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A case-control study of men with non-gonococcal urethritis at Auckland Sexual Health Service: rates of detection of Mycoplasma genitalium

Jackie Hilton A B , Sunita Azariah A and Murray Reid A
+ Author Affiliations
- Author Affiliations

A Greenlane Clinical Centre, Greenlane West Road, Private Bag 92024, Auckland, New Zealand.

B Corresponding author. Email:

Sexual Health 7(1) 77-81
Submitted: 25 August 2009  Accepted: 24 November 2009   Published: 15 February 2010


Background: Previous studies have identified Mycoplasma genitalium as a cause of urethritis in men. As there is no New Zealand data, a case-control study was conducted to determine whether this organism is a significant cause of urethritis in men presenting to Auckland Sexual Health Service. Methods: Enrolment for the study commenced in March 2006 and finished in February 2008. Inclusion criteria for cases of non-gonococcal urethritis were onset of urethritis symptoms within one month confirmed by urethral Gram staining showing ≥10 polymorphonuclear leucocytes per high-powered field. Controls were men presenting during the same time period for asymptomatic sexual health screening. All participants were tested for Neisseria gonorrhoeae, M. genitalium, and Chlamydia trachomatis. Information regarding symptoms, sexual behaviour and treatment was collected using a standard questionnaire. Results: We recruited 209 cases and 199 controls with a participation rate of 96%. The prevalence of C. trachomatis and M. genitalium in non-gonococcal urethritis cases was 33.5% and 10% respectively. Co-infection with these organisms was uncommon (1.9%). C. trachomatis and M. genitalium were diagnosed in 4% and 2% of controls, respectively, and both infections were detected significantly less often than in the cases (P < 0.0001, P < 0.005). Cases were more likely to report inconsistent condom use, multiple sexual contacts and not having sexual intercourse in the last week (P = 0.03, P = 0.02, P = 0.03). A past history of non-gonococcal urethritis was a significant predictor of current symptoms (P < 0.0001). Conclusions: This is the first study to investigate M. genitalium infection in New Zealand men. Our results confirm that M. genitalium is a cause of non-gonococcal urethritis in men presenting to our service.

Additional keyword: New Zealand.


The authors acknowledge the contribution of their nursing and clinical colleagues to the study. The authors also acknowledge the contribution of Sepehr Tabrizi and his laboratory at the Department of Microbiology, The Royal Women’s Hospital, Melbourne, Victoria, Australia.


[1] Tully JG,  Taylor-Robinson D,  Cole RM,  Rose DL. A newly diagnosed mycoplasma in the human urogenital tract. Lancet 1981; 371 1288–91.
CrossRef |

[2] Cohen CR,  Mugo NR,  Astete SG,  Odondo R,  Manhart LE,  Kiehlbauch JA, et al. Detection of Mycoplasma genitalium in women with laparoscopically diagnosed acute salpingitis. Sex Transm Infect 2005; 81 463–6.
CrossRef | CAS | PubMed |

[3] Simms I,  Eastick K,  Mallinson H,  Thomas K,  Gokhale R,  Hay P, et al. Associations between Mycoplasma genitalium, Chlamydia trachomatis, and pelvic inflammatory disease. Sex Transm Infect 2003; 79 154–6.
CrossRef | CAS | PubMed |

[4] Taylor-Robinson D. Mycoplasma genitalium – an update. Int J STD AIDS 2002; 13 145–51.
CrossRef | PubMed |

[5] Falk L,  Fredlund H,  Jensen JS. Symptomatic urethritis is more prevalent in men infected with Mycoplasma genitalium than with Chlamydia trachomatis. Sex Transm Infect 2004; 80 289–93.
CrossRef | CAS | PubMed |

[6] Anagrius C,  Lore B,  Jensen JS. Mycoplasma genitalium: Prevalence, clinical significance, and transmission. Sex Transm Infect 2005; 81 458–62.
CrossRef | CAS | PubMed |

[7] Leung A,  Eastick K,  Haddon LE,  Horn CK,  Ahuja D,  Horner PJ. Mycoplasma genitalium is associated with symptomatic urethritis. Int J STD AIDS 2006; 17 285–8.
CrossRef | CAS | PubMed |

[8] Taylor-Robinson D,  Gilroy CB,  Thomas BJ,  Hay PE. Mycoplasma genitalium in chronic non-gonococcal urethritis. Int J STD AIDS 2004; 15 21–5.
CrossRef | CAS | PubMed |

[9] Wikstrom A,  Jensen JS. Mycoplasma genitalium: A common cause of persistent urethritis among men treated with doxycycline. Sex Transm Infect 2006; 82 276–9.
CrossRef | CAS | PubMed |

[10] Uusküla A,  Kohl PK. Genital mycoplasmas, including Mycoplasma genitalium, as sexually transmitted agents. Int J STD AIDS 2002; 13 79–85.
CrossRef | PubMed |

[11] Deguchi T,  Maeda S-I. Mycoplasma genitalium: Another important pathogen of non-gonococcal urethritis. J Urol 2002; 167 1210–7.
CrossRef | PubMed |

[12] Yoshida T,  Deguchi T,  Ito M,  Maeda S,  Tamaki M,  Ishiko H. 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.
CrossRef | CAS | PubMed |

[13] Gambini D,  Decleva I,  Lupica L,  Ghislanzoni M,  Cusini M,  Alessi E. Mycoplasma genitalium in males with nongonococcal urethritis: Prevalence and clinical efficacy of eradication. Sex Transm Dis 2000; 27 226–9.
CrossRef | CAS | PubMed |

[14] Mena L,  Wang X,  Mroczkowski TF,  Martin DH. Mycoplasma genitalium infections in asymptomatic men and men with urethritis attending a sexually transmitted disease clinic in New Orleans. Clin Infect Dis 2002; 35 1167–73.
CrossRef | PubMed |

[15] Bradshaw CS,  Tabrizi SN,  Read TRH,  Garland SM,  Hopkins CA,  Moss LM, et al. Etiologies of nongonococcal urethritis: Bacteria, viruses, and the association with orogenital exposure. J Infect Dis 2006; 193 336–45.
CrossRef | PubMed |

[16] Bjornelius E,  Anagrius C,  Bojs G,  Carlberg H,  Johannisson G,  Johansson E, et al. Antibiotic treatment of symptomatic Mycoplasma genitalium infection in Scandinavia: A controlled clinical trial. Sex Transm Infect 2008; 84 72–6.
CrossRef | CAS | PubMed |

[17] Mena LA,  Mroczkowski TF,  Nsuami M,  Martin DH. A randomized comparison of azithromycin and doxycycline for the treatment of Mycoplasma genitalium-positive urethritis in men. Clin Infect Dis 2009; 48 1649–54.
CrossRef | CAS | PubMed |

[18] Bradshaw CS,  Jorgen S,  Jensen JS,  Tabrizi SN,  Read TRH,  Garland SM, et al. Azithromycin failure in Mycoplasma genitalium urethritis. Emerg Infect Dis 2006; 12 1149–51.
CAS | PubMed |

[19] Lawton BA,  Rose SB,  Bromhead C,  Gaitanos E,  MacDonald EJ,  Lund KA. High prevalence of Mycoplasma genitalium in women presenting for termination of pregnancy. Contraception 2008; 77 294–8.
CrossRef | PubMed |

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