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RESEARCH ARTICLE

Prevalence and correlates of Mycoplasma genitalium infection among prostatitis patients in Shanghai, China

Xiaohui Mo A C , Caixia Zhu A , Jin Gan A , Chong Wang A , Fang Wei B , Weiming Gong D E and Qiliang Cai A E
+ Author Affiliations
- Author Affiliations

A Key Laboratory of Medical Molecular Virology (Ministries of Education and Health), Department of Etiology, School of Basic Medical Sciences, Fudan University, Shanghai 200032, China.

B ShengYushou Center of Cell Biology and Immunology, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai 200240, China.

C Central Laboratory, Shanghai Dermatology Hospital, Shanghai 200443, China.

D Department of STD Institute, Shanghai Dermatology Hospital, Shanghai 200443, China.

E Corresponding authors. Email: qiliang@fudan.edu.cn, gongweiming101@163.com

Sexual Health 13(5) 474-479 https://doi.org/10.1071/SH15155
Submitted: 4 August 2015  Accepted: 11 May 2016   Published: 4 July 2016

Abstract

Background: Mycoplasma genitalium (M. genitalium) has been shown to be involved in chronic non-gonococcal urethritis (NGU). However, the prevalence and determinants of this emerging sexually transmissible infection among prostatitis patients remain obscure. Methods: Two hundred and thirty-five patients diagnosed with prostatitis and 152 health controls from sexually transmitted diseases (STD) clinics in Shanghai, China, were selected. M. genitalium was detected in the initial voided urine (VB1), midstream of urine (VB2), expressed prostatic secretion (EPS) and the opening urine after massage (VB3) by quantitative polymerase chain reaction (Q-PCR) targeting the Mycoplasma genitalium adhesion protein (MgPa). An infection of the prostate was considered positive if a uropathogen was found only in the EPS sample or VB3, or if it was at least four-fold greater in EPS or VB3 than in VB1 or VB2. The prostatitis patients with M. genitalium infection were treated with azithromycin. Results: The prevalence of M. genitalium infection was significantly higher among the prostatitis group than the control group (10 vs 3%, P = 0.005). Among the prostatitis group, M. genitalium infection was significantly associated with those patients who received treatment for genitourinary infection previously than those patients who did not (17 vs 6%; adjusted OR, 4.011; 95% CI, 1.562–10.300). The symptoms were totally or partially improved in 83% per cent (19/23) of prostatitis patients with M. genitalium, positive in EPS and M. genitalium turned negative after azithromycin treatment. Conclusions: M. genitalium was prevalent in the patients with prostatitis, particularly in those who received ineffective antibiotic treatment for the bacterium, and was identified as having a significant association of prostatitis.

Additional keywords: diagnosis, PCR, transmissible infection.


References

[1]  Wagenlehner FM, Pilatz A, Bschleipfer T, Diemer T, Linn T, et al Bacterial prostatitis. World J Urol 2013; 31 711–6.
Bacterial prostatitis.Crossref | GoogleScholarGoogle Scholar | 23519458PubMed |

[2]  Krieger JN, Lee SWH, Jeon J, Cheah PY, Liong ML, et al Epidemiology of prostatitis. Int J Antimicrob Agents 2008; 31 85–90.
Epidemiology of prostatitis.Crossref | GoogleScholarGoogle Scholar |

[3]  Krieger JN, Riley DE, Cheah PY, Liong ML, Yuen KH. Epidemiology of prostatitis: new evidence for a world-wide problem. World J Urol 2003; 21 70–4.
Epidemiology of prostatitis: new evidence for a world-wide problem.Crossref | GoogleScholarGoogle Scholar | 12712363PubMed |

[4]  Tully J, Cole R, Taylor-Robinson D, Rose D. A newly discovered mycoplasma in the human urogenital tract. Lancet 1981; 317 1288–91.
A newly discovered mycoplasma in the human urogenital tract.Crossref | GoogleScholarGoogle Scholar |

[5]  Pepin J, Labbe AC, Khonde N, Deslandes S, Alary M, et al Mycoplasma genitalium: an organism commonly associated with cervicitis among West African sex workers. Sex Transm Infect 2005; 81 67–72.
Mycoplasma genitalium: an organism commonly associated with cervicitis among West African sex workers.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD2M%2FlsVWktA%3D%3D&md5=8ef20a2418ad37ed6c97b7d1bc0df636CAS | 15681727PubMed |

[6]  Taylor-Robinson D, Gilroy CB, Thomas BJ, Hay PE. Mycoplasma genitalium in chronic non-gonococcal urethritis. Int J STD AIDS 2004; 15 21–5.
Mycoplasma genitalium in chronic non-gonococcal urethritis.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD2c%2FmvVakug%3D%3D&md5=1938edb638b721e909e1aecdc9332bbaCAS | 14769166PubMed |

[7]  Horner PJ, Taylor-Robinson D. Association of Mycoplasma genitalium with balanoposthitis in men with non-gonococcal urethritis. Sex Transm Infect 2011; 87 38–40.
Association of Mycoplasma genitalium with balanoposthitis in men with non-gonococcal urethritis.Crossref | GoogleScholarGoogle Scholar | 20852310PubMed |

[8]  Taylor-Robinson D, Jensen JS, Svenstrup H, Stacey CM. Difficulties experienced in defining the microbial cause of pelvic inflammatory disease. Int J STD AIDS 2012; 23 18–24.
Difficulties experienced in defining the microbial cause of pelvic inflammatory disease.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BC383mtVSmsg%3D%3D&md5=9b9cccb36679813f27ca168d53f16fd7CAS | 22362682PubMed |

[9]  Doble A, Thomas B, Furr P, Walker M, Harris J, et al A search for infectious agents in chronic abacterial prostatitis using ultrasound guided biopsy. Br J Urol 1989; 64 297–301.
A search for infectious agents in chronic abacterial prostatitis using ultrasound guided biopsy.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK3c%2FivFeitw%3D%3D&md5=0c58c112f75ec6deddb4d9bb909d4ebdCAS | 2679961PubMed |

[10]  Mändar R, Raukas E, Türk S, Korrovits P, Punab M. Mycoplasmas in semen of chronic prostatitis patients. Scand J Urol Nephrol 2005; 39 479–82.
Mycoplasmas in semen of chronic prostatitis patients.Crossref | GoogleScholarGoogle Scholar | 16303724PubMed |

[11]  Taylor-Robinson D, Furr P. Failure of Mycoplasma pneumoniae infection to confer protection against Mycoplasma genitalium: observations from a mouse model. J Med Microbiol 2001; 50 383–4.
Failure of Mycoplasma pneumoniae infection to confer protection against Mycoplasma genitalium: observations from a mouse model.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3M7pvF2gug%3D%3D&md5=dca2bc7f0eedb47b8ebb1d9f833402e6CAS | 11289524PubMed |

[12]  Jensen JS, Hansen HT, Lind K. Isolation of Mycoplasma genitalium strains from the male urethra. J Clin Microbiol 1996; 34 286–91.
| 1:STN:280:DyaK28zotV2ruw%3D%3D&md5=fe8d27f0ce87bc432f424193068e5265CAS | 8789002PubMed |

[13]  Deguchi T, Yoshida T, Yokoi S, Ito M, Tamaki M, et al Longitudinal quantitative detection by real-time PCR of Mycoplasma genitalium in first-pass urine of men with recurrent nongonococcal urethritis. J Clin Microbiol 2002; 40 3854–6.
Longitudinal quantitative detection by real-time PCR of Mycoplasma genitalium in first-pass urine of men with recurrent nongonococcal urethritis.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BD38Xot1Gnurc%3D&md5=23db034374455d32314987e918e627b4CAS | 12354899PubMed |

[14]  Weinstein SA, Stiles BG. Recent perspectives in the diagnosis and evidence-based treatment of Mycoplasma genitalium. Expert Rev Anti Infect Ther 2012; 10 487–99.
Recent perspectives in the diagnosis and evidence-based treatment of Mycoplasma genitalium.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC38XlvVKht7k%3D&md5=cf87f052628f22717fcffdd12453f8acCAS | 22512757PubMed |

[15]  Hardick J, Giles J, Hardick A, Hsieh YH, Quinn T, et al Performance of the gen-probe transcription-mediated [corrected] amplification research assay compared to that of a multitarget real-time PCR for Mycoplasma genitalium detection. J Clin Microbiol 2006; 44 1236–40.
Performance of the gen-probe transcription-mediated [corrected] amplification research assay compared to that of a multitarget real-time PCR for Mycoplasma genitalium detection.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BD28XkvVanuro%3D&md5=85d3f15bbe2e0e5255678848fd9c2173CAS | 16597844PubMed |

[16]  Yoshida T, Deguchi T, Meda S, Kubota Y, Tamaki M, et al Quantitative detection of Ureaplasma parvum (biovar 1) and Ureaplasma urealyticum (biovar 2) in urine specimens from men with and without urethritis by real-time polymerase chain reaction. Sex Transm Dis 2007; 34 416–9.
| 17522569PubMed |

[17]  Twin J, Taylor N, Garland SM, Hocking JS, Walker J, et al Comparison of two Mycoplasma genitalium real-time PCR detection methodologies. J Clin Microbiol 2011; 49 1140–2.
Comparison of two Mycoplasma genitalium real-time PCR detection methodologies.Crossref | GoogleScholarGoogle Scholar | 21209170PubMed |

[18]  McKechnie ML, Hillman R, Couldwell D, Kong F, Freedman E, et al Simultaneous identification of 14 genital microorganisms in urine by use of a multiplex PCR-based reverse line blot assay. J Clin Microbiol 2009; 47 1871–7.
Simultaneous identification of 14 genital microorganisms in urine by use of a multiplex PCR-based reverse line blot assay.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BD1MXosVeitr0%3D&md5=15af919766d18c7dc901a0812ccbef48CAS | 19357202PubMed |

[19]  Yoshida T, Deguchi T, Ito M, Maeda S, Tamaki M, et al Quantitative detection of Mycoplasma genitalium from first-pass urine of men with urethritis and asymptomatic men by real-time PCR. J Clin Microbiol 2002; 40 1451–5.
Quantitative detection of Mycoplasma genitalium from first-pass urine of men with urethritis and asymptomatic men by real-time PCR.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BD38XjtlCms7k%3D&md5=06373de07bfde272f52b8096ec55f36dCAS | 11923372PubMed |

[20]  Jensen JS, Bjornelius E, Dohn B, Lidbrink P. Use of TaqMan 5ʹ nuclease real-time PCR for quantitative detection of Mycoplasma genitalium DNA in males with and without urethritis who were attendees at a sexually transmitted disease clinic. J Clin Microbiol 2004; 42 683–92.
Use of TaqMan 5ʹ nuclease real-time PCR for quantitative detection of Mycoplasma genitalium DNA in males with and without urethritis who were attendees at a sexually transmitted disease clinic.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BD2cXit1SktLw%3D&md5=9e1016040a606a529e512f6293478922CAS | 14766837PubMed |

[21]  Meares EM, Stamey TA. Bacteriologic localization patterns in bacterial prostatitis and urethritis. Invest Urol 1968; 5 492-518
| 4870505PubMed |

[22]  Yoshida T, Maeda S-I, Deguchi T, Miyazawa T, Ishiko H. Rapid detection of Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma parvum, and Ureaplasma urealyticum organisms in genitourinary samples by PCR-microtiter plate hybridization assay. J Clin Microbiol 2003; 41 1850–5.
Rapid detection of Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma parvum, and Ureaplasma urealyticum organisms in genitourinary samples by PCR-microtiter plate hybridization assay.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BD3sXktlGrsro%3D&md5=a4d6161234249859f54025feb6b221b0CAS | 12734216PubMed |

[23]  Lee SR, Chung JM, Kim YG. Rapid one step detection of pathogenic bacteria in urine with sexually transmitted disease (STD) and prostatitis patient by multiplex PCR assay (mPCR). J Microbiol 2007; 45 453–9.
| 1:CAS:528:DC%2BD2sXhsVanu7%2FL&md5=89c4297b90058fd8510d828ed06e2ef8CAS | 17978806PubMed |

[24]  Robertson J, Vekris A, Bebear C, Stemke G. Polymerase chain reaction using 16S rRNA gene sequences distinguishes the two biovars of Ureaplasma urealyticum. J Clin Microbiol 1993; 31 824–30.
| 1:CAS:528:DyaK3sXktVWrtbg%3D&md5=64db31737b17909bcdbddf1f02766559CAS | 7681846PubMed |

[25]  Weinstein SA, Stiles BG. A review of the epidemiology, diagnosis and evidence-based management of Mycoplasma genitalium. Sex Health 2011; 8 143–58.
A review of the epidemiology, diagnosis and evidence-based management of Mycoplasma genitalium.Crossref | GoogleScholarGoogle Scholar | 21592428PubMed |

[26]  Yokoi S, Maeda S, Kubota Y, Tamaki M, Mizutani K, et al The role of Mycoplasma genitalium and Ureaplasma urealyticum biovar 2 in postgonococcal urethritis. Clin Infect Dis 2007; 45 866–71.
The role of Mycoplasma genitalium and Ureaplasma urealyticum biovar 2 in postgonococcal urethritis.Crossref | GoogleScholarGoogle Scholar | 17806051PubMed |

[27]  Khatib N, Bradbury C, Chalker V, Koh G, Smit E, et al Prevalence of Trichomonas vaginalis, Mycoplasma genitalium and Ureaplasma urealyticum in men with urethritis attending an urban sexual health clinic. Int J STD AIDS 2015; 26 388–92.
Prevalence of Trichomonas vaginalis, Mycoplasma genitalium and Ureaplasma urealyticum in men with urethritis attending an urban sexual health clinic.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BC2cfhvVeguw%3D%3D&md5=bff6e864b26cb1e7957b2de553cef3ecCAS | 24925897PubMed |

[28]  Dickson G. Prostatitis: diagnosis and treatment. Aust Fam Physician 2013; 42 216–9.
| 23550248PubMed |

[29]  Daley G, Russell D, Tabrizi S, McBride J. Mycoplasma genitalium: a review. Int J STD AIDS 2014; 25 475–87.
Mycoplasma genitalium: a review.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BC2cvjvFSruw%3D%3D&md5=2be063a1b1820f8e97a48092b5a6e8e0CAS | 24517928PubMed |

[30]  Jernberg E, Moghaddam A, Moi H. Azithromycin and moxifloxacin for microbiological cure of Mycoplasma genitalium infection: an open study. Int J STD AIDS 2008; 19 676–9.
Azithromycin and moxifloxacin for microbiological cure of Mycoplasma genitalium infection: an open study.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD1cnjtlGrtg%3D%3D&md5=b10c12b928813acc86e25928691f32f1CAS | 18824619PubMed |