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Mycoplasma genitalium: should we treat and how?

Lisa E Manhart1, Jennifer M Broad, Matthew R Golden

  • 1Departments of Epidemiology, University of Washington, Center for AIDS and STD, 325 9th Ave, Box 359931, Seattle, WA 98104, USA. lmanhart@u.washington.edu

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|November 15, 2011
PubMed

Insights

Mycoplasma genitalium infections can cause urethritis and pelvic inflammatory disease in both men and women. Azithromycin resistance is a growing concern, making moxifloxacin a key treatment option.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Sexual Health

Background:

  • Mycoplasma genitalium is linked to urethritis in men and potentially cervicitis, pelvic inflammatory disease, and infertility in women.
  • Current data on M. genitalium's role in female reproductive health and pregnancy outcomes are limited and inconsistent.
  • Azithromycin is generally effective, but rising resistance necessitates alternative treatment strategies.

Purpose of the Study:

  • To review the current understanding of Mycoplasma genitalium infections.
  • To discuss diagnostic challenges and treatment options, including emerging antibiotic resistance.
  • To provide guidance on testing and management of M. genitalium infections.

Main Methods:

  • Literature review of existing studies on Mycoplasma genitalium epidemiology, clinical associations, and treatment efficacy.
  • Analysis of data regarding antibiotic resistance patterns, particularly to azithromycin.
  • Evaluation of diagnostic limitations and recommendations for clinical practice.

Main Results:

  • Mycoplasma genitalium is a significant cause of urethritis in men and is associated with various gynecological conditions in women.
  • Azithromycin resistance is a documented issue globally, impacting treatment effectiveness.
  • Moxifloxacin demonstrates high efficacy in eradicating M. genitalium, including resistant strains.
  • A lack of commercially available diagnostic tests hinders widespread detection.

Conclusions:

  • Mycoplasma genitalium requires careful consideration in the diagnosis and management of urogenital infections.
  • Testing for M. genitalium is recommended for persistent urethritis, cervicitis, or pelvic inflammatory disease.
  • Treatment guidelines should account for azithromycin resistance, prioritizing moxifloxacin for treatment failures or suspected resistance.

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