11
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: not found
      • Article: not found

      Mycoplasma genitalium in Women: Current Knowledge and Research Priorities for This Recently Emerged Pathogen

      1 , 2
      The Journal of Infectious Diseases
      Oxford University Press (OUP)

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          <p id="d10244654e142">Health consequences of sexually transmitted diseases disproportionately affect women, making it important to determine whether newly emerged pathogens cause sequelae. Although the pathogenic role of <i>Mycoplasma genitalium</i> in male urethritis is clear, fewer studies have been conducted among women to determine its pathogenic role in the female reproductive tract. Pelvic inflammatory disease (PID) is an important cause of infertility and ectopic pregnancy, and <i>Chlamydia trachomatis</i> and <i>Neisseria gonorrhoeae</i> are recognized microbial causes. Emerging data demonstrate an association between <i>M. genitalium</i> and PID, and limited data suggest associations with infertility and preterm birth, yet the attributable risk for female genital tract infections remains to be defined. Further investigations are needed to better define the impact of <i>M. genitalium</i> on women’s reproductive health. Importantly, prospective studies evaluating whether screening programs and targeted treatment of <i>M. genitalium</i> improve reproductive outcomes in women are necessary to guide public health policy for this emerging pathogen. </p>

          Related collections

          Most cited references47

          • Record: found
          • Abstract: found
          • Article: not found

          Mycoplasma genitalium: from Chrysalis to multicolored butterfly.

          The history, replication, genetics, characteristics (both biological and physical), and factors involved in the pathogenesis of Mycoplasma genitalium are presented. The latter factors include adhesion, the influence of hormones, motility, possible toxin production, and immunological responses. The preferred site of colonization, together with current detection procedures, mainly by PCR technology, is discussed. The relationships between M. genitalium and various diseases are highlighted. These diseases include acute and chronic nongonococcal urethritis, balanoposthitis, chronic prostatitis, and acute epididymitis in men and urethritis, bacterial vaginosis, vaginitis, cervicitis, pelvic inflammatory disease, and reproductive disease in women. A causative relationship, or otherwise strong association, between several of these diseases and M. genitalium is apparent, and the extent of this, on a subjective basis, is presented; also provided is a comparison between M. genitalium and two other genital tract-orientated mollicutes, namely, Mycoplasma hominis, the first mycoplasma of human origin to be discovered, and Ureaplasma species. Also discussed is the relationship between M. genitalium and infertility and also arthritis in both men and women, as is infection in homosexual and immunodeficient patients. Decreased immunity, as in HIV infections, may enhance mycoplasmal detection and increase disease severity. Finally, aspects of the antimicrobial susceptibility and resistance of M. genitalium, together with the treatment and possible prevention of mycoplasmal disease, are discussed.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Prevention of pelvic inflammatory disease by screening for cervical chlamydial infection.

            Chlamydia trachomatis is a frequent cause of pelvic inflammatory disease. However, there is little information from clinical studies about whether screening women for cervical chlamydial infection can reduce the incidence of this serious illness. We conducted a randomized, controlled trial to determine whether selective testing for cervical chlamydial infection prevented pelvic inflammatory disease. Women who were at high risk for disease were identified by means of a questionnaire mailed to all women enrollees in a health maintenance organization who were 18 to 34 years of age. Eligible respondents were randomly assigned to undergo testing for C. trachomatis or to receive usual care; both groups were followed for one year. Possible cases of pelvic inflammatory disease were identified through a variety of data bases and were confirmed by review of the women's medical records. We used an intention-to-screen analysis to compare the incidence of pelvic inflammatory disease in the two groups of women. Of the 2607 eligible women, 1009 were randomly assigned to screening and 1598 to usual care. A total of 645 women in the screening group (64 percent) for chlamydia; 7 percent tested positive and were treated. At the end of the follow-up period, there had been 9 verified cases of pelvic inflammatory disease among the women in the screening group and 33 cases among the women receiving usual care (relative risk, 0.44; 95 percent confidence interval, 0.20 to 0.90). We found similar results when we used logistic-regression analysis to control for potentially confounding variables. A strategy of identifying, testing, and treating women at increased risk for cervical chlamydial infection was associated with a reduced incidence of pelvic inflammatory disease.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Trichomonas vaginalis as a cause of perinatal morbidity: a systematic review and meta-analysis.

              Trichomonas vaginalis is the most common curable sexually transmissible infection worldwide, with high rates in women of reproductive age. There have been inconsistent findings about the impact of infection and its treatment in pregnancy. We conducted a meta-analysis to determine the association between T. vaginalis and perinatal outcomes. Electronic databases were searched to May 2013. Included studies reported perinatal outcomes in women infected and uninfected with T. vaginalis. Meta-analysis calculated a pooled relative risk (RR) and 95% confidence interval (CI) using either a fixed- or random-effects model. Study bias was assessed using funnel plots. Of 178 articles identified, 11 studies met the inclusion criteria. The study populations, outcomes, and quality varied. T. vaginalis in pregnancy was associated with an increased risk of preterm birth (RR, 1.42; 95% CI, 1.15-1.75; 9 studies; n = 81,101; I = 62.7%), preterm premature rupture of membranes (RR, 1.41; 95% CI,1.10-1.82; 2 studies; n = 14,843; I = 0.0%) and small for gestational age infants (RR, 1.51; 95% CI,1.32-1.73; 2 studies; n = 14,843; I = 0.0%). Sensitivity analyses of studies that accounted for coinfection with other sexually transmissible infection found a slightly reduced RR of 1.34 for preterm birth (95% CI, 1.19-1.51; 6 studies; n = 72,077; I = 11.2%), and in studies where no treatment was confirmed, the RR was 1.83 (95% CI, 0.98-3.41; 3 studies; n = 1795; I = 22.3%). Our review provides strong evidence that T. vaginalis in pregnancy is associated with an increased risk of preterm birth. Based on fewer studies, there were also substantial increases in the risk of preterm premature rupture of membranes and small for gestational age infants. Further studies that address the current gaps in evidence on treatment effects in pregnancy are needed.
                Bookmark

                Author and article information

                Journal
                The Journal of Infectious Diseases
                Oxford University Press (OUP)
                0022-1899
                1537-6613
                July 15 2017
                July 15 2017
                July 27 2017
                July 15 2017
                July 15 2017
                July 27 2017
                : 216
                : suppl_2
                : S389-S395
                Affiliations
                [1 ] Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, and Magee-Womens Research Institute, Pittsburgh, Pennsylvania;
                [2 ] Departments of Epidemiology and Global Health, Center for AIDS and STD, University of Washington, Seattle
                Article
                10.1093/infdis/jix198
                5853983
                28838078
                b127a388-2d67-4390-a514-c16fd35c2161
                © 2017
                History

                Comments

                Comment on this article