{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T19:03:05Z","timestamp":1785006185033,"version":"3.55.0"},"reference-count":26,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2024,8,1]],"date-time":"2024-08-01T00:00:00Z","timestamp":1722470400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Public funding","award":["Not applicable"],"award-info":[{"award-number":["Not applicable"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2024,5,8]]},"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:sec>\n<jats:title>Objectives<\/jats:title>\n<jats:p>\nWhile\n<jats:italic>Mycoplasma genitalium<\/jats:italic>\nis reported as a common rectal infection among men who have sex with men (MSM), published data refer predominantly to urethral infections. Currently, most guidelines recommend\n<jats:italic>M. genitalium<\/jats:italic>\ntesting from urine in men with symptomatic, non-gonococcal urethritis. Macrolide resistance-associated mutations (MRMs) among\n<jats:italic>M. genitalium<\/jats:italic>\nhave increased during the last decade especially among MSM. We aim to demonstrate the prevalence and anatomical distribution of\n<jats:italic>M. genitalium<\/jats:italic>\ninfection and MRM in urine and rectal specimens among MSM in Sweden.\n<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>\nIn this cross-sectional study in 2019, paired urine and rectal samples from symptomatic and asymptomatic MSM attending a sexually transmitted infection clinic in the south of Sweden were screened for\n<jats:italic>M. genitalium<\/jats:italic>\n, presence of MRM,\n<jats:italic>Neisseria gonorrhoeae<\/jats:italic>\n,\n<jats:italic>Chlamydia trachomatis<\/jats:italic>\n, HIV and syphilis.\n<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>\nThe overall prevalence of\n<jats:italic>M. genitalium<\/jats:italic>\nwas 10.5% (64 of 609), rectal samples 7.6% (46 of 609) and urine samples 3.9% (24 of 609) (p=0.007). Among\n<jats:italic>M. genitalium<\/jats:italic>\n-positive cases, single rectal and single urethral infection was detected in 62.5% (40 of 64) and 28.1% (18 of 64), respectively (p&lt;0.0001). Infection at both sites was seen in 9.4% (6 of 64). The prevalence of MRM was 67.9% (19 of 28).\n<jats:italic>M. genitalium<\/jats:italic>\nwas significantly associated with HIV (OR 2.60, 95% CI 1.14 to 5.88, p=0.02). Among the MSM, 7.4% (45 of 609) were infected with\n<jats:italic>N. gonorrhoeae,<\/jats:italic>\n6.7% (41 of 609) with\n<jats:italic>C. trachomatis<\/jats:italic>\n, 7.1% (43 of 609) with HIV and 0.7% (4 of 609) with syphilis.\n<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>\nIn this study, among MSM, most infections with\n<jats:italic>M. genitalium<\/jats:italic>\nwere detected as rectal mono infections. The prevalence of\n<jats:italic>M. genitalium<\/jats:italic>\namong MSM was almost twofold higher in rectal samples (7.6%) compared with urine samples (3.9%). The prevalence of macrolide resistance was high with no difference between urine and rectal samples.\n<\/jats:p>\n<\/jats:sec>","DOI":"10.1136\/sextrans-2023-056044","type":"journal-article","created":{"date-parts":[[2024,8,1]],"date-time":"2024-08-01T17:24:45Z","timestamp":1722533085000},"page":"430-434","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":12,"title":["Prevalence of\n<i>Mycoplasma genitalium<\/i>\nand macrolide resistance in rectal and urine samples among men who have sex with men in Sweden"],"prefix":"10.1136","volume":"100","author":[{"given":"Carina","family":"Bjartling","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Kertes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0584-5574","authenticated-orcid":false,"given":"Sinja","family":"Kristiansen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annika","family":"Johnsson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ola","family":"Forslund","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,8,1]]},"reference":[{"key":"2024101702550756000_100.7.430.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.idc.2023.02.009"},{"key":"2024101702550756000_100.7.430.2","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jix145"},{"key":"2024101702550756000_100.7.430.3","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2019-054310"},{"key":"2024101702550756000_100.7.430.4","doi-asserted-by":"publisher","DOI":"10.3201\/eid2504.181258"},{"key":"2024101702550756000_100.7.430.5","doi-asserted-by":"crossref","DOI":"10.1186\/s12879-020-4831-4","article-title":"STI in times of PrEP: high prevalence of chlamydia, gonorrhea, and mycoplasma at different anatomic sites in men who have sex with men in Germany","volume":"20","author":"Jansen","year":"2020","journal-title":"BMC Infect Dis"},{"key":"2024101702550756000_100.7.430.6","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(20)30154-7"},{"key":"2024101702550756000_100.7.430.7","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2017-053480"},{"key":"2024101702550756000_100.7.430.8","doi-asserted-by":"crossref","unstructured":"Streeck H , Jansen K , Crowell TA , et al . HIV pre-exposure prophylaxis was associated with no impact on sexually transmitted infection prevalence in a high-prevalence population of predominantly men who have sex with men. 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