Prevalence of <i>Mycoplasma genitalium</i> and other sexually transmitted infections causing urethritis among high-risk heterosexual male patients in Estonia

Background: We aimed to evaluate the prevalence of sexually transmitted infections (STI, including Mycoplasma genitalium, Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis) among high-risk heterosexual male patients and to clarify their potency to cause complaints and inflammation. Methods: The study group included 825 men (18.0–49.5 y) consulting andrologist at Tartu University Hospital (Estonia) due to subjectively perceived risk of STI. Patients completed STI risk behaviour questionnaire. First voided urine was analysed for white blood cells and STIs. Results: In total 193 (23.4%) patients were positive for one or multiple STI. The prevalence of C. trachomatis, M. genitalium, N. gonorrhoeae, T. vaginalis and combined STI was 14.3%, 4.4%, 2.7%, 0.7% and 1.3%, respectively. N. gonorrhoeae had the highest potency to generate inflammatory reaction in first voided urine (100%) followed by C. trachomatis (72.0%), M. genitalium (63.9%) and T. vaginalis (33.3%). N. gonorrhoeae and T. vaginalis caused the highest mean number of complaints while half of T. vaginalis cases and nearly fifth of M. genitalium and C. trachomatis cases were asymptomatic. Conclusions:C. trachomatis has the highest prevalence among Estonian high-risk men but M. genitalium holds an important second place. Prevalence of combined STIs is low. N. gonorrhoeae has the highest potency to generate urethral inflammation followed by C. trachomatis and M. genitalium. The highest number of complaints is also associated with N. gonorrhoeae while half of T. vaginalis cases and nearly a fifth of M. genitalium and C. trachomatis cases are asymptomatic.背景：本研究旨在评估高危异性恋男性患者群体中性传播感染（Sexually Transmitted Infections, STI，包括生殖支原体（Mycoplasma genitalium）、沙眼衣原体（Chlamydia trachomatis）、淋病奈瑟菌（Neisseria gonorrhoeae）、阴道毛滴虫（Trichomonas vaginalis））的检出率，并明确上述病原体引发临床症状与炎症的能力。 方法：本研究队列纳入825名年龄18.0~49.5岁的男性，他们因主观感知存在STI感染风险，前往爱沙尼亚塔尔图大学医院男科就诊。所有患者完成了STI风险行为调查问卷，采集首段尿样检测白细胞计数与STI相关标志物。 结果：总计193例（23.4%）患者检出1种或多种STI阳性。沙眼衣原体、生殖支原体、淋病奈瑟菌、阴道毛滴虫及混合STI的检出率分别为14.3%、4.4%、2.7%、0.7%与1.3%。淋病奈瑟菌引发首段尿样炎症反应的能力最强（100%），其次为沙眼衣原体（72.0%）、生殖支原体（63.9%）与阴道毛滴虫（33.3%）。淋病奈瑟菌与阴道毛滴虫引发的平均临床症状数量最多；而半数阴道毛滴虫感染病例、近五分之一生殖支原体与沙眼衣原体感染病例为无症状感染。 结论：在爱沙尼亚高危男性群体中，沙眼衣原体的STI检出率最高，生殖支原体则位居第二位且具有重要临床意义。混合STI的检出率较低。淋病奈瑟菌引发尿道炎的能力最强，其次为沙眼衣原体与生殖支原体。淋病奈瑟菌相关的平均临床症状数量也最多，而半数阴道毛滴虫感染病例、近五分之一生殖支原体与沙眼衣原体感染病例为无症状感染。