Chlamydia trachomatis and Mycoplasma genitalium prevalence and associated factors among women presenting to a pregnancy termination and contraception clinic, 2009-2019

Hannah S. Shilling, Suzanne M. Garland, Anna-Maria Costa, Alex Marceglia, Katherine Fethers, Jennifer Danielewski, Gerald Murray, Catriona Bradshaw, Lenka Vodstrcil, Jane S. Hocking, John Kaldor, Rebecca Guy, Dorothy A. Machalek

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background: Risk of pelvic inflammatory disease associated with Chlamydia trachomatis and Mycoplasma genitalium is increased after termination of pregnancy (TOP) and may be increased after insertion of intrauterine devices (IUDs). Screening prior to these procedures is recommended only for C. trachomatis. We examined C. trachomatis and M. genitalium prevalence and associated factors among women presenting to a pregnancy termination and contraception service over 10 years. Methods: Retrospective analysis of clinical data collected from 17 573 women aged 15-45 years in 2009-2019 and for 266 M. genitalium positive women tested for macrolide resistance-associated mutations in 2016-2019. Results: C. trachomatis and M. genitalium prevalence was 3.7% and 3.4%, respectively. In multivariable analyses, shared risk factors were younger age (p<0.001, for both C. trachomatis and M. genitalium), socioeconomic disadvantage (p=0.045 and p=0.008, respectively) and coinfection (p<0.001, for both sexually transmitted infections), with 10.1% of C. trachomatis positive women also positive for M. genitalium. Additional risk factors were earlier year of visit (p=0.001) for C. trachomatis and for M. genitalium residing outside a major city (p=0.013). The proportion of M. genitalium infections tested between 2016 and 2019 with macrolide resistance-associated mutations was 32.7%. Conclusions: Given the high level of antimicrobial resistance and the prevalence of coinfection, testing C. trachomatis positive women for M. genitalium could be considered in this setting to prevent further spread of resistant infections. Further research is required into the causal link between M. genitalium and pelvic inflammatory disease in women undergoing TOP and IUD insertion.

Original languageEnglish
Article number054695
Number of pages6
JournalSexually Transmitted Infections
DOIs
Publication statusAccepted/In press - 2021

Keywords

  • antibiotic resistance
  • chlamydia trachomatis
  • M genitalium
  • pelvic inflammatory disease
  • sexual health

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