Gonococcal bacterial load in PrEP users with Mycoplasma genitalium coinfection

Christophe Van Dijck, Irith De Baetselier, Vicky Cuylaerts, Jozefien Buyze, Jolein Laumen, Bea Vuylsteke, Chris Kenyon

Research output: Contribution to journalA1: Web of Science-articlepeer-review


OBJECTIVES: Gonococcal infections with a higher bacterial load may pose a higher risk of transmission. We assessed the association between gonococcal bacterial load and coinfection with Mycoplasma genitalium.

METHODS: From September 2015 until May 2018, 200 men and transgender women who have sex with men participated in an HIV pre-exposure prophylaxis (PrEP) demonstration trial in Antwerp, Belgium. They underwent 3-monthly 3-site (anus, urine, and pharynx) molecular testing for N. gonorrhoeae and C. trachomatis and M. genitalium, irrespective of symptoms. Gonococcal bacterial load was determined on remnant DNA extracts using an in-house quantitative PCR. Results were expressed as log10 transformed copies/mL and analyzed with a linear regression model.

RESULTS: Gonococcal bacterial load could be determined for 82 (80.4%) of 102 anal, 17 (73.9%) of 23 urine, and 64 (90.1%) of 71 pharyngeal samples. M. genitalium was detected in five of these anal, two urine, and two pharyngeal samples and C. trachomatis was detected in 16 anal, one urine, and two pharyngeal samples. Gonococcal bacterial load was significantly higher in the presence of M. genitalium (difference 0.92 log copies/mL, 95% CI 0.16-1.67).

CONCLUSIONS: Gonococcal bacterial load was higher with M. genitalium coinfection. M. genitalium may thus be a cofactor in gonococcal transmission.

Original languageEnglish
JournalInternational Journal of STD & AIDS
Issue number2
Pages (from-to)129-135
Number of pages7
Publication statusPublished - 2022


  • Bacterial Load
  • Chlamydia Infections/complications
  • Chlamydia trachomatis/genetics
  • Coinfection/microbiology
  • Female
  • Humans
  • Male
  • Mycoplasma Infections/epidemiology
  • Mycoplasma genitalium/genetics
  • Prevalence
  • Urethritis/microbiology


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