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Mycoplasma genitalium is found in 1% to 3% of the general population, less commonly than Chlamydia trachomatis but more commonly than Neisseria gonorrhoeae.
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Strong and consistent evidence indicates that M genitalium causes nongonococcal urethritis in men.
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Building evidence links M genitalium with cervicitis, pelvic inflammatory disease, and infertility in women.
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Individuals infected with M genitalium have twice the risk of human immunodeficiency virus (HIV) infection and may be more likely to
Mycoplasma genitalium: An Emergent Sexually Transmitted Disease?
Section snippets
Key points
M genitalium: the bacterium
M genitalium is a bacterium of the Mollicutes class, characterized by the absence of a cell wall. As a result it is not detectable by Gram staining, and is not susceptible to cell wall synthesis–inhibiting antimicrobials such as penicillins, cephalosporins, or polypeptide/antimycobacterial antibiotics. M genitalium is among the smallest known bacteria,5 making it the target of efforts to determine the minimal requirements for life6 and to create the first chemically synthesized bacterium.7 It
M genitalium: epidemiology
The prevalence of M genitalium in general population samples ranges from 1% to 3%12, 13, 14; lower than the prevalence of C trachomatis, but higher than the prevalence of N gonorrhoeae. In higher risk populations, such as STD clinic attendees and individuals with compatible clinical syndromes, the prevalence is higher, ranging from 2% to 33%.
M genitalium was first identified in 2 of 13 urethral specimens from men with NGU2; so early studies were focused on determining whether the bacterium
Human immunodeficiency virus infection and M genitalium
According to a recent meta-analysis, individuals infected with M genitalium are twice as likely to be infected with human immunodeficiency virus (HIV) (summary OR, 2.0; 1.4–2.8),108 and nearly all of the additional reports published since43, 78, 109, 110, 111, 112, 113, 114, 115, 116, 117 have confirmed a strong association between M genitalium and HIV infection. All were either cross-sectional or retrospective reports; thus, the possibility of common risk behavior explaining this observation,
Treatment
Despite the availability of assays to detect M genitalium in research settings, there is currently no diagnostic test approved by the US Food and Drug Administration (FDA) on the market in the United States. Therefore, most individuals infected with M genitalium receive one of the recommended syndromic therapies for NGU or cervicitis (doxycycline 100 mg twice a day × 7days or azithromycin 1 g single dose). Of these two regimens, azithromycin is the more effective. The median microbiologic cure
Future challenges
In the 30 years since its first identification, M genitalium has emerged as a sexually transmitted pathogen. Consistent evidence from well-designed epidemiologic studies has shown a strong association between M genitalium infection and male urethritis, and it is now widely recognized as a cause of NGU. Treatment failure is common and, in many settings, M genitalium is the most frequently detected pathogen among men with persistent NGU. Although the evidence for female STD syndromes is less
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Cited by (27)
The JAID/JSC guidelines to Clinical Management of Infectious Disease 2017 concerning male urethritis and related disorders
2021, Journal of Infection and ChemotherapyCitation Excerpt :Many microbial species may be involved in non-chlamydial non-gonococcal urethritis as causative microorganisms [7–11]. Among them, studies have established the urethral pathogenicity of M. genitalium [1,12–18] (I, A). However, while tests for detection of this microorganism are available, its clinical use is not approved by the health insurance system of Japan, and it is presently used for research purposes alone.
Update on the Diagnosis of Sexually Transmitted Infections
2020, Actas Dermo-SifiliograficasCervicitis: Etiology, diagnosis and treatment
2019, Enfermedades Infecciosas y Microbiologia ClinicaMycoplasma and Ureaplasma
2017, Infectious Diseases, 2-Volume SetA combined systems and structural modeling approach repositions antibiotics for Mycoplasma genitalium
2015, Computational Biology and ChemistryCitation Excerpt :It infects 1–3% of all individuals, is the second most common cause of non-gonococcal urethritis in men, and is an increasingly common cause of cervicitis, endometritis, and pelvic inflammatory disease in women (Manhart, 2013). M. genitalium infection has also been associated with adverse sequelae including infertility, ectopic pregnancy, preterm birth, and cancer (Manhart, 2013; Zarei et al., 2013). M. genitalium infection is typically treated with macrolides such as azithromycin, fluoroquinolones such as moxifloxacin, and tetracyclines such as doxycycline (Taylor-Robinson, 2014).
Prevalence of and risk factors for curable sexually transmitted infections on Bubaque Island, Guinea Bissau
2021, Sexually Transmitted Infections
Conflict of Interest: L.E. Manhart previously received study drugs from Pfizer, Inc and diagnostic test reagents from Gen-Probe, Inc.