Comparative Epidemiology and Co-Detection of Mycoplasma genitalium and Mycoplasma hominis in Adult Urogenital PCR Testing.

Urogenital multiplex polymerase chain reaction (PCR) panels report Mycoplasma genitalium (MG) and Mycoplasma hominis (MH) similarly despite different clinical significance. We retrospectively analyzed 176,855 adult specimen-level laboratory records (2018-2022). MG and MH were compared using modified Poisson regression and a year-adjusted stacked interaction model. MG was detected in 4215 records (2.38%) and MH in 8024 (4.54%). MG prevalence fell from 4.48% (95% confidence interval (CI), 4.30-4.68) at 18-29 years to 0.21% (0.16-0.27) at ≥60 years, whereas MH fell from 5.70% to 2.39%. Female sex was associated with lower MG (adjusted prevalence ratio [aPR], 0.32) and higher MH (1.44). Age and sex gradients differed significantly (interaction PRs, 1.519 and 4.653; both p < 0.001), whereas no specimen-type interaction reached significance (all p ≥ 0.19). No other target was positive in 52.1% of MG-positive versus 54.5% of MG-negative records, but in 4.9% of MH-positive versus 55.7% of MH-negative records. MH co-detection was strongest with Gardnerella vaginalis (aPR, 9.94), Ureaplasma urealyticum (6.12), and Trichomonas vaginalis (5.48). These profiles support target-specific reporting. Cross-panel analytical differences cannot be excluded because MG and MH were measured on different panels.