Background review for the 2016 European guideline on Mycoplasma genitalium infections

Abstract

Mycoplasma genitalium is a cause of 10-35% of non-chlamydial non-gonococcal urethritis in men and in women, and is associated with cervicitis and pelvic inflammatory disease (PID). Transmission of M. genitalium occurs through direct mucosal contact. In women, symptoms include vaginal discharge, dysuria or symptoms of PID -abdominal pain and dyspareunia. In men, urethritis, dysuria and discharge predominates. Asymptomatic infections are frequent. In this review, we present the evidence base for the recommendations in the 2016 European guideline on M. genitalium infections and describe indications for testing, recommended diagnostic methods, treatment and patient management. The guideline was prepared on behalf of the

Prevalence and antibiotic resistance ofMycoplasma genitaliumamong STI clinic attendees in Western Canada: a cross-sectional analysis

“…28 The optimal specimen type for MG testing remains unresolved with urine specimens considered acceptable in men and women, and in women vaginal swabs are also considered suitable. 25 In our study, the excellent agreement between the test performance in female endocervical swabs and urine is reassuring and supports the use of less invasive urine specimens for testing in women. It should be noted, however, that the comparison of test positivity in female urine and female endocervical swabs is likely biased since the subpopulation included in this calculation was more likely to be symptomatic than those not included.…”

“…The optimal specimen type for MG testing remains unresolved with urine specimens considered acceptable in men and women, and in women vaginal swabs are also considered suitable 25. In our study, the excellent agreement between the test performance in female endocervical swabs and urine is reassuring and supports the use of less invasive urine specimens for testing in women.…”

“…Alternates to macrolides and moxifloxacin, the antibiotics usually proposed for the treatment of MG, are limited since the lack of a cell wall in MG precludes the use of penicillins and other beta lactam antibiotics 25. Further complicating this is that mycoplasmas can develop resistance either by gene mutation or by acquisition of a resistance gene 26.…”

“…2 Alternates to macrolides and moxifloxacin, the antibiotics usually proposed for the treatment of MG, are limited since the lack of a cell wall in MG precludes the use of penicillins and other beta lactam antibiotics. 25 Further complicating this is that mycoplasmas can develop resistance either by gene mutation or by acquisition of a resistance gene. 26 Since azithromycin has been proposed as the preferred first-line agent for the treatment of MG infections, 27 28 the high rate of mutations (~2/3 of eligible specimens) conferring resistance to azithromycin in our study is particularly alarming.…”

Cervicitis: an Unresolved Gynecological Problem

“…Существуют данные о роли M. genitalium в этиологии цервицита, эндо-метрита, ВЗОМТ, а в последнее время -в трубно-перитоне-альном факторе бесплодия. Эпидемиологические исследо-вания [34,35] показали, что вероятность инфицирования M. genitalium у женщин ассоциируется с увеличением числа сексуальных партнеров и партнеров с симптомами воспа-лительного процесса. Сообщается о низких показателях распространенности M. genitalium у пациенток с бессимп-томным течением ВЗОМТ: у 6% в шведском исследовании и у 7% в исследовании, выполненном в клинике по ИППП в США.…”