Mycoplasma genitalium infection and pelvic inflammatory disease: A 12-month prospective study in Japanese women.
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BACKGROUND: The clinical significance of Mycoplasma genitalium in pelvic inflammatory disease (PID) remains incompletely understood. METHODS: This prospective study investigated the prevalence and possible clinical relevance of M. genitalium among 230 women aged 18-60 years undergoing cervical cancer screening at a clinic in Gifu City, Japan. M. genitalium was detected using the cobas® TV/MG assay on the cobas® 4800 system. Follow-up self-collected vaginal samples were obtained by mail 12 months after baseline to estimate annual incidence and repeat positivity. RESULTS: The baseline prevalence of M. genitalium was 3.5% (8/230; 95% confidence interval [CI], 1.5-6.7). Infection was more frequently observed among women with established STI-related risk factors, including younger age, multiple sexual partners, bacterial vaginosis, and smoking. Follow-up samples were obtained from 80 women (34.8%; 95% CI, 28.6-41.3), including 2 baseline-positive and 78 baseline-negative women. Clinical PID at 12 months was observed in 0/2 baseline-positive women (0.0%; 95% CI, 0.0-84.2) and 1/78 baseline-negative women (1.3%; 95% CI, 0.03-6.9). Among 78 baseline-negative women with follow-up, 2 tested positive at 12 months (2.6%; 95% CI, 0.3-9.0). Both baseline-positive women with follow-up remained NAAT-positive at 12 months (2/2; 100.0%; 95% CI, 15.8-100.0). CONCLUSIONS: No clinical PID was observed among the two baseline-positive women who completed follow-up. However, because of the very small number of infected women with longitudinal follow-up and the low follow-up rate, this study was underpowered to evaluate the short-term PID risk associated with asymptomatic M. genitalium infection. These findings should be interpreted as preliminary.