Encore Presentations
Sunday, November 12, 2023
12:45 PM–02:15 PM
Abstract
Introduction
Mycoplasma genitalium is an emerging sexually transmitted (STI) in the United States. Symptomatic or asymptomatic urethritis, cervicitis, pelvic inflammatory disease, and obstetric complications associated with M. genitalium have prevalence rates ranging from 4% to 30%. Emergency Department (ED) providers play an essential role in the diagnosis and management of STIs. The 2021 Centers for Disease Control and Prevention STI Guidelines are the first domestic guidelines to address M. genitalium. These guidelines recommend testing in men with recurrent non-gonococcal urethritis and in women with recurrent cervicitis. First-line treatment options include doxycycline 100 mg twice daily for 7 days followed by either a 4-day course of azithromycin or a 7-day course of moxifloxacin for most patients. Treatment recommendations vary depending on availability of macrolide resistance testing.
Methods
This is a single-center, retrospective, descriptive study of adult ED patients with a positive Mycoplasma genitalium result from September 23, 2019 to May 31, 2021. The study describes the percentage of positive M. genitalium test results, patient demographics, patient symptoms and exam findings, rates of co-infection with other STIs, and treatment decisions. Additional analysis of positive M. genitalium results in patients who receive treatment versus those who do not is included. This analysis focuses on patient demographics, ED disposition status, and culture callback nurse documentation on the ability to contact the patient.
Results
A total of 355 patients were tested during the study period with a total of 402 tests. 229 total patients consisting of 260 unique tests were included in the analysis, indicating a 64.7% positive test rate. 87.3% of patient presented with at least one symptom, with only 36.9% of patients having a documented genitourinary examination. 43.8% of patients had a previous history of any STI with 14.2% of patients having had positive M. genitalium test in past. 35.8% of patients presented with co-infection with at least one other STI. Providers opted to treat in 86.2% of patient encounters with a doxycycline-azithromycin based regimen being most commonly prescribed. 87.5% of patients opted to be treated were able to be reached for treatment. Complete results will be presented.
Conclusion
Mycoplasma genitalium is commonly encountered in the ED setting. Patients often present symptomatically and may also be co-infected with other STIs. Providers frequently opted to treat with doxycycline-azithromycin based regimens. Screening and treatment for M. genitalium should be considered alongside other STIs.
Presenting Author
Bryan Gendron PharmD, BCPSBoston Medical Center
Authors
Sopheaktra Kong PharmD
Boston Medical Center
Anne Marie Guthrie PharmD, BCPS
Boston Medical Center
Natalija Farrell Pharm.D., BCPS, DABAT, FAACT
Boston Medical Center