Mycoplasma genitalium: A Review

Abstract

Mycoplasma genitalium is a fastidious organism of the class Mollicutes, the smallest prokaryote capable of independent replication. First isolated in 1981, much is still unknown regarding its natural history in untreated infection. It is recognized as a sexually transmitted pathogen causing acute and chronic non-gonococcal urethritis (NGU) in men, with a growing body of evidence to suggest it also causes cervicitis and pelvic inflammatory disease in women. Its role in several other clinical syndromes is uncertain. The majority of people infected remain asymptomatic and clear infection without developing disease; asymptomatic screening is therefore not recommended. Prevalence rates are higher in patients attending sexual health clinics and in men with NGU. Limited availability of diagnostics has encouraged syndromic management, resulting in widespread antimicrobial resistance and given that few antimicrobial classes have activity against M. genitalium , there is significant concern regarding the emergence of untreatable strains. There is a need for wider availability of testing, which should include detection of macrolide resistance mediating mutations. Expertise in interpretation of microbiological results with clinical correlation ensures targeted treatment avoiding unnecessary antibiotic exposure. Public health surveillance nationally and internationally is vital in monitoring and responding to changing epidemiology trends. In this review, we summarize current knowledge of M. genitalium , including epidemiology, clinical and microbiological data, and discuss treatment challenges in the era of rising multidrug resistance.

Mycoplasma genitalium Biofilms Contain Poly-GlcNAc and Contribute to Antibiotic Resistance

“…Biofilms have also been shown to form in vivo in other bacterial species and contribute directly to antibiotic resistance and persistence of infection in patients (Sharma et al, 2019). There are many reports of persistent detection of M. genitalium upward of 100 days after antibiotic therapy and clinical cure (Gnanadurai and Fifer, 2019). Data presented in our study show that in vitro bacterial growth may be impacted by antibiotic treatment with M. genitalium in intact biofilms better able to tolerate high levels of drug.…”

“…M. genitalium is a sexually transmitted pathogen and a causative agent of acute and chronic nongonococcal urethritis in men (Tully et al, 1981;Taylor-Robinson and Jensen, 2011;Taylor-Robinson, 2017). There is evidence that it also causes cervicitis and pelvic inflammatory disease in women (Gnanadurai and Fifer, 2019). M. genitalium is rarely culturable and can take >6 months to adapt to growth in vitro.…”

Antibiotic Resistance and Genotypes of Mycoplasma genitalium during a Resistance-Guided Treatment Regime in a German University Hospital

“…M. genitalium has been detected in 10 to 25% of patients with NGU resulting in persistent symptoms in up to 41% of men after treatment failure (reviewed in [ 4 , 6 ]). However, the evaluation of prevalence is difficult as many infected patients are asymptomatic [ 3 , 7 , 8 , 9 ]. Due to the intrinsic resistance to all betalactam antibiotics and the narrowed efficacy (22–45%) of doxycycline [ 10 ], options for the treatment of infections are limited.…”

Too Much of a Good Thing: How Ectopic DNA Replication Affects Bacterial Replication Dynamics

“…The improved ability to sequence whole genomes has revealed considerable variations. For example, Mycoplasma genitalium, a sexually transmitted pathogen that can cause non-gonococcal urethritis, is one of the smallest prokaryotes capable of independent replication with a genome size of 0.58 Mbp and less than 500 genes (Taylor-Robinson and Jensen, 2011;Gnanadurai and Fifer, 2020). In strictly opportunistic or symbiotic bacteria, genomes can be even smaller: the symbiotic bacterium Carsonella ruddii carries a single circular chromosome containing 0.159 Mbp and is predicted to encode 182 genes (Nakabachi et al, 2006).…”