Mycoplasma genitalium in the US (MyGeniUS): Surveillance Data from Sexual Health Clinics in Four US Regions

Mycoplasma genitalium (MG) is on the CDC Watch List of Antimicrobial Resistance Threats yet there is no systematic surveillance to monitor change. We initiated surveillance in sexual health clinics in six cities, selecting a quota sample of urogenital specimens tested for gonorrhea and/or chlamydia....

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Hauptverfasser: Manhart, Lisa E, Leipertz, Gina, Soge, Olusegun O, Jordan, Stephen J, McNeil, Candice, Pathela, Preeti, Reno, Hilary, Wendel, Karen, Parker, Anika, Geisler, William M, Getman, Damon, Golden, Matthew R
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container_title Clinical infectious diseases
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creator Manhart, Lisa E
Leipertz, Gina
Soge, Olusegun O
Jordan, Stephen J
McNeil, Candice
Pathela, Preeti
Reno, Hilary
Wendel, Karen
Parker, Anika
Geisler, William M
Getman, Damon
Golden, Matthew R
description Mycoplasma genitalium (MG) is on the CDC Watch List of Antimicrobial Resistance Threats yet there is no systematic surveillance to monitor change. We initiated surveillance in sexual health clinics in six cities, selecting a quota sample of urogenital specimens tested for gonorrhea and/or chlamydia. We abstracted patient data from medical records and detected MG and macrolide resistance mutations (MRM) by nucleic acid amplification testing. We employed Poisson regression to estimate adjusted prevalence ratios (aPR) and 95% confidence intervals (CI), adjusting for sampling criteria (site, birth-sex, symptom status). From October-December 2020 we tested 1,743 urogenital specimens: 57.0% from males, 46.1% from non-Hispanic Black people, 43.8% from symptomatic patients. MG prevalence was 16.6% (95%CI = 14.9-18.5) (site-specific range = 9.9%-23.5%) and higher in St Louis (aPR = 1.9; 1.27-2.85), Greensboro (aPR = 1.8; 1.18-2.79), and Denver (aPR = 1.7; 1.12-2.44) than Seattle. Prevalence was highest in people
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We initiated surveillance in sexual health clinics in six cities, selecting a quota sample of urogenital specimens tested for gonorrhea and/or chlamydia. We abstracted patient data from medical records and detected MG and macrolide resistance mutations (MRM) by nucleic acid amplification testing. We employed Poisson regression to estimate adjusted prevalence ratios (aPR) and 95% confidence intervals (CI), adjusting for sampling criteria (site, birth-sex, symptom status). From October-December 2020 we tested 1,743 urogenital specimens: 57.0% from males, 46.1% from non-Hispanic Black people, 43.8% from symptomatic patients. MG prevalence was 16.6% (95%CI = 14.9-18.5) (site-specific range = 9.9%-23.5%) and higher in St Louis (aPR = 1.9; 1.27-2.85), Greensboro (aPR = 1.8; 1.18-2.79), and Denver (aPR = 1.7; 1.12-2.44) than Seattle. Prevalence was highest in people &lt;18 years (30.4%) and declined 3% per each additional year of age (aPR = 0.97; 0.955-0.982). MG was detected in 26.8%, 21.1%, 11.8% and 15.4% of urethritis, vaginitis, cervicitis, and pelvic inflammatory disease (PID), respectively. It was present in 9% of asymptomatic males and 15.4% of asymptomatic females, and associated with male urethritis (aPR = 1.7; 1.22-2.50) and chlamydia (aPR = 1.7; 1.13-2.53). MRM prevalence was 59.1% (95%CI = 53.1-64.8) (site-specific range = 51.3%-70.6%). MRM were associated with vaginitis (aPR = 1.8; 1.14-2.85), cervicitis (aPR = 3.5; 1.69-7.30), and PID cervicitis (aPR = 1.8; 1.09-3.08). MG infection is common in people at high risk of STIs; testing symptomatic patients would facilitate appropriate therapy. Macrolide resistance is high and azithromycin should not be used without resistance testing.</description><identifier>EISSN: 1537-6591</identifier><identifier>PMID: 37402645</identifier><language>eng</language><publisher>United States</publisher><ispartof>Clinical infectious diseases, 2023-07</ispartof><rights>The Author(s) 2023. 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We initiated surveillance in sexual health clinics in six cities, selecting a quota sample of urogenital specimens tested for gonorrhea and/or chlamydia. We abstracted patient data from medical records and detected MG and macrolide resistance mutations (MRM) by nucleic acid amplification testing. We employed Poisson regression to estimate adjusted prevalence ratios (aPR) and 95% confidence intervals (CI), adjusting for sampling criteria (site, birth-sex, symptom status). From October-December 2020 we tested 1,743 urogenital specimens: 57.0% from males, 46.1% from non-Hispanic Black people, 43.8% from symptomatic patients. MG prevalence was 16.6% (95%CI = 14.9-18.5) (site-specific range = 9.9%-23.5%) and higher in St Louis (aPR = 1.9; 1.27-2.85), Greensboro (aPR = 1.8; 1.18-2.79), and Denver (aPR = 1.7; 1.12-2.44) than Seattle. Prevalence was highest in people &lt;18 years (30.4%) and declined 3% per each additional year of age (aPR = 0.97; 0.955-0.982). MG was detected in 26.8%, 21.1%, 11.8% and 15.4% of urethritis, vaginitis, cervicitis, and pelvic inflammatory disease (PID), respectively. It was present in 9% of asymptomatic males and 15.4% of asymptomatic females, and associated with male urethritis (aPR = 1.7; 1.22-2.50) and chlamydia (aPR = 1.7; 1.13-2.53). MRM prevalence was 59.1% (95%CI = 53.1-64.8) (site-specific range = 51.3%-70.6%). MRM were associated with vaginitis (aPR = 1.8; 1.14-2.85), cervicitis (aPR = 3.5; 1.69-7.30), and PID cervicitis (aPR = 1.8; 1.09-3.08). MG infection is common in people at high risk of STIs; testing symptomatic patients would facilitate appropriate therapy. 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We initiated surveillance in sexual health clinics in six cities, selecting a quota sample of urogenital specimens tested for gonorrhea and/or chlamydia. We abstracted patient data from medical records and detected MG and macrolide resistance mutations (MRM) by nucleic acid amplification testing. We employed Poisson regression to estimate adjusted prevalence ratios (aPR) and 95% confidence intervals (CI), adjusting for sampling criteria (site, birth-sex, symptom status). From October-December 2020 we tested 1,743 urogenital specimens: 57.0% from males, 46.1% from non-Hispanic Black people, 43.8% from symptomatic patients. MG prevalence was 16.6% (95%CI = 14.9-18.5) (site-specific range = 9.9%-23.5%) and higher in St Louis (aPR = 1.9; 1.27-2.85), Greensboro (aPR = 1.8; 1.18-2.79), and Denver (aPR = 1.7; 1.12-2.44) than Seattle. Prevalence was highest in people &lt;18 years (30.4%) and declined 3% per each additional year of age (aPR = 0.97; 0.955-0.982). MG was detected in 26.8%, 21.1%, 11.8% and 15.4% of urethritis, vaginitis, cervicitis, and pelvic inflammatory disease (PID), respectively. It was present in 9% of asymptomatic males and 15.4% of asymptomatic females, and associated with male urethritis (aPR = 1.7; 1.22-2.50) and chlamydia (aPR = 1.7; 1.13-2.53). MRM prevalence was 59.1% (95%CI = 53.1-64.8) (site-specific range = 51.3%-70.6%). MRM were associated with vaginitis (aPR = 1.8; 1.14-2.85), cervicitis (aPR = 3.5; 1.69-7.30), and PID cervicitis (aPR = 1.8; 1.09-3.08). MG infection is common in people at high risk of STIs; testing symptomatic patients would facilitate appropriate therapy. Macrolide resistance is high and azithromycin should not be used without resistance testing.</abstract><cop>United States</cop><pmid>37402645</pmid><orcidid>https://orcid.org/0000-0002-4896-7654</orcidid></addata></record>
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source Oxford University Press Journals All Titles (1996-Current); EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection
title Mycoplasma genitalium in the US (MyGeniUS): Surveillance Data from Sexual Health Clinics in Four US Regions
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