Molecular Diagnostics Update for the Emerging (If Not Already Widespread) Sexually Transmitted Infection Agent Mycoplasma genitalium: Just About Ready for Prime Time

Munson, Erik

doi:10.1128/jcm.00818-17

Cited by 26 publications

(11 citation statements)

References 34 publications

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“…Our results support the argument for close monitoring of antibiotic resistance in M. genitalium in Singapore, as in the rest of the world. Management of such resistance relies on timely diagnosis and appropriate treatment, ideally with subsequent confirmation of clearance of M. genitalium infections, but although diagnosis of M. genitalium has never been easier in light of novel and more convenient molecular tests [4], M. genitalium is often not part of routine screening or tested for in cases of NGU [8,30]. Evidently the ideal approach would be to consider M. genitalium in all cases of NGU, routine screening and monitoring of populations at risk of high M. genitalium transmission, and susceptibility-guided therapy of treatment failures [31].…”

Section: Discussionmentioning

confidence: 99%

“…Mycoplasma genitalium is a sexually transmitted pathogen of rapidly increasing significance [1], which may cause cervicitis and urethritis in women and has been linked to pelvic inflammatory disease and infertility [2], as well as with non-gonococcal urethritis (NGU) in men [3]. Diagnosis of M. genitalium by bacterial culture is difficult due to requirements for specific media and prolonged incubation; in practice, diagnosis is constrained by a necessary reliance on molecular methods [4].…”

Section: Introductionmentioning

confidence: 99%

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Mycoplasma genitalium in Singapore is associated with Chlamydia trachomatis infection and displays high macrolide and Fluoroquinolone resistance rates

Hart

Tang

Mansoor³

et al. 2020

BMC Infect Dis

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Background: Mycoplasma genitalium is an emerging sexually transmitted infection, with increasing rates of resistance to fluroquinolones and macrolides, the recommended treatments. Despite this, M. genitalium is not part of routine screening for Sexually Transmitted Infections (STIs) in many countries and the prevalence of infection and patterns of disease remain to be determined in many populations. Such data is of particular importance in light of the reported rise in antibiotic resistance in M. genitalium isolates. Methods: Urine and urethral swab samples were collected from the primary public sexual health clinic in Singapore and tested for C. trachomatis (CT) or N. gonorrhoeae (NG) infection and for the presence of M. genitalium. Antibiotic resistance in M. genitalium strains detected was determined by screening for genomic mutations associated with macrolide and fluroquinolone resistance. Results: We report the results of a study into M. genitalium prevalence at the national sexual health clinic in Singapore. M. genitalium was heavily associated with CT infection (8.1% of cases), but present in only of 2.4% in CT negative cases and not independently linked to NG infection. Furthermore, we found high rates of resistance mutations to both macrolides (25%) and fluoroquinolones (37.5%) with a majority of resistant strains being dualresistant. Resistance mutations were only found in strains from patients with CT co-infection. Conclusions: Our results support targeted screening of CT positive patients for M. genitalium as a cost-effective strategy to reduce the incidence of M. genitalium in the absence of comprehensive routine screening. The high rate of dual resistance also highlights the need to ensure the availability of alternative antibiotics for the treatment of multi-drug resistant M. genitalium isolates.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Mycoplasma genitalium in Singapore is associated with Chlamydia trachomatis infection and displays high macrolide and Fluoroquinolone resistance rates

Hart

Tang

Mansoor³

et al. 2020

BMC Infect Dis

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“…genitalium has been recently recognized as an important pathogen implicated in pelvic inflammatory disease and infertility [12,78]. Although some early diagnostic tests have been described [79,80], very few clinicians test for its presence. Furthermore, the vaginal microbiota composition has been reported to be associated with the progression of HPV infection, from early states to cervical cancer [37,40].…”

Section: Discussionmentioning

confidence: 99%

A novel sequencing-based vaginal health assay combining self-sampling, HPV detection and genotyping, STI detection, and vaginal microbiome analysis

Bik¹,

Bird²,

Bustamante³

et al. 2019

PLoS ONE

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The composition of the vaginal microbiome, including both the presence of pathogens involved in sexually transmitted infections (STI) as well as commensal microbiota, has been shown to have important associations for a woman’s reproductive and general health. Currently, healthcare providers cannot offer comprehensive vaginal microbiome screening, but are limited to the detection of individual pathogens, such as high-risk human papillomavirus (hrHPV), the predominant cause of cervical cancer. There is no single test on the market that combines HPV, STI, and microbiome screening. Here, we describe a novel inclusive vaginal health assay that combines self-sampling with sequencing-based HPV detection and genotyping, vaginal microbiome analysis, and STI-associated pathogen detection. The assay includes genotyping and detection of 14 hrHPV types, 5 low-risk HPV types (lrHPV), as well as the relative abundance of 31 bacterial taxa of clinical importance, including Lactobacillus , Sneathia , Gardnerella , and 3 pathogens involved in STI, with high sensitivity, specificity, and reproducibility. For each of these taxa, reference ranges were determined in a group of 50 self-reported healthy women. The HPV sequencing portion of the test was evaluated against the digene High-Risk HPV HC2 DNA test. For hrHPV genotyping, agreement was 95.3% with a kappa of 0.804 (601 samples); after removal of samples in which the digene hrHPV probe showed cross-reactivity with lrHPV types, the sensitivity and specificity of the hrHPV genotyping assay were 94.5% and 96.6%, respectively, with a kappa of 0.841. For lrHPV genotyping, agreement was 93.9% with a kappa of 0.788 (148 samples), while sensitivity and specificity were 100% and 92.9%, respectively. This novel assay could be used to complement conventional cervical cancer screening, because its self-sampling format can expand access among women who would otherwise not participate, and because of its additional information about the composition of the vaginal microbiome and the presence of pathogens.

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“…Other studies have identified a link between M. genitalium and increased HIV acquisition (30,31). Although this organism was first characterized as a pathogen in the 1980s, recognition of M. genitalium as a significant cause of urethritis has been hampered by the lack of reliable diagnostic methods (32). Because of fastidious growth requirements and an extremely slow growth rate, culture is not practical for diagnosis (33), and serologic testing is of limited value because of antigenic variation in M. genitalium and cross-reactivity (34,35).…”

Section: Stismentioning

confidence: 99%

New Bugs and New Drugs: Updates in Clinical Microbiology

Lainhart

Yarbrough

Jean

2018

The Journal of Applied Laboratory Medicine

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Background:The landscape of clinical microbiology laboratories is changing. As new technologies are introduced, we are better able to detect and identify pathogens and to recognize and characterize emerging antimicrobial resistance mechanisms. Content: In this review, a selected cross-section of current hot topics in clinical microbiology is discussed. These topics include (a) diagnostics for urinary tract and sexually transmitted infections; (b) phenotypic and genotypic methods of detecting carbapenem resistance and discussion of newly approved anti-infective agents for these multi-drug resistant organisms; and (c) the significance, epidemiology, and identification of the emerging pathogens Mycobacterium chimaera and Candida auris. Summary: Communication between clinical microbiologists and their clinical colleagues is imperative to convey the significance of emerging pathogens and resistance determinants, as well as the performance characteristics of new diagnostic methods. Additionally, as antimicrobial resistance is surging, it is important to comprehensively evaluate the resistance profiles of clinical isolates to facilitate antimicrobial stewardship and inform infection prevention measures. Although antimicrobial resistance is a global public health crisis, it is encouraging that new anti-infective agents are in the pipeline and being approved for use in patients. IMPACT STATEMENTThis review focuses on a cross-section of hot topics in clinical microbiology, including urinary tract and sexually transmitted infections and antimicrobial resistance determinants. As diagnostic methods in clinical microbiology result in enhanced identification of pathogens and antimicrobial resistance determinants, our understanding of the clinical relevance and impact of emerging infections is evolving.In this review, selected new technologies and assays are discussed, in addition to key emerging pathogens of public health importance and newly approved antimicrobial agents.

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Molecular Diagnostics Update for the Emerging (If Not Already Widespread) Sexually Transmitted Infection Agent Mycoplasma genitalium: Just About Ready for Prime Time

Cited by 26 publications

References 34 publications

Mycoplasma genitalium in Singapore is associated with Chlamydia trachomatis infection and displays high macrolide and Fluoroquinolone resistance rates

Mycoplasma genitalium in Singapore is associated with Chlamydia trachomatis infection and displays high macrolide and Fluoroquinolone resistance rates

A novel sequencing-based vaginal health assay combining self-sampling, HPV detection and genotyping, STI detection, and vaginal microbiome analysis

New Bugs and New Drugs: Updates in Clinical Microbiology

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