Mycoplasma genitalium: a review

Daley, GM; Db, Russell; Tabrizi, S N; McBride, William J. H.

doi:10.1177/0956462413515196

Cited by 69 publications

(58 citation statements)

References 101 publications

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“…14,41,42 M. genitalium has been detected in males with HIV and its adherence to HIV-infected cells has demonstrated an increase in virus release 26,43,44 ; thus, it is possible that undiagnosed M. genitalium infection could influence the risk of acquiring and transmitting HIV infection. 45,46 Data demonstrated in this study confirm a role for M. genitalium in NCNGU and a higher prevalence in MSM. Further research is clearly needed of the significance of these findings and in particular whether the high rates of undiagnosed infection may influence HIV transmission in MSM.…”

Section: Discussionsupporting

confidence: 90%

Ureaplasma parvum and Mycoplasma genitalium are found to be significantly associated with microscopy-confirmed urethritis in a routine genitourinary medicine setting

et al. 2016

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Inflammation of the urethra defined by an excess of polymorphonuclear leukocytes in the absence of sexually transmitted Chlamydia trachomatis and Neisseria gonorrhoeae is called non-chlamydial non-gonococcal urethritis (NCNGU). Although Mycoplasma genitalium is now recognised as causing a sexually transmitted infection, the clinical significance of the other Mollicute species is less clear. This study used specific real-time quantitative polymerase chain reaction assays to detect and quantify four Mollicute species, M. genitalium, M. hominis, Ureaplasma urealyticum and U. parvum, in urine specimens from men with and without NCNGU. A total of 165 urine specimens from male patients attending a genitourinary medicine clinic were eligible for the study, with microscopy-confirmed (≥5 polymorphonuclear leukocytes in urethral swab) NCNGU in 75 (45.5%) and non-confirmed NCNGU in 90 (54.5%). Chi-squared statistical analysis indicated a significantly higher prevalence of U. parvum (17.3% vs. 5.6%; p = 0.03) and M. genitalium (12% vs. 0%; p < 0.001) in NCNGU. In a subset analysis, M. genitalium was also significantly (p = 0.03) higher in men who have sex with men (MSM; 13.5%) compared to non-MSM (3.1%). No significant associations were reported for U. urealyticum and M. hominis In conclusion, this study supports a clinically significant role in NGNCU for both U. parvum and M. genitalium.

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Section: Discussionsupporting

confidence: 90%

Ureaplasma parvum and Mycoplasma genitalium are found to be significantly associated with microscopy-confirmed urethritis in a routine genitourinary medicine setting

et al. 2016

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“…In addition, azithromycin is commonly administered empirically in monotherapy to treat urethritis that is presumed to be due to C. trachomatis or Mycoplasma genitalium. This practice can pose a risk of selecting azithromycin-resistant NG isolates [17,18].…”

Section: Discussionmentioning

confidence: 99%

High-level azithromycin-resistant Neisseria gonorrhoeae clinical isolate in France, March 2014

et al. 2014

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We report the first case in France of a high-level azithromycin-resistant Neisseria gonorrhoeae (minimum inhibitory concentration (MIC) = 96 mg/L) assigned to MLST7363 (NG-MAST ST6360), also resistant to ciprofloxacin and tetracycline but susceptible to ceftriaxone. The patient was a 51 year-old heterosexual man who returned following 1g azithromycin monotherapy. Mechanisms of azithromycin resistance were a C2599T mutation in the four copies of the rrl gene and a novel mutation in the promoter of the mtrR gene.The surveillance of Neisseria gonorrhoeae (NG) susceptibility to antibiotics in France is based on a voluntary sentinel network of laboratories [1]. In March 2014, the first NG strain showing a high level of azithromycin resistance was isolated from the urine of a 51 year-old man living in the south of France. He had a history of a Chlamydia trachomatis infection 20 years ago. The patient was heterosexual and declared having sex with only two regular female partners (last sexual contact four and ten days before symptoms). Case descriptionAt the first visit, the patient presented with mild symptoms of urethritis. He was in good general state of health and his HIV test was negative. No microbiological analyses were performed and the patient was treated empirically with a single dose of azithromycin (1 g orally) for suspected C. trachomatis infection. The patient presented again with persisting symptoms 48 hours later. At that time, he was treated empirically with a single dose of spectinomycin (2 g intramuscularly) and bacteriological examination was performed with direct microscopic examination and culture. Culture results indicated the presence of an azithromycin-resistant NG isolate. The absence of C. trachomatis infection was determined retrospectively by negative nucleic acid amplification test. At a third visit, one week later the patient was successfully cured and free of clinical symptoms.In France, the first-line treatment of uncomplicated urogenital gonorrhoea is ceftriaxone (500 mg intramuscularly), whereas spectinomycin is used in cases of contraindication to beta-lactams. For our patient, the clinician chose spectinomycin because of his own prescribing practices. Infection with the azithromycinresistant-strain was presumably acquired in France since neither the patient nor his sexual contacts had travelled in the past six months or had other known sexual contacts. In addition, they had not received any antibiotic treatment in the preceding six months.

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“…Although oralurethral transmission of MG has not been proven, this case raises questions about this route of infection. 1,2 In the present case, we propose that the apparent treatment failure might represent macrolide resistance in this patient. 3 Moreover, this might be present in the local population in Lebanon but further work with a large series of patients is warranted to investigate MG prevalence and resistance rate estimation.…”

Section: Commentmentioning

confidence: 63%

Mycoplasma genitalium: a possible case of macrolide resistance from Lebanon

Maatouk

2016

Int J STD AIDS

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Mycoplasma genitalium: a review

Cited by 69 publications

References 101 publications

Ureaplasma parvum and Mycoplasma genitalium are found to be significantly associated with microscopy-confirmed urethritis in a routine genitourinary medicine setting

Ureaplasma parvum and Mycoplasma genitalium are found to be significantly associated with microscopy-confirmed urethritis in a routine genitourinary medicine setting

High-level azithromycin-resistant Neisseria gonorrhoeae clinical isolate in France, March 2014

Mycoplasma genitalium: a possible case of macrolide resistance from Lebanon

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