Research article
'The difference in determinants of Chlamydia trachomatis and Mycoplasma genitalium in a sample of young Australian women.'
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* Corresponding authors: Jennifer Walker walker@unimelb.edu.au - Jane S Hocking jhocking@unimelb.edu.au
1 Centre for Women's Health, Gender and Society, School of Population Health, University of Melbourne, Victoria 3010, Australia
2 Sexual Health Unit, School of Population Health, University of Melbourne, Victoria 3010, Australia
3 Melbourne Sexual Health Centre, Alfred Health, Melbourne Victoria 3010, Australia
4 Department of Epidemiology and Preventive Medicine, Monash University, Melbourne Victoria, Australia
5 The Royal Women's Hospital, Parkville, Victoria, Australia
6 National Centre in HIV Epidemiology and Clinical Research, UNSW, Sydney, Australia
7 Family Planning Victoria, Melbourne, Australia
8 Monash Medical Centre. Department of Obstetrics and Gynaecology, Clayton, Victoria, Australia
9 Australian National University, Canberra, Australia
10 North Coast Medical Education Collaboration, Sydney School of Public Health, University of Sydney, Lismore, NSW, Australia
11 Primary Care Research Unit, Department of General Practice, University of Melbourne, Victoria 3010, Australia
12 Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, School of Population Health, University of Melbourne, Victoria 3010, Australia
13 St Mary's Hospital, Portsmouth, UK
14 Department of Obstetrics and Gynaecology, University of Melbourne, Victoria 3010, Australia
BMC Infectious Diseases 2011, 11:35 doi:10.1186/1471-2334-11-35
Published: 1 February 2011Abstract
Background
Differences in the determinants of Chlamydia trachomatis ('chlamydia') and Mycoplasma genitalium (MG) genital infection in women are not well understood.
Methods
A cohort study of 16 to 25 year old Australian women recruited from primary health care clinics, aimed to determine chlamydia and MG prevalence and incidence. Vaginal swabs collected at recruitment were used to measure chlamydia and MG prevalence, organism-load and chlamydia-serovar a cross-sectional analysis undertaken on the baseline results is presented here.
Results
Of 1116 participants, chlamydia prevalence was 4.9% (95% CI: 2.9, 7.0) (n = 55) and MG prevalence was 2.4% (95% CI: 1.5, 3.3) (n = 27). Differences in the determinants were found - chlamydia not MG, was associated with younger age [AOR:0.9 (95% CI: 0.8, 1.0)] and recent antibiotic use [AOR:0.4 (95% CI: 0.2, 1.0)], and MG not chlamydia was associated with symptoms [AOR:2.1 (95% CI: 1.1, 4.0)]. Having two or more partners in last 12 months was more strongly associated with chlamydia [AOR:6.4 (95% CI: 3.6, 11.3)] than MG [AOR:2.2 (95% CI: 1.0, 4.6)] but unprotected sex with three or more partners was less strongly associated with chlamydia [AOR:3.1 (95%CI: 1.0, 9.5)] than MG [AOR:16.6 (95%CI: 2.0, 138.0)]. Median organism load for MG was 100 times lower (5.7 × 104/swab) than chlamydia (5.6 × 106/swab) (p < 0.01) and not associated with age or symptoms for chlamydia or MG.
Conclusions
These results demonstrate significant chlamydia and MG prevalence in Australian women, and suggest that the differences in strengths of association between numbers of sexual partners and unprotected sex and chlamydia and MG might be due to differences in the transmission dynamics between these infections.