Mycoplasma genitalium in Males With Nongonococcal Urethritis

Abstract

These data reveal the high prevalence of M genitalium in symptomatic patients, the rarity of asymptomatic carriers, the high susceptibility to antibiotic treatment, and the clinical efficacy of M genitalium eradication. Moreover, data confirm the etiologic role of M genitalium in inflammatory processes of the human urogenital tract in the Mediterranean area.

Mycoplasma genitalium: from Chrysalis to Multicolored Butterfly

“…Furthermore, the development and use of quantitative PCR assays for M. genitalium have shown greater M. genitalium DNA loads in urine from men with NGU than in urine from those without the disease (98,100). It is noteworthy that the association between mycoplasma and disease is even stronger for acute nonchlamydial NGU (NCNGU) (2,9,14,19,24,30,35,40,47,55,58,74,84,95,105,108,113,120,133,144,147,149,164,182,185,211,217,232,235) (Fig. 3), with the mycoplasma being found in more than one-third of men with such disease, indicating that M. genitalium and C. trachomatis act as separate causes of the condition.…”

Mycoplasma genitalium - an up-date

“…These aspects of antibiotic susceptibility, added to the fact that M. genitalium has the ability to invade epithelial cells 61 , and in this protected environment multiply and persist 62 , might account for it sometimes continuing to be found in the urethra or other sites, especially following treatment with one of the tetracyclines. In this regard, one group of investigators recorded that doxycycline (200 mg per day for 7 days) or azithromycin (1 g single dose) were equally effective in eradicating the mycoplasma and curing the symptoms of NGU when assessed one week later 63 . However, this has not been the experience of all investigators.…”

Intrastrain Heterogeneity of the mgpB Gene in Mycoplasma genitalium Is Extensive In Vitro and In Vivo and Suggests that Variation Is Generated via Recombination with Repetitive Chromosomal Sequences

“…Similarly, we analyzed mgpB sequences from cervical specimens from a persistently infected woman (21 months) and identified 17 different mgpB variants within a single infecting M. genitalium strain, confirming that mgpB heterogeneity occurs over the course of a natural infection. These observations support the hypothesis that recombination occurs between the mgpB gene and MgPar sequences and that the resulting antigenically distinct MgPa variants may contribute to immune evasion and persistence of infection.Mycoplasma genitalium has been identified as a possible cause of several reproductive tract disease syndromes including urethritis in men and mucopurulent cervicitis, endometritis, pelvic inflammatory disease, and tubal factor infertility in women (3,6,7,18,23,28,30,34,35,41,48,52,55,56). When untreated (or inappropriately treated), this organism persists at infected sites as demonstrated by its association with chronic nongonococcal urethritis in men (22, 53) and its persistence for months, if not years, in the lower genital tract of women (C. R. Cohen, M. Nosek, A. Meier, S. G. Astete, S. Iverson-Cabral, N. R. Mugo, and P. A. Totten, submitted for publication).…”