Mycoplasma genitalium and Bacterial Vaginosis-Associated Bacteria in a Non-Clinic-Based Sample of African American Women

Background Mycoplasma genitalium is associated with adverse reproductive problems. However, prevalence estimates from studies that screen women not seeking care are rare. Studies have reported co-occurrence of M. genitalium with bacterial vaginosis (BV), but no prior study of specific BV-associated bacteria has been conducted in African Americans whose reproductive tract infection burden is high. Methods Using quantitative polymerase chain reaction, we screened vaginal swabs for M. genitalium, 9 BV-associated bacteria, and 4 Lactobacillus species from 200 participants drawn from a cohort of African Americans 23 to 35 years old. Sexual history, herpes serostatus, and Nugent score had been assessed. Prevalence of M. genitalium was computed. The associations of other vaginal bacteria with M. genitalium were examined with binomial regression. Results M. genitalium prevalence was 18%. Detection and quantity of 2 BV-associated bacteria were significantly associated with a higher prevalence of M. genitalium (Leptotrichia/Sneathia: detection prevalence ratio (PR) of 2.9 [95% confidence interval {CI}, 1.1-7.7] and quantity PR of 1.2 [95% CI, 1.0-1.3]; Megasphaera phylotype 1: detection PR of 2.2 [95% CI, 1.2-4.2] and quantity PR of 1.1 [95% CI, 1.0-1.2]). Increased quantity of L. iners was also positively associated with M. genitalium (PR, 1.3 [95% CI, 1.0-1.8]). Nugent >= 7, herpes serostatus, and lifetime number of sex partners were not associated with M. genitalium. Conclusions Specific BV-associated microbes and L. iners were associated with M. genitalium, but Nugent >= 7 was not. Studies are needed to confirm a high prevalence of M. genitalium in African Americans and to understand its interactions with other vaginal bacteria.

Automated summary

The prevalence of Mycoplasma genitalium was found to be 18% among African American women aged 23-35 years old. Specific BV-associated microbes, including Leptotrichia/Sneathia and Megasphaera phylotype 1, were significantly associated with a higher prevalence of M. genitalium. Increased quantity of L. iners was also positively associated with M. genitalium, while Nugent score, herpes serostatus, and lifetime number of sex partners showed no association. Further studies are needed to confirm these findings and understand the interactions between M. genitalium and other vaginal bacteria in African American women.