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Microbiology (Reading, England) Jan 2020is a fastidious organism of the class the smallest prokaryote capable of independent replication. First isolated in 1981, much is still unknown regarding its natural... (Review)
Review
is a fastidious organism of the class 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 , 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 , including epidemiology, clinical and microbiological data, and discuss treatment challenges in the era of rising multidrug resistance.
Topics: Anti-Bacterial Agents; Drug Resistance, Bacterial; Humans; Mycoplasma Infections; Mycoplasma genitalium; Prevalence; Public Health Surveillance; Risk Factors; Sexually Transmitted Diseases, Bacterial; Urethritis
PubMed: 31329090
DOI: 10.1099/mic.0.000830 -
Nursing Jul 2017
Review
Topics: Coinfection; HIV Infections; Humans; Mycoplasma Infections; Mycoplasma genitalium; Practice Guidelines as Topic
PubMed: 28640054
DOI: 10.1097/01.NURSE.0000520524.30192.07 -
Journal of Clinical Microbiology Mar 2023Mycoplasma genitalium is an important sexually transmitted pathogen affecting both men and women. Its extremely slow growth and very demanding culture requirements... (Review)
Review
Mycoplasma genitalium is an important sexually transmitted pathogen affecting both men and women. Its extremely slow growth and very demanding culture requirements necessitate the use of molecular-based diagnostic tests for its detection in clinical specimens. The recent availability of U.S. Food and Drug Administration (FDA)-cleared commercial molecular-based assays has enabled diagnostic testing to become more widely available in the United States and no longer limited to specialized reference laboratories. Advances in the knowledge of the epidemiology and clinical significance of M. genitalium as a human pathogen made possible by the availability of molecular-based testing have led to updated guidelines for diagnostic testing and treatment that have been published in various countries. This review summarizes the importance of M. genitalium as an agent of human disease, explains the necessity of obtaining a microbiological diagnosis, describes currently available diagnostic methods, and discusses how the emergence of antimicrobial resistance has complicated treatment alternatives and influenced the development of diagnostic tests for resistance detection, with an emphasis on developments over the past few years.
Topics: Male; Humans; Female; Anti-Bacterial Agents; Mycoplasma genitalium; Laboratories; Drug Resistance, Bacterial; Mycoplasma Infections; Macrolides; Urethritis
PubMed: 36598247
DOI: 10.1128/jcm.00790-21 -
Infectious Disease Clinics of North... Jun 2023Mycoplasma genitalium is a frequent cause of urogenital syndromes in men and women and is associated with adverse sequelae in women. M genitalium also infects the... (Review)
Review
Mycoplasma genitalium is a frequent cause of urogenital syndromes in men and women and is associated with adverse sequelae in women. M genitalium also infects the rectum, and may cause proctitis, but rarely infects the pharynx. Diagnosis requires nucleic acid amplification testing. Antibiotic resistance is widespread: more than half of infections are resistant to macrolides and fluoroquinolone resistance is increasing. Resistance-guided therapy is recommended for symptomatic patients, involving initial treatment with doxycycline to reduce organism load followed by azithromycin for macrolide-sensitive infections or moxifloxacin for macrolide-resistant infections. Neither screening nor tests of cure are recommended in asymptomatic persons.
Topics: Male; Humans; Female; Mycoplasma genitalium; Mycoplasma Infections; Drug Resistance, Bacterial; Anti-Bacterial Agents; Macrolides
PubMed: 37105645
DOI: 10.1016/j.idc.2023.02.009 -
European Journal of Clinical... Feb 2020Mycoplasma genitalium was first isolated from the urethral swabs of two symptomatic men with urethritis in 1980. It is a sexually transmitted bacterium associated with a... (Review)
Review
Mycoplasma genitalium was first isolated from the urethral swabs of two symptomatic men with urethritis in 1980. It is a sexually transmitted bacterium associated with a number of urogenital conditions in women like cervicitis, endometritis, pelvic inflammatory disease, infertility, and susceptibility to human immunodeficiency virus (HIV). However, M. genitalium may also act like a stealth pathogen at female reproductive tract, giving no symptoms. Its prevalence varies between different groups, with the average being 0.5-10% in the general population and 20-40% in women with sexually transmitted infections. The recommended treatment of this infection is azithromycin as a single 1-g dose. However, in recent years, macrolide resistance has increased which is significantly lowering the cure rate, being less than 50% in some studies. New treatment regimens need to be investigated due to increasing drug resistance. The discussion and suggestion of an algorithm for management of this infection is the highlight of this paper.
Topics: Anti-Bacterial Agents; Asymptomatic Infections; Azithromycin; Drug Resistance, Bacterial; Female; Humans; Macrolides; Mycoplasma Infections; Mycoplasma genitalium; Pelvic Inflammatory Disease; Prevalence; Reproductive Tract Infections; Sexually Transmitted Diseases; Urethritis
PubMed: 31522281
DOI: 10.1007/s10096-019-03707-8 -
The Journal of Infectious Diseases Jul 2017Mycoplasmagenitalium is one of the major causes of nongonococcal urethritis (NGU) worldwide but an uncommon sexually transmitted infection (STI) in the general... (Review)
Review
Mycoplasmagenitalium is one of the major causes of nongonococcal urethritis (NGU) worldwide but an uncommon sexually transmitted infection (STI) in the general population. The risk of sexual transmission is probably lower than for Chlamydia trachomatis. Infection in men is usually asymptomatic and it is likely that most men resolve infection without developing disease. The incubation period for NGU caused by Mycoplasma genitalium is probably longer than for NGU caused by C. trachomatis. The clinical characteristics of symptomatic NGU have not been shown to identify the pathogen specific etiology. Effective treatment of men and their sexual partner(s) is complicated as macrolide antimicrobial resistance is now common in many countries, conceivably due to the widespread use of azithromycin 1 g to treat STIs and the limited availability of diagnostic tests for M. genitalium. Improved outcomes in men with NGU and better antimicrobial stewardship are likely to arise from the introduction of diagnostic M. genitalium nucleic acid amplification testing including antimicrobial resistance testing in men with symptoms of NGU as well as in their current sexual partner(s). The cost effectiveness of these approaches needs further evaluation. The evidence that M. genitalium causes epididymo-orchitis, proctitis, and reactive arthritis and facilitates human immunodeficiency virus transmission in men is weak, although biologically plausible. In the absence of randomized controlled trials demonstrating cost effectiveness, screening of asymptomatic men cannot be recommended.
Topics: Anti-Bacterial Agents; Azithromycin; Drug Resistance, Bacterial; Female; Humans; Macrolides; Male; Male Urogenital Diseases; Mycoplasma Infections; Mycoplasma genitalium; Nucleic Acid Amplification Techniques; Sexual Partners; Urethritis
PubMed: 28838074
DOI: 10.1093/infdis/jix145 -
International Journal of STD & AIDS Jun 2014Mycoplasma genitalium (M. genitalium)was first isolated from the urethral swabs of two symptomatic men with urethritis in 1980. Published prevalence rates vary greatly... (Review)
Review
Mycoplasma genitalium (M. genitalium)was first isolated from the urethral swabs of two symptomatic men with urethritis in 1980. Published prevalence rates vary greatly between populations studied. A number of urogenital conditions have been ascribed toM. genitalium, which is recognised to cause a sexually transmitted infection. The association of M. genitalium with non-specific urethritis is now well established, but the evidence supporting its role in both male and female infertility remains inconclusive. Laboratory methods are challenging and there is a lack of test standardisation. The recommended treatment of the infection is azithromycin as a single 1 gm dose. However, in recent years macrolide resistance has been observed. More studies are required to establish the clinical importance of M. genitaliumin urogenital conditions, particularly infertility, and to establish the role for screening and treatment in high-risk populations.
Topics: Anti-Bacterial Agents; DNA, Bacterial; Female; Humans; Macrolides; Male; Mycoplasma Infections; Mycoplasma genitalium; Sexually Transmitted Diseases; Urethritis
PubMed: 24517928
DOI: 10.1177/0956462413515196 -
Virulence Dec 2022, a pathogen from class Mollicutes, has been linked to sexually transmitted diseases and sparked widespread concern. To adapt to its environment, has evolved specific... (Review)
Review
, a pathogen from class Mollicutes, has been linked to sexually transmitted diseases and sparked widespread concern. To adapt to its environment, has evolved specific adhesins and motility mechanisms that allow it to adhere to and invade various eukaryotic cells, thereby causing severe damage to the cells. Even though traditional exotoxins have not been identified, secreted nucleases or membrane lipoproteins have been shown to cause cell death and inflammatory injury in infection. However, as both innate and adaptive immune responses are important for controlling infection, the immune responses that develop upon infection do not necessarily eliminate the organism completely. Antigenic variation, detoxifying enzymes, immunoglobulins, neutrophil extracellular trap-degrading enzymes, cell invasion, and biofilm formation are important factors that help the pathogen overcome the host defence and cause chronic infections in susceptible individuals. Furthermore, can increase the susceptibility to several sexually transmitted pathogens, which significantly complicates the persistence and chronicity of infection. This review aimed to discuss the virulence factors of to shed light on its complex pathogenicity and pathogenesis of the infection.
Topics: Adhesins, Bacterial; Humans; Mycoplasma Infections; Mycoplasma genitalium; Virulence; Virulence Factors
PubMed: 35791283
DOI: 10.1080/21505594.2022.2095741 -
International Journal of STD & AIDS Mar 2020
Review
Topics: Anti-Bacterial Agents; DNA, Bacterial; Drug Resistance, Bacterial; Fluoroquinolones; Humans; Macrolides; Mycoplasma Infections; Mycoplasma genitalium
PubMed: 32000587
DOI: 10.1177/0956462419890737 -
Current Opinion in Pediatrics Aug 2020Mycoplasma genitalium (M. genitalium) and Trichomonas vaginalis (T. vaginalis), sexually transmitted infections that remain non-reportable in the United States, may lead... (Review)
Review
PURPOSE OF REVIEW
Mycoplasma genitalium (M. genitalium) and Trichomonas vaginalis (T. vaginalis), sexually transmitted infections that remain non-reportable in the United States, may lead to pelvic inflammatory disease (PID) and adverse pregnancy outcomes if left untreated. Prevalence estimates have highlighted socioeconomic and racial/ethnic disparities in rates of infection. This review summarizes the recent literature on M. genitalium and T. vaginalis with a focus on the epidemiology, screening, and treatment of M. genitalium and T. vaginalis.
RECENT FINDINGS
The burden of T. vaginalis testing remains on women. Antimicrobial resistance is of great concern for M. genitalium. Comprehensive screening and treatment guidelines present an opportunity to address these public health concerns.
SUMMARY
M. genitalium and T. vaginalis infections disproportionately affect sexual and racial/ethnic minorities and those facing socioeconomic disparities. The availability of nucleic acid amplification test testing has facilitated accurate diagnosis of both disorders. Safe and efficacious treatments are available for treatment of both disorders. Integrating macrolide resistance testing into treatment algorithms for M. genitalium and dual antibiotic therapy may prove a useful strategy for future US-based guidance. Public health reporting and increased public awareness campaigns are key next steps to addressing the observed reproductive health disparities.
Topics: Anti-Bacterial Agents; Drug Resistance, Bacterial; Female; Humans; Macrolides; Mycoplasma Infections; Mycoplasma genitalium; Pregnancy; Public Health; Trichomonas Vaginitis; Trichomonas vaginalis
PubMed: 32520821
DOI: 10.1097/MOP.0000000000000909