Mycoplasma genitalium presence, resistance and epidemiology in Greenland

OBJECTIVES: Greenland reports the highest rates of chlamydial infection and gonorrhea in the Arctic. Our objective was to determine the presence, and describe the basic epidemiology, of Mycoplasma genitalium for Greenland. STUDY DESIGN: Cross-sectional study. METHODS: 314 residents from Nuuk and Sisimiut, between the ages of 15 and 65 years, participated in “Inuulluataarneq” (the Greenland Sexual Health Project) between July 2008 and November 2009. Participants provided self-collected samples for sexually transmitted infection (STI) testing and completed a sexual health survey. Descriptive statistics and logistic regression were used to summarize the basic characteristics of STI cases overall and M. genitalium and Chlamydia trachomatis specifically. Clinically relevant characteristics in each full model were gender (male or female), age (in years), age at sexual debut (in years), number of sexual partners in the past 3 months (continuous) and history of forced sex and community. RESULTS: The overall prevalence of STIs was 19.0%, specifically: 9.8% for M. genitalium and 9.4% for C. trachomatis; 100% of M. genitalium-positive cases carried macrolide resistance determinants. Being female [OR =3.2; 95% confidence interval (CI): 1.1–9.8] and younger age (OR=0.9; 95% CI: 0.9–1.0) were associated with M. genitalium positivity. Age was also associated with C. trachomatis (OR=0.9; 95% CI: 0.8–0.9) and STI positivity overall (OR=0.9; 95% CI: 0.9–0.9). CONCLUSIONS: We observed a high prevalence of M. genitalium and macrolide resistance in this study. A better understanding of M. genitalium sequelae is needed to inform policy around testing, treatment, control and antibiotic use.