Mycoplasma Genitalium (MG) Infections in Canadian Women with Chlamydia Trachomatis (CT) and/or Neisseria Gonorrhoeae (NG)

Chernesky, Max

Thursday, September 22, 2016: 3:00 PM

Salon A

Max Chernesky, PhD¹, Dan Jang, BSc², Jodi Gilchrist, BSc, MSc¹, Linda Hoang, MD³, Prenilla Naidu, MD, FRCPC⁴, Paul Levett, PHD⁵, John Wylie, PhD⁶, Anu Rebbapragada, PhD⁷, Todd Hatchette, MD⁸, Ameeta Singh, BMBS, MSc, FRCPC⁹, Ron Read, MD/PhD¹⁰, Petra Smyczek, MD PhD FRCPC¹¹, Sam Ratnam, PhD¹², Paul Vancaeseele, MD¹³, Annie-Claude Labbe, MD¹⁴, Damon Getman, PhD¹⁵, Marek Smieja, MD, PhD¹ and Irene Martin, BSC¹⁶, 1St. Joseph's Healthcare/McMaster University, Hamilton, ON, Canada, 2Research, St. Joseph's Healthcare/McMaster University, Hamilton, ON, Canada, 3British Columbia Centre for Disease Control, Vancouver, BC, Canada, 4Bacteriology, Provincial Laboratory for Public Health, Alberta Health Services, Edmonton, AB, Canada, 5Saskatchewan Disease Control Laboratory, 6Cadham Provincial Laboratory, University of Manitoba, Winnipeg, MB, Canada, 7Dynacare, Brampton, ON, Canada, 8Dalhousie University, Halifax, NS, Canada, 9Division of Infectious Diseases, University of Alberta, Edmonton, AB, Canada, 10Alberta Health Services, Edmonton, AB, Canada, 11STI Services, Alberta Health Services, Edmonton, AB, Canada, 12Public Health Laboratory, Eastern Health, St. John's, NF, Canada, 13Cadham Provincial Laboratory, Winnipeg, MB, Canada, 14University of Montreal, Montreal, QC, Canada, 15Research and Development, Women's Health Diagnostics, Hologic Inc, San Diego, CA, 16National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada

Background: Mycoplasma genitalium (MG) is an emerging sexually transmitted infection, implicated in non-gonococcal, non-chlamydial urethritis and cervicitis. There are minimal data on MG infections in Canada. A research use only (RUO)-based test using transcription mediated amplification (TMA), which is compatible with specimens collected into transport media tested for CT and NG by the Aptima Combo 2 (AC2) assay (Hologic) was used to examine infections in women with CT and NG. The objectives were to determine provincial infection rates and examine MG positives for macrolide resistance.

Methods: During 2015, eight diagnostic laboratories across Canada performing AC2 testing on Panther or Tigris instruments, selected remnant Aptima cervical swabs (CS), vaginal swabs (VS), or first void urine (FVU) samples positive for CT and/or NG matched with negatives within the same age group of women. Samples were tested with the MG RUO test and positives were retested with an MG alternate TMA research test. Positives were tested for 23s rRNA mutations conferring macrolide resistance.

Results: To date, 417 cervical, 537 urines, and 9 vaginal samples have been tested with 8.1% (78/963) MG positive, and 71.8% (56/78) were in women infected with CT and/or NG. Positivity rates by province were: BC 11%, AB 7.4%, SK 20%, MB 16%, ON 5%, QC 3%, NS and NL 1.9%. Specimen detection rates were 7.7% (32/417) from CS, 8.6% (46/537) from FVU and 0% (0/9) from VS. Of 78 samples tested, 67 were 23s PCR positive and 23 (34.3%) showed macrolide resistance, with an unequal distribution across the country.

Conclusions: Testing Aptima remnant specimens with an MG RUO TMA test demonstrated an overall positivity rate of 8.1% with a 34.3% macrolide resistance rate. The majority of infections were in women infected with CT and/or NG. Further studies are required to explore geographic differences in infection and macrolide resistance.

4A1 Mycoplasma Genitalium (MG) Infections in Canadian Women with Chlamydia Trachomatis (CT) and/or Neisseria Gonorrhoeae (NG)