A review of the epidemiology, diagnosis and evidence-based management of Mycoplasma genitalium

Sexual Health ◽  
2011 ◽  
Vol 8 (2) ◽  
pp. 143 ◽  
Author(s):  
Scott A. Weinstein ◽  
Bradley G. Stiles
Keyword(s):  
Mycoplasma Genitalium ◽  
Nucleic Acid Amplification ◽  
Individual Factors ◽  
Evidence Based ◽  
Emerging Pathogen ◽  
Sexually Transmitted ◽  
Health Clinics ◽  
Detection Assay ◽  
Public Health Clinics ◽  
Low Incidence

Mycoplasma genitalium is attracting increasing recognition as an important sexually transmitted pathogen. Presented is a review of the epidemiology, detection, presentation and management of M. genitalium infection. Accumulating evidence suggests that M. genitalium is an important cause of non-gonococcal, non-chlamydial urethritis and cervicitis, and is linked with pelvic inflammatory disease and, possibly, obstetric complications. Although there is no standard detection assay, several nucleic acid amplification tests have >95% sensitivity and specificity for M. genitalium. To date, there is a general lack of established protocols for screening in public health clinics. Patients with urethritis or cervicitis should be screened for M. genitalium and some asymptomatic sub-groups should be screened depending on individual factors and local prevalence. Investigations estimating M. genitalium geographic prevalence document generally low incidence, but some communities exhibit infection frequencies comparable to that of Chlamydia trachomatis. Accumulating evidence supports an extended regimen of azithromycin for treatment of M. genitalium infection, as data suggest that stat 1 g azithromycin may be less effective. Although data are limited, azithromycin-resistant cases documented to date respond to an appropriate fluoroquinolone (e.g. moxifloxacin). Inconsistent clinical recognition of M. genitalium may result in treatment failure and subsequent persistence due to ineffective antibiotics. The contrasting nature of existing literature regarding risks of M. genitalium infection emphasises the need for further carefully controlled studies of this emerging pathogen.

scholarly journals Mycoplasma genitalium and sexually transmitted infections: evidences and figures in a tertiary hospital

2021 ◽  
Author(s):  
Gloria Martín-Saco ◽  
Alexander Tristancho ◽  
Antonina Arias ◽  
Isabel Ferrer ◽  
Ana Milagro ◽  
...  
Keyword(s):  
Multiplex Pcr ◽  
Sexually Transmitted Infections ◽  
Mycoplasma Genitalium ◽  
Tertiary Hospital ◽  
Clinical Samples ◽  
Emerging Pathogen ◽  
Sexually Transmitted ◽  
Gonococcal Urethritis ◽  
Low Incidence ◽  
Level Hospital

Introduction. Mycoplasma genitalium is an emerging cause of sexually transmitted infections (STIs) and has been implicated in non-gonococcal urethritis in men and cervicitis in woman. The aim of this study is determinate the incidence and pathogenicity of M. genitalium within the diagnosis of STIs detected from clinical samples in a third level hospital. Material and methods. A total of 8,473 samples from endocervix, urethra, vagina, rectum and others were processed applying Allpex STI Essential Assay. More than 190 records were reviewed to determinate M. genitalium pathogenicity. Results. M. genitalium was detected in a rate 2.8%. Co-infections were detected in 20% of the patients. Conclusions. M. genitalium is considered a STI emerging pathogen thanks to the renewal of multiplex-PCR tests although with a low incidence in our approach. Emerging from our experience and the institutional recommendations both detection of acid nucleic techniques (NAATs) and gonococcal culture might be implemented accurately and coexist to adequate prescriptions.

scholarly journals Ureaplasma urealyticumandU. parvumin sexually active women attending public health clinics in Brazil

2017 ◽  
Vol 145 (11) ◽  
pp. 2341-2351 ◽  
Author(s):  
T. N. LOBÃO ◽  
G. B. CAMPOS ◽  
N. N. SELIS ◽  
A. T. AMORIM ◽  
S. G. SOUZA ◽  
...  
Keyword(s):  
Trichomonas Vaginalis ◽  
Ureaplasma Urealyticum ◽  
Bacterial Load ◽  
Family Health ◽  
Signs And Symptoms ◽  
Gardnerella Vaginalis ◽  
Sexually Active ◽  
Sexually Transmitted ◽  
Health Clinics ◽  
Public Health Clinics

SUMMARYUreaplasma urealyticumandU. parvumhave been associated with genital infections. The purpose of this study was to detect the presence of ureaplasmas and other sexually transmitted infections in sexually active women from Brazil and relate these data to demographic and sexual health, and cytokines IL-6 and IL-1β. Samples of cervical swab of 302 women were examined at the Family Health Units in Vitória da Conquista. The frequency of detection by conventional PCR was 76·2% forMollicutes. In qPCR, the frequency found was 16·6% forU. urealyticumand 60·6%U. parvumand the bacterial load of these microorganisms was not significantly associated with signs and symptoms of genital infection. The frequency found forTrichomonas vaginalis,Neisseria gonorrhoeae,Gardnerella vaginalisandChlamydia trachomatiswas 3·0%, 21·5%, 42·4% and 1·7%, respectively. Higher levels of IL-1βwere associated with control women colonized byU. urealyticumandU. parvum. Increased levels of IL-6 were associated with women who exhibitedU. parvum. Sexually active women, with more than one sexual partner in the last 3 months, living in a rural area were associated with increased odds of certainU. parvumserovar infection.

scholarly journals The Prevalence of HSV, HHV-6, HPV and Mycoplasma genitalium in Chlamydia trachomatis positive and Chlamydia trachomatis Negative Urogenital Samples among Young Women in Finland

Pathogens ◽  
2019 ◽  
Vol 8 (4) ◽  
pp. 276
Author(s):  
Suvi Korhonen ◽  
Kati Hokynar ◽  
Tiina Eriksson ◽  
Kari Natunen ◽  
Jorma Paavonen ◽  
...  
Keyword(s):  
Chlamydia Trachomatis ◽  
Human Herpesvirus ◽  
Mycoplasma Genitalium ◽  
Nucleic Acid Amplification Test ◽  
Nucleic Acid Amplification ◽  
Human Herpesvirus 6 ◽  
Hpv Dna ◽  
Sexually Transmitted ◽  
Increased Risk ◽  
Simplex Virus

Chlamydia trachomatis, Mycoplasma genitalium, herpes simplex virus (HSV) and human papillomavirus (HPV) cause sexually transmitted infections. In addition, human herpesvirus 6 (HHV-6) may be a genital co-pathogen. The prevalence rates of HSV, HHV-6, HPV, M. genitalium, and the C. trachomatis ompA genotypes were investigated by PCR in urogenital samples of the C. trachomatis nucleic acid amplification test positive (n = 157) and age-, community- and time-matched negative (n = 157) women. The prevalence of HPV DNA was significantly higher among the C. trachomatis positives than the C. trachomatis negatives (66% vs. 25%, p < 0.001). The prevalence of HSV (1.9% vs. 0%), HHV-6 (11% vs. 14%), and M. genitalium DNA (4.5% vs. 1.9%) was not significantly different between the C. trachomatis-positive and -negative women. Thirteen per cent of test-of-cure specimens tested positive for C. trachomatis. The prevalence of HSV, HHV-6, HPV, M. genitalium, and the C. trachomatis ompA genotypes did not significantly differ between those who cleared the C. trachomatis infection (n = 105) and those who did not (n = 16). The higher prevalence of HPV DNA among the C. trachomatis positives suggests greater sexual activity and increased risk for sexually transmitted pathogens.

scholarly journals Mycoplasma genitalium: An Emerging Sexually Transmitted Infection

Scientifica ◽  
2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Jessian L. Munoz ◽  
Oluwatosin Jaiyeoba Goje
Keyword(s):  
Mycoplasma Genitalium ◽  
Nucleic Acid Amplification Test ◽  
Nucleic Acid Amplification ◽  
Treatment Modalities ◽  
First Line ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
The World ◽  
The Impact ◽  
Slow Growing

Mycoplasma genitaliumhas been recognized as a cause of male urethritis, and there is now evidence suggesting that it causes cervicitis and pelvic inflammatory disease in women.M. genitaliumis a slow growing organism, and, with the advent of nucleic acid amplification test (NAAT), more studies are being performed, and knowledge about the pathogenicity of this organism elucidated. With NAAT detection, treatment modalities have been studied, and the next challenge is to determine the most effective antimicrobial therapy. Doxycycline, the first-line antibiotic for urethritis, is largely ineffective in the treatment ofM. genitaliumand furthermore, resistance to macrolide has also emerged. The most effective drug is Moxifloxacin although there are emerging reports of resistance to it in various parts of the world. This paper not only highlights the current research and knowledge, but also reviews the diversity of health implications on the health of men and women infected withM. genitalium. Alternate antibiotics and the impact ofM. genitaliumon infertility are areas that require more studies as we continue to research into this microorganism.

scholarly journals 424. Use of the ResistancePlus® MG Multiplex PCR Assay to Determine the Prevalence of Mycoplasma genitalium and Macrolide Resistance in a High-Risk US Population

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S213-S213
Author(s):  
Charles Cartwright ◽  
Ayla Harris ◽  
Michael Levandoski ◽  
Amanda Pherson ◽  
Melinda Nye
Keyword(s):  
Neisseria Gonorrhoeae ◽  
Sexual Health ◽  
Mycoplasma Genitalium ◽  
Macrolide Resistance ◽  
Nucleic Acid Amplification ◽  
Pcr Assay ◽  
Health Clinics ◽  
Multiplex Pcr Assay ◽  
Therapeutic Decisions ◽  
Sexual Health Clinics

Abstract Background Mycoplasma genitalium is a significant agent of sexually transmitted infection (STI). Cure rates have declined as rates of macrolide resistance has become increasingly prevalent. Diagnosis of M. genitalium infection and macrolide resistance detection is possible using nucleic-acid amplification tests (NAAT); use of such assays could improve patient management and antimicrobial stewardship. In this study we used one such assay, ResistancePlus MG (RPMG) to determine the prevalence of M. genitalium infection and macrolide resistance in a cohort of patients attending 3 public sexual health clinics in mid-Atlantic US states. Methods De-identified urogenital samples submitted to the LabCorp facility in Burlington, NC for routine Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) NAAT testing from 3 public sexual health clinics were analyzed in the study. All samples had been collected in the Aptima Specimen Collection system and tested with the Aptima Combo 2 CT/NG NAAT. A total of 1,261 samples (770 male, 491 female) from this cohort were successfully tested for M. genitalium and macrolide-resistance mediating mutations (MRMM) using the RPMG multiplexed PCR assay. Results The prevalence of M. genitalium in this patient cohort was 10.4% (131/1,261), not significantly different to the prevalence of C. trachomatis (12.0%; P = 0.202) but significantly higher than the prevalence of Neisseria gonorrhoeae (6.7%; P = 0.0009). Sixty of the 131 M. genitalium positives were also positive for MRMM and thus azithromycin resistant. Conclusion M. genitalium infections were common amongst unselected individuals evaluated for treatable STI in the eastern United States and the rate of macrolide resistance in this population was significant. In addition, the RPMG assay was shown to be a simple and accurate method for simultaneously diagnosing M. genitalium infections and detecting MRMM and could be used to inform therapeutic decisions. Disclosures All authors: No reported disclosures.

Mycoplasma genitalia – a mysterious destroyer

2018 ◽  
pp. 10-14
Author(s):  
O.A. Burka ◽  
◽  
N.F. Ligirda ◽  
Keyword(s):  
Inflammatory Diseases ◽  
Mycoplasma Genitalium ◽  
Nucleic Acid Amplification ◽  
Sexually Transmitted ◽  
Treatment Regimens ◽  
Pelvic Organs ◽  
Gonococcal Urethritis ◽  
Complicated Course ◽  
Dna Pcr

Mycoplasma genitalium is a common cause of cervicitis and non-gonococcal urethritis. Today, this causative agent is already associated with inflammatory diseases of the pelvic organs and sexually acquired reactive arthritis. The only diagnostic method is a nucleic acid amplification (NAAT) test that detects specific DNA (PCR) or M. genitalium RNA. Several treatment regimens are proposed, depending on the uncomplicated or complicated course of M. genitalium infection and the determination of macrolide resistance. Key words: Mycoplasma genitalium, sexually transmitted infections, inflammatory diseases of the pelvic organs, cervicitis, non-gonococcal urethritis.

scholarly journals Molecular epidemiology and antimicrobials resistance mechanism of Mycoplasma genitlaium

2021 ◽  
Vol 97 (3) ◽  
pp. 14-23
Author(s):  
Elizaveta Dmitrievna Shedko ◽  
Elena Nokolaevna Goloveshkina ◽  
Vasiliy Gennadievich Akimkin
Keyword(s):  
Antibiotic Resistance ◽  
Molecular Mechanisms ◽  
Wide Spectrum ◽  
Resistance Mechanism ◽  
Mycoplasma Genitalium ◽  
Current Data ◽  
Nucleic Acid Amplification ◽  
Laboratory Diagnostics ◽  
Culture Methods ◽  
Sexually Transmitted

Currently, infections caused by Mycoplasma genitalium are ones the most common sexually transmitted infections. Their prevalence is varied from 1.3% to 15.9%. Infections caused by M.genitalium may lead to urethritis in men and a wide spectrum of diseases in women. Antibiotic resistance now is one of the most emerging problems both in the scientific and in the healthcare fields. The usage of antimicrobials inhibiting cell wall synthesis for the treatment of M.genitalium is ineffective, and resistance to macrolides and fluoroquinolones is increasing rapidly. M.genitalium infections diagnostics is complicated due to specific conditions and duration of culture methods. The usage of nucleic acid amplification techniques is the most relevant for laboratory diagnostics, and is used in existing assays. This review compiles current data on the prevalence, molecular mechanisms of pathogenesis and antibiotic resistance, as well as diagnostics methods of M.genitalium.

scholarly journals A portable magnetofluidic platform for detecting sexually transmitted infections and antimicrobial susceptibility

2021 ◽  
Vol 13 (593) ◽  
pp. eabf6356
Author(s):  
Alexander Y. Trick ◽  
Johan H. Melendez ◽  
Fan-En Chen ◽  
Liben Chen ◽  
Annet Onzia ◽  
...  
Keyword(s):  
Sexually Transmitted Infections ◽  
Magnetic Beads ◽  
Point Of Care ◽  
Low Cost ◽  
Nucleic Acid Amplification ◽  
Sexually Transmitted ◽  
Health Clinics ◽  
Automated Processing ◽  
Analysis Of Results ◽  
Sexual Health Clinics

Effective treatment of sexually transmitted infections (STIs) is limited by diagnostics that cannot deliver results rapidly while the patient is still in the clinic. The gold standard methods for identification of STIs are nucleic acid amplification tests (NAATs), which are too expensive for widespread use and have lengthy turnaround times. To address the need for fast and affordable diagnostics, we have developed a portable, rapid, on-cartridge magnetofluidic purification and testing (PROMPT) polymerase chain reaction (PCR) test. We show that it can detect Neisseria gonorrhoeae, the pathogen causing gonorrhea, with simultaneous genotyping of the pathogen for resistance to the antimicrobial drug ciprofloxacin in <15 min. The duplex test was integrated into a low-cost thermoplastic cartridge with automated processing of penile swab samples from patients using magnetic beads. A compact instrument conducted DNA extraction, PCR, and analysis of results while relaying data to the user via a smartphone app. This platform was tested on penile swab samples from sexual health clinics in Baltimore, MD, USA (n = 66) and Kampala, Uganda (n = 151) with an overall sensitivity and specificity of 97.7% (95% CI, 94.7 to 100%) and 97.6% (95% CI, 94.1 to 100%), respectively, for N. gonorrhoeae detection and 100% concordance with culture results for ciprofloxacin resistance. This study paves the way for delivering accessible PCR diagnostics for rapidly detecting STIs at the point of care, helping to guide treatment decisions and combat the rise of antimicrobial resistant pathogens.

scholarly journals Mycoplasma genitalium: A Review

Microbiology ◽  
2020 ◽  
Vol 166 (1) ◽  
pp. 21-29 ◽  
Author(s):  
Roshina Gnanadurai ◽  
Helen Fifer
Keyword(s):  
Type Species ◽  
Current Knowledge ◽  
Mycoplasma Genitalium ◽  
Content Type ◽  
Sexually Transmitted ◽  
Link Type ◽  
Health Clinics ◽  
Clinical Syndromes ◽  
Independent Replication ◽  
Sexual Health Clinics

Mycoplasma genitalium is a fastidious organism of the class Mollicutes, the smallest prokaryote capable of independent replication. First isolated in 1981, much is still unknown regarding its natural history in untreated infection. It is recognized as a sexually transmitted pathogen causing acute and chronic non-gonococcal urethritis (NGU) in men, with a growing body of evidence to suggest it also causes cervicitis and pelvic inflammatory disease in women. Its role in several other clinical syndromes is uncertain. The majority of people infected remain asymptomatic and clear infection without developing disease; asymptomatic screening is therefore not recommended. Prevalence rates are higher in patients attending sexual health clinics and in men with NGU. Limited availability of diagnostics has encouraged syndromic management, resulting in widespread antimicrobial resistance and given that few antimicrobial classes have activity against M. genitalium , there is significant concern regarding the emergence of untreatable strains. There is a need for wider availability of testing, which should include detection of macrolide resistance mediating mutations. Expertise in interpretation of microbiological results with clinical correlation ensures targeted treatment avoiding unnecessary antibiotic exposure. Public health surveillance nationally and internationally is vital in monitoring and responding to changing epidemiology trends. In this review, we summarize current knowledge of M. genitalium , including epidemiology, clinical and microbiological data, and discuss treatment challenges in the era of rising multidrug resistance.

scholarly journals Prevalence of urogenital, anal, and pharyngeal infections with Chlamydia trachomatis, Neisseria gonorrhoeae, and Mycoplasma genitalium: a cross-sectional study in Reunion island

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
A. Calas ◽  
N. Zemali ◽  
G. Camuset ◽  
J. Jaubert ◽  
R. Manaquin ◽  
...  
Keyword(s):  
Chlamydia Trachomatis ◽  
Neisseria Gonorrhoeae ◽  
Mycoplasma Genitalium ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Transmitted Infection ◽  
Cross Sectional ◽  
Sexually Transmitted ◽  
Urogenital Infection ◽  
High Prevalence

Abstract Background Recommendations for sexually transmitted infection (STI) screening vary significantly across countries. This study evaluated the prevalence of urogenital and extragenital infections with Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and Mycoplasma genitalium (MG) in patients visiting a French STI clinic in the Indian Ocean region to determine whether current STI screening practices should be updated. Methods This cross-sectional study examined all patients who visited the STI clinic between 2014 and 2015. Triplex polymerase chain reaction screening for CT, NG, and MG was performed on urine, vaginal, pharyngeal, and anal specimens (FTD Urethritis Basic Kit, Fast Track Diagnostics, Luxembourg). Results Of the 851 patients enrolled in the study, 367 were women (367/851, 43.2%) and 484 were men (484/851, 56.0%). Overall, 826 urogenital specimens (826/851, 97.1%), 606 pharyngeal specimens (606/851, 71.2%), and 127 anal specimens (127/851, 14.9%) were taken from enrolled patients. The prevalence of urogenital CT and MG was high in women ≤25 years (19/186, 10.21%; 5/186, 2.69%) and in men who have sex with women ≤30 years (16/212, 7.54%; 5/212, 2.36%). Among patients with urogenital CT infection, 13.7% (7/51) had urethritis. All patients with urogenital MG infection were asymptomatic. Men who have sex with men had a high prevalence of pharyngeal CT (2/45, 4.44%) and NG (3/44, 6.81%) and a high prevalence of anal CT (2/27, 7.41%), NG (2/27, 7.40%), and MG (1/27, 3.70%). After excluding patients with concomitant urogenital infection, extragenital infections with at least 1 of the 3 pathogens were found in 20 swabs (20/91, 21.9%) taken from 16 patients (16/81, 19.7%), all of them asymptomatic. Conclusions Routine multisite screening for CT, NG, and MG should be performed to mitigate the transmission of STIs in high-risk sexually active populations.

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