Features Associated With Mycoplasma genitalium Infection

Background Sexually transmitted infections (STIs) are commonly encountered in the emergency department (ED) in the United States. Limited data exist on the prevalence and risk factors for Mycoplasma genitalium (M. genitalium), specifically within the ED. We describe the epidemiological and laboratory findings associated with M. genitalium infection at the Mayo Clinic, the whole institution, and specifically in the ED. Methods We examined Mayo Clinic Enterprise data for encounters occurring between October 29, 2014, and September 23, 2023, in patients 12-120 years of age who had research authorization present and had testing for gonorrhea, chlamydia, trichomonas, and M. genitalium. Results Among 332,619 encounters, M. genitalium testing occurred in 1.7% (n=5,572) of encounters, in which a positive M. genitalium test occurred in 1.8% (n=103) of those tested. Since 2020, there has been an increasing trend for M. genitalium testing in the ED in the United States, yet testing for M. genitalium occurred in <1% of those being tested for other STIs in the ED. M. genitalium coinfection in the ED with gonorrhea, chlamydia, or trichomonas occurred <1% of the time for all. Factors significant for M. genitalium infection were non-White race (OR 2.33 95% CI (1.50-3.37)), age 45-101 years (vs. 25-35 years) (0.16 (0.05-0.42)), age 36-44 (vs. 25-35 years) (0.47 (0.21-0.94)), married/life partner (vs. divorced, separated, widowed, or unknown) (0.27 (0.11-0.72)), being tested in the ED (versus inpatient and outpatient) and infection with Ureaplasma species (3.19 (1.10-9.86)); p<0.04 for all. Conclusion M. genitalium is infrequently tested in the ED, yet those tested in the ED had a high association with a positive infection. We identified other risk factors for M. genitalium infection, including non-White race, age, marital status, and infection with Ureaplasma species.