A silent epidemic: The prevalence, incidence and persistence of mycoplasma genitalium among young, asymptomatic high-risk women in the United States

Arlene C. Seña, Jeannette Y. Lee, Jane Schwebke, Susan S. Philip, Harold C. Wiesenfeld, Anne Marie Rompalo, Robert L. Cook, Marcia M. Hobbs

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)73-79
Number of pages7
JournalClinical Infectious Diseases
Volume67
Issue number1
DOIs
StatePublished - Jan 1 2018

Fingerprint

Mycoplasma genitalium
Incidence
Bacterial Vaginosis
Confidence Intervals
Mycoplasma Infections
Odds Ratio
Pelvic Inflammatory Disease
Reproductive Health
Pregnancy Outcome
Sexually Transmitted Diseases
Natural History

Keywords

  • Incidence
  • Mycoplasma genitalium
  • Persistence
  • Prevalence
  • Young women

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Cite this

A silent epidemic : The prevalence, incidence and persistence of mycoplasma genitalium among young, asymptomatic high-risk women in the United States. / Seña, Arlene C.; Lee, Jeannette Y.; Schwebke, Jane; Philip, Susan S.; Wiesenfeld, Harold C.; Rompalo, Anne Marie; Cook, Robert L.; Hobbs, Marcia M.

In: Clinical Infectious Diseases, Vol. 67, No. 1, 01.01.2018, p. 73-79.

Research output: Contribution to journalArticle

Seña, Arlene C. ; Lee, Jeannette Y. ; Schwebke, Jane ; Philip, Susan S. ; Wiesenfeld, Harold C. ; Rompalo, Anne Marie ; Cook, Robert L. ; Hobbs, Marcia M. / A silent epidemic : The prevalence, incidence and persistence of mycoplasma genitalium among young, asymptomatic high-risk women in the United States. In: Clinical Infectious Diseases. 2018 ; Vol. 67, No. 1. pp. 73-79.
@article{02e566f86b8c4edd859bbf8dac288cd2,
title = "A silent epidemic: The prevalence, incidence and persistence of mycoplasma genitalium among young, asymptomatic high-risk women in the United States",
abstract = "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.",
keywords = "Incidence, Mycoplasma genitalium, Persistence, Prevalence, Young women",
author = "Se{\~n}a, {Arlene C.} and Lee, {Jeannette Y.} and Jane Schwebke and Philip, {Susan S.} and Wiesenfeld, {Harold C.} and Rompalo, {Anne Marie} and Cook, {Robert L.} and Hobbs, {Marcia M.}",
year = "2018",
month = "1",
day = "1",
doi = "10.1093/cid/ciy025",
language = "English (US)",
volume = "67",
pages = "73--79",
journal = "Clinical Infectious Diseases",
issn = "1058-4838",
publisher = "Oxford University Press",
number = "1",

}

TY - JOUR

T1 - A silent epidemic

T2 - The prevalence, incidence and persistence of mycoplasma genitalium among young, asymptomatic high-risk women in the United States

AU - Seña, Arlene C.

AU - Lee, Jeannette Y.

AU - Schwebke, Jane

AU - Philip, Susan S.

AU - Wiesenfeld, Harold C.

AU - Rompalo, Anne Marie

AU - Cook, Robert L.

AU - Hobbs, Marcia M.

PY - 2018/1/1

Y1 - 2018/1/1

N2 - 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.

AB - 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.

KW - Incidence

KW - Mycoplasma genitalium

KW - Persistence

KW - Prevalence

KW - Young women

UR - http://www.scopus.com/inward/record.url?scp=85055438799&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85055438799&partnerID=8YFLogxK

U2 - 10.1093/cid/ciy025

DO - 10.1093/cid/ciy025

M3 - Article

C2 - 29342269

AN - SCOPUS:85055438799

VL - 67

SP - 73

EP - 79

JO - Clinical Infectious Diseases

JF - Clinical Infectious Diseases

SN - 1058-4838

IS - 1

ER -