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Mycoplasma Genitalium (MG)

An Unrecognized STI

Mycoplasma Genitalium is a complex bacterial organism that was discovered in 1980, however due to its particular structure and its specific growth requirements has been incredibly difficult to isolate and study. Because of this it was only recently recognized in sexual transmission and proven a sexually transmitted infectious agent.

M. genitalium transmission occurs by direct genital-genital mucosal contact as well as genital-anorectal contact. The infection has become recognized as a cause of male urethritis, responsible for approximately 15%–20% of nongonococcal urethritis (NGU) cases, 20%–25% of nonchlamydial NGU, and approximately 30% of persistent or recurrent urethritis. In women it is also responsible for pain and discomfort associated with cervicitis.

However despite it being symptomatic in about 70% of men,  the infection is most often asymptomatic in women posing a great health risk as infection is transmitted between partner to partner unknowingly.

Difficulties in addressing MG prevalence

Though this organism is seemingly in its infancy, research has exponentially grown in this field and has proven MG to be more dangerous than initially realized. If left untreated, mycoplasma genitalium is being implicated in severe health complications for men and women. These include Pelvic inflammatory disease (PID), adverse pregnancy outcomse such as preterm delivery and miscarriage, increased risk of HPV acquisition, sexually acquired reactive arthritis, and infertility.

Mycoplasma genitalium has also developed antibiotic resistance, making these long term sequelae more prevalent as the infection becomes more difficult to treat. Already across the globe in countries such as Japan, Australia, The Netherlands, England, Russia, Estonia, and France the emergence of multi-drug resistant Mycoplasma Genitalium strains has been identified.

As certain strains avert host therapies and become more difficult to cure, there is an imperative need for widely available diagnostic tools to identify the organisms and monitor their incidence.

The need for surveillance

Because of its more recent emergence as a sexually transmitted infection, most countries do not have a surveillance program in place for testing infection status. However due to the growing burden of disease, rising antibiotic resistance, and  three fold risk incurred for acquiring HIV, accurate and efficient diagnostic tools and screening methods are critical.

The advancement and development of nucleic acid amplification tests have made studying and diagnosing infection a possibility that was never available in previous years. Mycoplasma genitalium is a fastidious organism which requires very specific nutrients and conditions to grow, therefore other diagnostic techniques such as lab culture are very difficult, time consuming, and inadequate for growing and diagnosing the organism. As NAATs, using PCR technology have been created, such as the test at Roche, scientists have been able to discover how this enigmatic organism functions and how it can be identified and treated in the growing patient population.

 

References:

  1. Centers for Disease Control and Prevention.(2010). Mycoplasma genitalium | Questions & Answers | 2010 Treatment Guidelines. Retrieved July 10, 2017, from https://www.cdc.gov/std/treatment/2010/qanda/mgenitalium.htm
  2. Ross, J. D. (2006). Mycoplasma genitalium as a sexually transmitted infection: implications for screening, testing, and treatment. Sexually Transmitted Infections,82(4), 269-271. doi:10.1136/sti.2005.017368
  3. Ona, S., Molina, R. L., & Diouf, K. (2016). Mycoplasma genitalium: An Overlooked Sexually Transmitted Pathogen in Women? Infectious Diseases in Obstetrics and Gynecology,2016, 1-9. doi:10.1155/2016/4513089Centers For Disease Control and Prevention. Emerging Issues. (2015, June 04). Retrieved July 14, 2017, from
  4. https://www.cdc.gov/std/tg2015/emerging.htmLis, R., Rowhani-Rahbar, A., & Manhart, L. E. (2015, August 01). Mycoplasma genitalium infection and female reproductive tract disease: a meta-analysis. Retrieved July 15, 2017, from https://www.ncbi.nlm.nih.gov/pubmed/25900174