This study aimed to determine the role of asymptomatic bacterial sexually transmitted infections (STIs), such as Chlamydia trachomatis ( Ct), Mycoplasma genitalium ( Mg), Mycoplasma hominis (Mh), and Ureaplasma urealyticum ( Uu) in human papillomavirus (HPV) infection.
In total, 264 asymptomatic outpatients aged between 21 and 80 years were prospectively enrolled in this study during routine gynecological screening tests. Specimens collected with a Cervex Brush were routinely analyzed with the Hybrid Capture 2 assay for HPV. Simultaneously, a specimen obtained with an endocervical swab was used to detect Ct and Mg with a monoplex real-time polymerase chain reaction (PCR) and to confirm Mh and Uu with a Mycoplasma IST 2 kit.
The detection rates (%) of HPV, Ct, Mg, Mh, and Uu were 82/264 (31.1), 6/264 (2.3), 5/264 (1.9), 16/264 (6.1), and 95/264 (36.0), respectively. Of 95 Uu, 32 (33.7%) showed high density colonization (HDC, ≥10 4 color-changing units/mL). HDC- Uu was significantly associated with HPV infection ( p=0.014, chi-square test). Mg infection and Mh infection were not associated with HPV infection ( p=0.981 and p=0.931, chi-square test). Age was not associated with HPV infection or bacterial infection.
Our data suggested that asymptomatic HDC- Uu was closely associated with HPV infection. Therefore, simultaneous evaluation for Uu and HPV should be performed during gynecological screening, even in asymptomatic individuals.