Epidemiology of Mycoplasma genitalium Infections of the Genitourinary Tract Among Attendees of STI Clinic in Hangzhou, China

OBJECTIVE: This study aimed to investigate the prevalence, associated clinical manifestations, and co-infection patterns of Mycoplasma genitalium (MG) infection among patients attending Venereal Disease, Urology, and Gynecology clinics in Hangzhou, China. The findings provide foundational evidence to guide sexually transmitted infection (STI) screening in patients with genitourinary tract conditions. METHODS: Between January 2020 and December 2023, 12,934 outpatients from Hangzhou Third People's Hospital were tested for MG using isothermal amplification targeting the 16S rRNA gene. Concurrent testing for Neisseria gonorrhoeae (NG), Chlamydia trachomatis (CT), and Ureaplasma urealyticum (UU) was performed. RESULTS: Of these 12,934 patients, 589 tested positive for MG, yielding an overall prevalence of 4.55% (589/12,934). Prevalence was significantly higher in males (416/7915, 5.26%) than in females (173/5,019, 3.44%). Significant age-related differences were observed (p < 0.001), with the highest prevalence in patients ≤ 20 years 7.83% and the lowest in those > 60 years 0.57%. Of 416 MG-positive males, 295 (70.91%) exhibited symptoms of urethritis, prostatitis, and epididymitis. whereas 49.71% (86/173) of MG-positive females exhibited vaginitis, cervicitis, or pelvic inflammatory disease (p < 0.001). Symptomatic infection rates were significantly higher in males than in females. Co-infections were found in 44.31% (261/589) of MG-positive patients, with MG + UU co-infection being the most frequent 22.92% (135/589). CONCLUSIONS: MG infection prevalence in Hangzhou is substantial, with significantly higher rates among males and young adults (≤ 20 years). Females exhibit markedly lower symptomatic infection rates. MG demonstrates frequent co-infection, predominantly with UU, underscoring the necessity of multipathogen testing to prevent missed diagnoses.