Mycoplasma Genitalium

Mycoplasma genitalium infection is one of the pathogens that causes nongonococcal urethritis. Reports show that approximately 1.3% to 3.9% of the population are infected with Mycoplasma genitalium^[1]. A study conducted in Southern China in 2021 showed that up to 7.2% of patients had Mycoplasma genitalium infection, and 36.7% are asymptomatic ^[2]. Another study showed that in China region, Mycoplasma genitalium infection are detected in the approximately 19.7% of non-gonococcal urethritis reported cases. ^[3]

Symptoms of Mycoplasma Genitalium

Common symptoms of Mycoplasma genitalium infection include^[2]

• Nongonococcal urethritis
• Cervicitis
• Prostatitis
• Balanoposthitis or
• pelvic inflammatory disease
• infertility

Treatment of Mycoplasma Genitalium

Macrolide or fluoroquinolone antibiotics can be used to treat the infection of Mycoplasma genitalium.

High prevalence of drug resistance of Mycoplasma genitalium

However, studies indicate that more than 40% of Mycoplasma genitalium are resistant to macrolide antibiotics, such as Azithromycin or tetracycline, and 4.5% to 11.4% are resistant to fluoroquinolone antibiotics, such as Moxifloxacin, ^[4,5]. In addition, approximately 2.8% of infections developed resistance to both drugs. 

Numerous researches suggested that sub-optimal treatment, abuse or misuse of antibiotics are the causes of the emergence/development of large-scale drug resistance of Mycoplasma genitalium.

Susceptibility test of Mycoplasma genitalium

The bacterial cultivation of Mycoplasma genitalium is extremely difficult, with very low successful rate. The process may take several weeks to several months which makes it very difficult to perform the drug resistance test. Thus, molecular biology methods can only be used for the drug resistance testing. The drug resistance of Mycoplasma genitalium is determined by single nucleotide polymorphisms (SNP) analysing of the 23rRNA and parC gene of Mycoplasma genitalium^[4,5,6] . Apparently, there is an urgent need for drug resistance testing of Mycoplasma genitalium in Hong Kong, there are very few private institutions that can provide such drug resistance testing services. Our professional team at Urban Medical has introduced SNP testing services for Mycoplasma genitalium resistance to macrolide antibiotics, with the use of CE-IVD registered reagents, which enable clinician to make appropriate clinical management and treatment plans.

The Mycoplasma genitalium susceptibility test we provide mainly analyzes the resistance of Mycoplasma genitalium to macrolide antibiotics, such as azithromycin or tetracycline. Doctors can take reference and choose appropriate antibiotics.

People who are recommended to take the Mycoplasma genitalium susceptibility test:

• People who are known to be recurrently infected with Mycoplasma genitalium
• People with recurrent urethritis or persistent urethritis
• Those who have detected for initial Mycoplasma genitalium infection

Test of cure of Mycoplasma genitalium

Test of cure should be performed in all patients positive for M. genitalium, even if symptoms have resolved. It should be performed at least 4 weeks (4-6 weeks) after treatment is completed. Test of cure before this time can produce inaccurate (false-negative) results.

Susceptibility test fee of Mycoplasma genitalium

$1350

Ref:

1. Baumann L, Cina M, Egli-Gany D, et al. Prevalence of Mycoplasma genitalium in different population groups: systematic review and meta-analysis Sexually Transmitted Infections (2018);94:255-262.
2. Zhang, XH., Zhao, PZ., Ke, WJ. et al. Prevalence and correlates of Mycoplasma genitalium infection among patients attending a sexually transmitted infection clinic in Guangdong, China: a cross-sectional study. BMC Infect Dis. (2021)  21, 649 
3. Li Y, Su X, Le W, et al. Mycoplasma genitalium in Symptomatic Male Urethritis: Macrolide Use Is Associated With Increased Resistance. Clin Infect Dis. 2020;70(5):805-810.
4. Pond MJ, Nori AV, Witney AA et. al. High prevalence of antibiotic-resistant Mycoplasma genitalium in nongonococcal urethritis: the need for routine testing and the inadequacy of current treatment options. Clin Infect Dis. 2014;58(5):631-637.  
5. Dorothy AM, Yusha Tao, Hannah Shilling et al. Prevalence of mutations associated with resistance to macrolides and fluoroquinolones in Mycoplasma genitalium: a systematic review and meta-analysis. Lancet Infec Dis. 2020; 20(11):1302-1324)
6. Van Der Pol B, Waites KB, Xiao L et. al.  2020. Mycoplasma genitalium detection in urogenital specimens from symptomatic and asymptomatic men and women by use of the cobas TV/MG test. J Clin Microbiol 58:e02124-19