British Association for Sexual Health and HIV national guideline for the management of infection with <i>Mycoplasma genitalium</i> (2018)

Soni, Suneeta; Horner, Patrick J; Rayment, Michael; Pinto-Sander, Nicolas; Naous, Nadia; Parkhouse, Andy; Bancroft, Darren; Patterson, Carl; Fifer, Helen

doi:10.1177/0956462419825948

Cited by 125 publications

(129 citation statements)

References 95 publications

(207 reference statements)

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“…Levels of Mgen in NGU and PID were high but comparable to recognised national chlamydia levels and much higher than gonorrhoea levels in NGU and PID 16 17. In addition, our observed Mgen prevalences in those with NGU and PID are within the region noted by the BASHH 2018 Mgen guidelines 2. Our unit was one of the first units to test for Mgen in the UK and this study adds to the body of international data by providing evidence of clinical treatment failures in a UK-based setting.…”

Section: Discussionsupporting

confidence: 72%

“…Mycoplasma genitalium (Mgen) is undisputedly a cause of non-gonococcal urethritis (NGU), accounting for 10%–20% of diagnoses,1 and there is now good evidence that Mgen is a cause of pelvic inflammatory disease (PID) 2–6. The newly published British Association for Sexual Health and HIV (BASHH) guidelines recommend testing in all men with NGU and women with suspected PID 2…”

Section: Introductionmentioning

confidence: 99%

“…Patients infected with a resistant organism may see improvement in their symptoms despite not clearing the infection completely, and pose a risk of transmission to sexual partners. National guidance therefore recommends test of cure 5 weeks after initiating treatment to ensure eradication of infection 2…”

Section: Introductionmentioning

confidence: 99%

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High rates of treatment failure forMycoplasma genitaliumamong men and women attending a sexual health clinic

Ovens

Reynolds-Wright

Cross

et al. 2019

BMJ Sex Reprod Health

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BackgroundMycoplasma genitalium (Mgen) causes non-gonococcal urethritis (NGU) and is believed to cause pelvic inflammatory disease (PID). High rates of macrolide resistance are well documented globally for Mgen. In Brighton, patients with NGU and PID are tested for Mgen and test of cure (TOC) offered post-treatment.MethodsDemographic, clinical and treatment history data were collected over a 12-month period for all Mgen-positive patients in a Brighton-based genitourinary clinic.ResultsThere were 114 patients with Mgen. 18% (61/339) of men with NGU and 9% (15/160) of women with PID had Mgen. 62/114 (54%) returned for first test TOC 4 weeks after treatment. 27/62 (44%) had a positive TOC; 25/27 (92.6%) had received azithromycin first line (500 mg stat then 250 mg OD for 4 days), 1/27 (3.7%) had received moxifloxacin first line (400 mg OD for 14 days) and 1/27 (3.7%) had received doxycycline first line (100 mg BD for 7 days). 20/27 (74%) returned for a second TOC 4 weeks later. 5/20 (25%) patients were positive on second TOC; 3/5 (60%) had received azithromycin second line and 2/5 (40%) had received moxifloxacin second line. Patients were more likely to have a positive TOC if they were at risk of reinfection (9/27 positive TOC vs 3/35 negative TOC; p=0.02). Patients given moxifloxacin were more likely to have a negative TOC (1/27 positive TOC vs 9/35 negative TOC; p=0.03) than those who received other antibiotic regimens.ConclusionsTreatment failure rates for Mgen following azithromycin use are substantial, raising concerns regarding resistance. However, reinfection risk may contribute, suggesting a requirement for improved public awareness and clinician knowledge.

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Section: Discussionsupporting

confidence: 72%

Section: Introductionmentioning

confidence: 99%

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High rates of treatment failure forMycoplasma genitaliumamong men and women attending a sexual health clinic

Ovens

Reynolds-Wright

Cross

et al. 2019

BMJ Sex Reprod Health

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“…Associations between M. genitalium and acute and chronic conditions in women, including cervicitis [2], pelvic inflammatory disease (PID) [3,4] infertility [3,4] and preterm birth [3,4] have been established. In response to these findings, published guidelines for the management of STIs continue to be revised to reflect the need for assessment of M. genitalium in patients at risk of STI [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Mycoplasma genitalium infection in women with bacterial vaginosis

et al. 2020

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Background: Bacterial vaginosis (BV) is a common condition in reproductive-age women and is known to be positively associated with risk of acquisition of sexually transmitted infections (STI) such as chlamydia and gonorrhea. Mycoplasma genitalium is an emerging STI that has been linked to increased risk of pelvic inflammatory disease, adverse pregnancy outcomes and infertility. In the present study we sought to examine whether women diagnosed with symptomatic BV were at increased risk of having concurrent infection with Mycoplasma genitalium. Methods: We used a novel PCR-based assay (ResistancePlus MG; SpeeDx Pty. Ltd., Sydney, Australia) to determine the prevalence of Mycoplasma genitalium infection and 23S rRNA macrolide-resistance mediating mutations (MRMM) in a cohort of 1532 women presenting with symptoms of vaginitis. Results: M. genitalium was detected in 4.0% (62/1532) of samples with 37.1% (23/62) harboring MRMMs. The prevalence of M. genitalium infection in subjects with BV was significantly higher than in subjects with non-BV vaginitis (7.0% v 3.6%; OR = 1.97 (95% CI: 1.14-3.39). Conclusions: Prevalence of M. genitalium infection is associated with BV in women with symptomatic vaginitis. Improved management of BV is needed as a component of STI prevention strategies.

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“…Although Ureaplasma spp. were isolated approximately 30 years prior to Mycoplasma genitalium, the latter has risen to prominent pathogen status more rapidly, and new guidelines for its management are now in place in the UK (3,22,23) .…”

Section: Introductionmentioning

confidence: 99%

The Role of Ureaplasma spp. in the Development of Nongonococcal Urethritis and Infertility among Men

2019

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SUMMARYUreaplasmaspp. are a genus of bacteria for which two human-associated species exist:Ureaplasma urealyticumandUreaplasma parvum. Their definition as a pathogen in the context of nongonococcal urethritis (NGU) and infertility among males remains highly controversial, largely due to historically high rates of isolation of these bacteria from the urethra of seemingly healthy men. This review summarizes the emerging evidence suggesting a true pathogenic role of these bacteria under specific conditions, which we term risk factors. We examine the historical, clinical, and experimental studies which support a causal role forUreaplasmaspp. in the development of NGU as well as some of the proposed mechanisms behind the association ofUreaplasmaspp. and the development of infertility. Finally, we discuss the potential for developing a case-by-case risk-based approach toward the management of men who present with seemingly idiopathic NGU but who are positive forUreaplasmaspp.

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British Association for Sexual Health and HIV national guideline for the management of infection with Mycoplasma genitalium (2018)

Cited by 125 publications

References 95 publications

High rates of treatment failure forMycoplasma genitaliumamong men and women attending a sexual health clinic

High rates of treatment failure forMycoplasma genitaliumamong men and women attending a sexual health clinic

Prevalence of Mycoplasma genitalium infection in women with bacterial vaginosis

The Role of Ureaplasma spp. in the Development of Nongonococcal Urethritis and Infertility among Men

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