Prevalence of Chlamydia trachomatis and Mycoplasma genitalium coinfections and M. genitalium antimicrobial resistance in rectal specimens

To the Editor-in-Chief It has recently been reported that 13% of men who have sex with men (MSM) attending a sexual health clinic were coinfected with Chlamydia trachomatis and Mycoplasma genitalium in the rectum,1 a site that has been described as a reservoir for asymptomatic M. genitalium infection.2 Public Health England’s (PHE) reference laboratory detects mutations associated with macrolide and fluoroquinolone resistance in M. genitalium and the lymphogranuloma venereum (LGV) genovars of C. trachomatis . In 2018, 2491 specimens were submitted to the reference laboratory for M. genitalium resistance testing where local assays were unavailable (488/2491 (19.6%) M . genitalium positive). Only 16 (0.6%) were documented from ano-rectal sites, probably because UK guidelines do not recommend asymptomatic screening for M. genitalium . …