Mycoplasma genitalium incidence, organism load, and treatment failure in a cohort of young Australian women

Jennifer Walker, Christopher Kit Fairley, Catriona Bradshaw, Sepehr Tabrizi, Jimmy Twin, Marcus Y Chen, Nicole Taylor, Basil Donovan, John M Kaldor, Kathleen Margaret McNamee, Eve Urban, Sandra Walker, Marian Currie, Hudson Birden, Francis Bowden, Jane Maree Gunn, Marie Pirotta, Lyle C Gurrin, Veerakathy Harindra, Suzanne Marianne Garland & 1 others Jane Hocking

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Abstract

Mycoplasma genitalium (MG) is an emerging sexually transmitted infection (STI) that is potentially associated with reproductive tract sequelae in women. This study aimed to estimate MG incidence and treatment failure and provide estimates of organism load in infection. Methods. 1110 women aged 16?25 years were recruited from primary care clinics in Australia. Women were tested for MG at baseline, 6 months, and 12 months, and MG organism load was measured by quantitative polymerase chain reaction (PCR). MG-positive cases were screened for MG 23S ribosomal RNA (rRNA) gene point mutations shown to confer azithromycin resistance using high-resolution melt following PCR. Results. MG incidence rate was 1.3 per 100 person-years (n = 14; 95 confidence interval [CI], .8?2.3); women reporting 3 or more sex partners in the last 12 months had an increased rate of incident infection (rate ratio [RR], 5.1; 95 CI, 1.3?19.6]). There were 3 cases of MG reinfection (0.8 per 100 person-years [95 CI, .1?.9]. Organism load was higher for prevalent than incident infection (P = .04). There were 3 cases of treatment failure (9.4 [95 CI, 2.0?25.0]); organism load was higher in cases with treatment failure than in successfully treated cases (P <.01). An MG 23S rRNA mutation was detected in 5 cases (3 cases of treatment failure and 2 successfully treated). Conclusions. Although MG incidence was relatively low, testing should be recommended for women considered to be at increased risk based on sexual history. Our results also suggest that organism load might be important in azithromycin treatment failure.
Original languageEnglish
Pages (from-to)1094 - 1100
Number of pages7
JournalClinical Infectious Diseases
Volume56
Issue number8
DOIs
Publication statusPublished - 2013

Cite this

Walker, Jennifer ; Fairley, Christopher Kit ; Bradshaw, Catriona ; Tabrizi, Sepehr ; Twin, Jimmy ; Chen, Marcus Y ; Taylor, Nicole ; Donovan, Basil ; Kaldor, John M ; McNamee, Kathleen Margaret ; Urban, Eve ; Walker, Sandra ; Currie, Marian ; Birden, Hudson ; Bowden, Francis ; Gunn, Jane Maree ; Pirotta, Marie ; Gurrin, Lyle C ; Harindra, Veerakathy ; Garland, Suzanne Marianne ; Hocking, Jane. / Mycoplasma genitalium incidence, organism load, and treatment failure in a cohort of young Australian women. In: Clinical Infectious Diseases. 2013 ; Vol. 56, No. 8. pp. 1094 - 1100.
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title = "Mycoplasma genitalium incidence, organism load, and treatment failure in a cohort of young Australian women",
abstract = "Mycoplasma genitalium (MG) is an emerging sexually transmitted infection (STI) that is potentially associated with reproductive tract sequelae in women. This study aimed to estimate MG incidence and treatment failure and provide estimates of organism load in infection. Methods. 1110 women aged 16?25 years were recruited from primary care clinics in Australia. Women were tested for MG at baseline, 6 months, and 12 months, and MG organism load was measured by quantitative polymerase chain reaction (PCR). MG-positive cases were screened for MG 23S ribosomal RNA (rRNA) gene point mutations shown to confer azithromycin resistance using high-resolution melt following PCR. Results. MG incidence rate was 1.3 per 100 person-years (n = 14; 95 confidence interval [CI], .8?2.3); women reporting 3 or more sex partners in the last 12 months had an increased rate of incident infection (rate ratio [RR], 5.1; 95 CI, 1.3?19.6]). There were 3 cases of MG reinfection (0.8 per 100 person-years [95 CI, .1?.9]. Organism load was higher for prevalent than incident infection (P = .04). There were 3 cases of treatment failure (9.4 [95 CI, 2.0?25.0]); organism load was higher in cases with treatment failure than in successfully treated cases (P <.01). An MG 23S rRNA mutation was detected in 5 cases (3 cases of treatment failure and 2 successfully treated). Conclusions. Although MG incidence was relatively low, testing should be recommended for women considered to be at increased risk based on sexual history. Our results also suggest that organism load might be important in azithromycin treatment failure.",
author = "Jennifer Walker and Fairley, {Christopher Kit} and Catriona Bradshaw and Sepehr Tabrizi and Jimmy Twin and Chen, {Marcus Y} and Nicole Taylor and Basil Donovan and Kaldor, {John M} and McNamee, {Kathleen Margaret} and Eve Urban and Sandra Walker and Marian Currie and Hudson Birden and Francis Bowden and Gunn, {Jane Maree} and Marie Pirotta and Gurrin, {Lyle C} and Veerakathy Harindra and Garland, {Suzanne Marianne} and Jane Hocking",
year = "2013",
doi = "10.1093/cid/cis1210",
language = "English",
volume = "56",
pages = "1094 -- 1100",
journal = "Clinical Infectious Diseases",
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Walker, J, Fairley, CK, Bradshaw, C, Tabrizi, S, Twin, J, Chen, MY, Taylor, N, Donovan, B, Kaldor, JM, McNamee, KM, Urban, E, Walker, S, Currie, M, Birden, H, Bowden, F, Gunn, JM, Pirotta, M, Gurrin, LC, Harindra, V, Garland, SM & Hocking, J 2013, 'Mycoplasma genitalium incidence, organism load, and treatment failure in a cohort of young Australian women', Clinical Infectious Diseases, vol. 56, no. 8, pp. 1094 - 1100. https://doi.org/10.1093/cid/cis1210

Mycoplasma genitalium incidence, organism load, and treatment failure in a cohort of young Australian women. / Walker, Jennifer; Fairley, Christopher Kit; Bradshaw, Catriona; Tabrizi, Sepehr; Twin, Jimmy; Chen, Marcus Y; Taylor, Nicole; Donovan, Basil; Kaldor, John M; McNamee, Kathleen Margaret; Urban, Eve; Walker, Sandra; Currie, Marian; Birden, Hudson; Bowden, Francis; Gunn, Jane Maree; Pirotta, Marie; Gurrin, Lyle C; Harindra, Veerakathy; Garland, Suzanne Marianne; Hocking, Jane.

In: Clinical Infectious Diseases, Vol. 56, No. 8, 2013, p. 1094 - 1100.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Mycoplasma genitalium incidence, organism load, and treatment failure in a cohort of young Australian women

AU - Walker, Jennifer

AU - Fairley, Christopher Kit

AU - Bradshaw, Catriona

AU - Tabrizi, Sepehr

AU - Twin, Jimmy

AU - Chen, Marcus Y

AU - Taylor, Nicole

AU - Donovan, Basil

AU - Kaldor, John M

AU - McNamee, Kathleen Margaret

AU - Urban, Eve

AU - Walker, Sandra

AU - Currie, Marian

AU - Birden, Hudson

AU - Bowden, Francis

AU - Gunn, Jane Maree

AU - Pirotta, Marie

AU - Gurrin, Lyle C

AU - Harindra, Veerakathy

AU - Garland, Suzanne Marianne

AU - Hocking, Jane

PY - 2013

Y1 - 2013

N2 - Mycoplasma genitalium (MG) is an emerging sexually transmitted infection (STI) that is potentially associated with reproductive tract sequelae in women. This study aimed to estimate MG incidence and treatment failure and provide estimates of organism load in infection. Methods. 1110 women aged 16?25 years were recruited from primary care clinics in Australia. Women were tested for MG at baseline, 6 months, and 12 months, and MG organism load was measured by quantitative polymerase chain reaction (PCR). MG-positive cases were screened for MG 23S ribosomal RNA (rRNA) gene point mutations shown to confer azithromycin resistance using high-resolution melt following PCR. Results. MG incidence rate was 1.3 per 100 person-years (n = 14; 95 confidence interval [CI], .8?2.3); women reporting 3 or more sex partners in the last 12 months had an increased rate of incident infection (rate ratio [RR], 5.1; 95 CI, 1.3?19.6]). There were 3 cases of MG reinfection (0.8 per 100 person-years [95 CI, .1?.9]. Organism load was higher for prevalent than incident infection (P = .04). There were 3 cases of treatment failure (9.4 [95 CI, 2.0?25.0]); organism load was higher in cases with treatment failure than in successfully treated cases (P <.01). An MG 23S rRNA mutation was detected in 5 cases (3 cases of treatment failure and 2 successfully treated). Conclusions. Although MG incidence was relatively low, testing should be recommended for women considered to be at increased risk based on sexual history. Our results also suggest that organism load might be important in azithromycin treatment failure.

AB - Mycoplasma genitalium (MG) is an emerging sexually transmitted infection (STI) that is potentially associated with reproductive tract sequelae in women. This study aimed to estimate MG incidence and treatment failure and provide estimates of organism load in infection. Methods. 1110 women aged 16?25 years were recruited from primary care clinics in Australia. Women were tested for MG at baseline, 6 months, and 12 months, and MG organism load was measured by quantitative polymerase chain reaction (PCR). MG-positive cases were screened for MG 23S ribosomal RNA (rRNA) gene point mutations shown to confer azithromycin resistance using high-resolution melt following PCR. Results. MG incidence rate was 1.3 per 100 person-years (n = 14; 95 confidence interval [CI], .8?2.3); women reporting 3 or more sex partners in the last 12 months had an increased rate of incident infection (rate ratio [RR], 5.1; 95 CI, 1.3?19.6]). There were 3 cases of MG reinfection (0.8 per 100 person-years [95 CI, .1?.9]. Organism load was higher for prevalent than incident infection (P = .04). There were 3 cases of treatment failure (9.4 [95 CI, 2.0?25.0]); organism load was higher in cases with treatment failure than in successfully treated cases (P <.01). An MG 23S rRNA mutation was detected in 5 cases (3 cases of treatment failure and 2 successfully treated). Conclusions. Although MG incidence was relatively low, testing should be recommended for women considered to be at increased risk based on sexual history. Our results also suggest that organism load might be important in azithromycin treatment failure.

UR - http://cid.oxfordjournals.org/content/56/8/1094.full.pdf

U2 - 10.1093/cid/cis1210

DO - 10.1093/cid/cis1210

M3 - Article

VL - 56

SP - 1094

EP - 1100

JO - Clinical Infectious Diseases

JF - Clinical Infectious Diseases

SN - 1058-4838

IS - 8

ER -