Trends and Themes in Mycoplasma genitalium Consultations Received Through the Sexually Transmitted Diseases Clinical...

Mycoplasma genitalium is an emerging sexually transmitted pathogen. M. genitalium is often asymptomatic but can cause urethritis, is associated with cervicitis and pelvic inflammatory disease, and possibly infertility and premature labor. Although multiplex sexually transmitted infection (STI) testing platforms that include M. genitalium are available, screening for asymptomatic infection is not recommended as its potential clinical impact is unknown. Leveraging the STD Clinical Consultation Network (STDCCN)-an STI consultation service for healthcare and public health professionals in the USA-our study aimed to identify training needs by analyzing temporal and thematic trends in M. genitalium consultations.

We reviewed STDCCN consults referencing "Mycoplasma," "genitalium," "m gen" and "mgen" between 2015 and 2024. Consult data were extracted, reviewed by 2 groups of 2 authors (with another reviewer adjudicating disagreements), and categorized by theme(s) and patient characteristics.

336 M. genitalium consults were identified, of which 75% occurred after 1 January 2023. Common themes were management in pregnancy (42%) and treatment failure (35%). Pregnant patients were less likely than nonpregnant patients to have symptoms reported. Consults pertaining to M. genitalium versus other topics were more likely to come from providers (physicians, nurse practitioners, nurse midwives, and physician assistants) than individuals in other roles, and more likely to come from individuals in private practices or women's health clinics than other practice settings.

STDCCN observed a substantial increase in M. genitalium consultations starting in 2023. This rise was likely driven by M. genitalium treatment failures and detection of M. genitalium in asymptomatic pregnant people. This study highlights the need for provider education about appropriate use of M. genitalium diagnostics, indications for M. genitalium screening/testing, and management of M. genitalium treatment failures.