61

79

75. McGowinCL

PopovVL

PylesRB

2009

Intracellular Mycoplasma genitalium infection of human vaginal and cervical epithelial cells elicits distinct patterns of inflammatory cytokine secretion and provides a possible survival niche against macrophage-mediated killing.

BMC Microbiol

9

139

76. UenoPM

TimenetskyJ

CentonzeVE

WewerJJ

CagleM

2008

Interaction of Mycoplasma genitalium with host cells: evidence for nuclear localization.

Microbiology

154

3033

3041

77. McGowinCL

MaL

MartinDH

PylesRB

2009

Mycoplasma genitalium-encoded MG309 activates NF-kappaB via Toll-like receptors 2 and 6 to elicit proinflammatory cytokine secretion from human genital epithelial cells.

Infect Immun

77

1175

1181

78. Napierala MavedzengeS

WeissHA

2009

Association of Mycoplasma genitalium and HIV infection: a systematic review and meta-analysis.

AIDS

23

611

620

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Hygiena a epidemiológia Infekčné lekárstvo Laboratórium

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