Abstract：
OBJECTIVE: While Mycoplasma genitalium is reported as a common rectal infection among men who have sex with men (MSM), published data refer predominantly to urethral infections. Currently, most guidelines recommend M. genitalium testing from urine in men with symptomatic, non-gonococcal urethritis. Macrolide resistance-associated mutations (MRMs) among M. genitalium have increased during the last decade especially among MSM. We aim to demonstrate the prevalence and anatomical distribution of M. genitalium infection and MRM in urine and rectal specimens among MSM in Sweden.
METHODS: In this cross-sectional study in 2019, paired urine and rectal samples from symptomatic and asymptomatic MSM attending a sexually transmitted infection clinic in the south of Sweden were screened for M. genitalium, presence of MRM, Neisseria gonorrhoeae, Chlamydia trachomatis, HIV and syphilis.
RESULTS: The overall prevalence of M. genitalium was 10.5% (64 of 609), rectal samples 7.6% (46 of 609) and urine samples 3.9% (24 of 609) (p=0.007). Among M. genitalium-positive cases, single rectal and single urethral infection was detected in 62.5% (40 of 64) and 28.1% (18 of 64), respectively (p<0.0001). Infection at both sites was seen in 9.4% (6 of 64). The prevalence of MRM was 67.9% (19 of 28). M. genitalium was significantly associated with HIV (OR 2.60, 95% CI 1.14 to 5.88, p=0.02). Among the MSM, 7.4% (45 of 609) were infected with N. gonorrhoeae, 6.7% (41 of 609) with C. trachomatis, 7.1% (43 of 609) with HIV and 0.7% (4 of 609) with syphilis.
CONCLUSIONS: In this study, among MSM, most infections with M. genitalium were detected as rectal mono infections. The prevalence of M. genitalium among MSM was almost twofold higher in rectal samples (7.6%) compared with urine samples (3.9%). The prevalence of macrolide resistance was high with no difference between urine and rectal samples.
METHODS: In this cross-sectional study in 2019, paired urine and rectal samples from symptomatic and asymptomatic MSM attending a sexually transmitted infection clinic in the south of Sweden were screened for M. genitalium, presence of MRM, Neisseria gonorrhoeae, Chlamydia trachomatis, HIV and syphilis.
RESULTS: The overall prevalence of M. genitalium was 10.5% (64 of 609), rectal samples 7.6% (46 of 609) and urine samples 3.9% (24 of 609) (p=0.007). Among M. genitalium-positive cases, single rectal and single urethral infection was detected in 62.5% (40 of 64) and 28.1% (18 of 64), respectively (p<0.0001). Infection at both sites was seen in 9.4% (6 of 64). The prevalence of MRM was 67.9% (19 of 28). M. genitalium was significantly associated with HIV (OR 2.60, 95% CI 1.14 to 5.88, p=0.02). Among the MSM, 7.4% (45 of 609) were infected with N. gonorrhoeae, 6.7% (41 of 609) with C. trachomatis, 7.1% (43 of 609) with HIV and 0.7% (4 of 609) with syphilis.
CONCLUSIONS: In this study, among MSM, most infections with M. genitalium were detected as rectal mono infections. The prevalence of M. genitalium among MSM was almost twofold higher in rectal samples (7.6%) compared with urine samples (3.9%). The prevalence of macrolide resistance was high with no difference between urine and rectal samples.
摘要：
目的：虽然生殖支原体是男男性行为者（MSM）中常见的直肠感染，公布的数据主要涉及尿道感染。目前,大多数指南建议对有症状的男性进行尿液中的生殖支原体检测，非淋菌性尿道炎。在过去十年中，尤其是在MSM中，生殖分枝杆菌中的大环内酯抗性相关突变（MRM）有所增加。我们的目的是证明瑞典MSM中生殖支原体感染和尿液和直肠标本中MRM的患病率和解剖分布。
方法：在2019年的这项横断面研究中，对来自瑞典南部性传播感染诊所的有症状和无症状MSM的配对尿液和直肠样本进行了生殖支原体筛查，MRM的存在，淋病奈瑟菌,沙眼衣原体,艾滋病毒和梅毒。
结果：生殖分枝杆菌的总体患病率为10.5％（609个中的64个），直肠样本7.6%(609个样本中的46个)和尿液样本3.9%(609个样本中的24个)(p=0.007)。在生殖支原体阳性病例中，在62.5%（64个中的40个）和28.1%（64个中的18个）中检测到单个直肠和单个尿道感染，分别(p<0.0001)。两个部位的感染均为9.4％（64个中的6个）。MRM的患病率为67.9％（28个中的19个）。生殖分枝杆菌与HIV显著相关(OR2.60,95%CI1.14至5.88,p=0.02)。在MSM中，7.4%(609人中有45人)感染淋病奈瑟菌,6.7%(609人中的41人)患有沙眼衣原体，7.1%(609人中的43人)感染艾滋病毒，0.7%(609人中的4人)感染梅毒。
结论：在这项研究中，在MSM中，大多数生殖器分枝杆菌感染被检测为直肠单一感染。与尿液样本（3.9％）相比，直肠样本（7.6％）中MSM的生殖支原体患病率几乎高出两倍。大环内酯耐药性的患病率很高，尿液和直肠样本之间没有差异。
方法：在2019年的这项横断面研究中，对来自瑞典南部性传播感染诊所的有症状和无症状MSM的配对尿液和直肠样本进行了生殖支原体筛查，MRM的存在，淋病奈瑟菌,沙眼衣原体,艾滋病毒和梅毒。
结果：生殖分枝杆菌的总体患病率为10.5％（609个中的64个），直肠样本7.6%(609个样本中的46个)和尿液样本3.9%(609个样本中的24个)(p=0.007)。在生殖支原体阳性病例中，在62.5%（64个中的40个）和28.1%（64个中的18个）中检测到单个直肠和单个尿道感染，分别(p<0.0001)。两个部位的感染均为9.4％（64个中的6个）。MRM的患病率为67.9％（28个中的19个）。生殖分枝杆菌与HIV显著相关(OR2.60,95%CI1.14至5.88,p=0.02)。在MSM中，7.4%(609人中有45人)感染淋病奈瑟菌,6.7%(609人中的41人)患有沙眼衣原体，7.1%(609人中的43人)感染艾滋病毒，0.7%(609人中的4人)感染梅毒。
结论：在这项研究中，在MSM中，大多数生殖器分枝杆菌感染被检测为直肠单一感染。与尿液样本（3.9％）相比，直肠样本（7.6％）中MSM的生殖支原体患病率几乎高出两倍。大环内酯耐药性的患病率很高，尿液和直肠样本之间没有差异。
