[Mycoplasma genitalium probably as common in Sweden as Chlamydia trachomatis]

Mycoplasma genitalium is a common sexually transmitted infection, probably as common in Swedish STI clinics as Chlamydia trachomatis. M. genitalium may cause urethritis in men and and urethritis, cervicitis, pelvic inflammatory disease (PID) and infertility in women. The proportion of PID and its implications need further studies. The prevalence of M. genitalium infection in a general population and in asymptomatic patients is estimated to be low and general screening is not recommended. Antimicrobial resistance is a growing problem. Nucleic acid amplification tests (NAATs) including resistance testing for macrolides are available in Sweden. The first-line treatment in the absence of macrolide resistance is with azithromycin, but not as a single dose. Pretreatment with doxycycline to lower bacterial load and reduce risk of macrolide resistance during treatment is under discussion.