Have you ever heard of Mycoplasma genitalium? Or ever wondered what it is?

If not, you’re not alone, and you’re in the right place.

In this blog, Karepedia will throw light on Mycoplasma genitalium, a sexually transmitted infection (STI) caused by the microscopic organism, M Genitalium.

It has been relatively overlooked since its discovery in the early 1980s. So, this piece should be a must read on your list if you’re interested to know about this condition.

Interestingly, its prevalence is rising and its growing antibiotic resistance makes it a matter of concern.

Want to know how this microscopic organism can be a threat to your sexual health? How is it caused? And how can it be prevented? We’ve got you covered.

Let’s have a look at those.

Understanding Mycoplasma Genitalium

Here’s some scientific knowledge for you to begin with.

M. genitalium is a fastidious organism (an organism having a complex or particular nutritional requirement), belonging to the class Mollicutes meaning 'soft skin'.

It is recognised as the smallest prokaryote (an organism whose cells lack a nucleus and other organelles) capable of independent replication. 

It was first identified in 1981 from the urethras of two men with non-gonococcal urethritis (NGU), an infection of the urethra (the tube running through the penis in men and labia in women through which the urine passes) caused by some agent other than gonorrhea.

A 2019 report by CDC highlighted M. genitalium as a significant antibiotic resistance threat in the US. And the story is not much different in India too.

This concern stems from the organism's rapid progression towards becoming an untreatable infection.

Symptoms

M. genitalium often shows no visible symptoms. Its symptoms can be mistaken for other conditions. That’s why it is important for you to be able to identify its signs.

Symptoms in men can include:

• Dysuria: painful or difficult urination

• Urethral pruritus: itching or rashes in the urethra

• Abnormal urethral discharge: often not visible without applying pressure

In women, symptoms may include:

• Vaginal itching

• Vaginal discharge

• Dysuria

• Pelvic discomfort

• Mild abdominal pain

• Bleeding

Recent research suggests that M. genitalium might infect the renal system. It could potentially affect pharynx through oral sex. However, further research is needed to confirm these findings.

Complications

M. genitalium is associated with several complications in both men and women. The research in this area is still evolving.

Wondering what the possible complications could be?

Men, be cautious of these:

• Acute and chronic non-gonococcal urethritis

• Acute epididymitis

• Chronic posthitis

• Balanoposthitis

Women, requesting your attention to these:

• Non-gonococcal urethritis

• Bacterial vaginosis and vaginitis

• Cervicitis

• Pelvic inflammatory disease

• Endometritis

• Salpingitis

• Reproductive issues

Common complications for both genders include infertility and arthritis.

Prevention

M.genitalium is a sexually transmitted infection.

There are several ways by which you can prevent it:

• Safe sex practices by using condoms 

• Avoiding multiple sex partners

• Regular STI screening to reduce chance of co infection 

• Communicating with the partners

• Health Awareness Education 

Diagnosis

Diagnosing M. genitalium is challenging due to often asymptomatic infections. Untreated and undiagnosed cases can lead to severe consequences. 

That’s why you must be prompt enough to diagnose it. Here’s how you can do that:

That’s why you must be prompt enough to get it diagnosed at the earliest. Here’s how you can do that.

• Screening programs, especially using molecular testing methods are highly recommended.

• Those with recurrent urethritis and cervicitis should consider testing. This is especially recommended if previous treatments have failed.

• M. genitalium is a fastidious organism without a cell wall. It eludes conventional susceptibility testing methods.

• M.genitalium is an extremely slow growing organism. Culture can take up to six months for results.

• Nucleic Acid Amplification test (NAAT) is the preferred method for testing M.genitalium. In NAAT, urine samples from men are the optimal specimen.

• While in women urine samples and vaginal swabs can be taken, but vaginal swabs are preferred.

Treatment

M. genitalium lacks a cell wall making antibiotics targeting cell-wall biosynthesis ineffective. 

The prevalence of resistant strains of M. genitalium has increased over the past few decades. Now we have only limited treatment options.

Resistance-guided therapy, with a cure rate of over 90%, can be used.

This approach often begins with doxycycline. It is then followed by high-dose azithromycin for macrolide-sensitive infections and moxifloxacin for macrolide-resistant cases. 

Monitoring for antibiotic resistance is crucial to ensure effective treatment.

Other known treatments for M.genitalium includes

• Tetracycline and macrolides 

• Fluoroquinolone

• Streptogramins

• Spectinomycin

• Thiamphenicol

Potential Risks or Side Effects

Treating M.genitalium with antibiotics may lead to adverse effects, often serious.

Monitoring and managing side effects is a critical part of every treatment process.

Here’s what you should know:

• The common side effects are gastrointestinal disturbances (like vomiting, nausea, diarrhoea), allergic reaction or increased sensitivity to sunlight.

• In some rare cases it may cause tendon rupture or tendonitis. It occurs in older people or those with pre-existing conditions.

• It is important for you to discuss the possible risks and side effects with the healthcare professionals.

Risk of Contracting Other Infections

The risk of contracting M. genitalium is higher in individuals with:

• Other STIs such as Chlamydia trachomatis and Neisseria gonorrhoeae.

• Bacterial vaginosis.

• More than two sexual partners in a year.

• HIV-positive men who have sex with men (MSM), compared to HIV-negative MSM.

These factors increase exposure to the pathogen and potential co-infections.

Now that you’re empowered with information and the right knowledge on this STI, take charge of your health, and remain healthy.