Prevalence of Bacterial Sexually Transmitted Infections and Their Coinfections Among MSM in Mexico City

Sexually transmitted infections remain a major public health concern among men who have sex with men (MSM), particularly due to the high frequency of coinfections and the limitations of syndromic management. This study aimed to describe the frequency of bacterial sexually transmitted and urogenital pathogens among symptomatic MSM attending two specialized sexual health clinics in Mexico City. A prospective cross-sectional study was conducted with 150 adult MSM presenting symptoms suggestive of urethritis. Urethral swab samples were analyzed using a multiplex real-time polymerase chain reaction (PCR) assay for the detection of Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma urealyticum, Ureaplasma parvum, and Trichomonas vaginalis. At least one pathogen was detected in 91/150 participants (60.7%). N. gonorrhoeae was the most frequent pathogen (33.3%), followed by U. urealyticum (15.3%), M. genitalium (9.3%), and C. trachomatis (9.3%). Coinfections were identified in 15 participants, representing 10.0% of the total population and 16.5% of those with a positive PCR result. Most coinfections involved N. gonorrhoeae, particularly with C. trachomatis. These findings provide descriptive microbiological evidence on the frequency and coinfection patterns of bacterial sexually transmitted infections (STIs) associated pathogens among symptomatic MSM attending specialized sexual health clinics in Mexico City. The high detection rate and occurrence of concurrent infections highlight the limitations of syndromic management and support the value of timely multiplex molecular diagnostics to improve etiological characterization, antimicrobial stewardship, and clinical decision-making in this population.