LAUSR

BACKGROUND Mycoplasma genitalium infection can adversely affect female reproductive health, but data are limited about prevalence and characteristics of the infection in female adolescents. We employed a sensitive assay to detect M.genitalium infection and we describe its characteristics in a clinical sample of females aged <21 years. METHODS We recruited females aged 13-20 years in children's hospital clinics whose clinicians were testing for chlamydia/gonorrhea. Participants completed a questionnaire providing demographics, sexual history, and current symptoms. Urine/endocervical samples were tested for chlamydia/gonorrhea and partitioned for M.genitalium testing using Aptima M.genitalium assay. We reviewed records for the clinic visit to document examination, diagnosis, and results of STI testing. We compared prevalence of M.genitalium infection by demographics, sexual history, symptoms, and signs. RESULTS Of 153 participants mean age 18.07 ± 1.68 years, 58% self-identified as Hispanic, 27% Black, 64% straight/heterosexual, 27% bisexual, 1% gay/lesbian, 29% reported a prior STI diagnosis. Prevalence of M.genitalium was 11.1% (17/153), 13/17 were asymptomatic, 2/17 had PID, 3/17 co-infected with chlamydia or gonorrhea. Prevalence of chlamydia was 6.6%, and of gonorrhea 2.6%. A logistic regression model indicated independent associations of bisexual orientation vs all other orientations (aOR = 4.80; 95%CI = 1.38-16-67), self-reported prior STI (aOR = 3.83; 95%CI = 1.10-13.37) and self-reported prior PID (aOR = 9.12; 95%CI = 1.02-81.72) with higher odds of M.genitalium infection. CONCLUSIONS Findings suggest that in at-risk female populations aged <21 years, M.genitalium is a prevalent STI and symptomatic adolescents may warrant testing and treatment. Further study of harms and benefits of testing asymptomatic bisexual female adolescents or those with prior STI/PID is needed.