Mycoplasma Genitalium
What is Mycoplasma genitalium?
Mycoplasma genitalium (M. genitalium) is a bacterium that can be transmitted through sexual contact. In women, it may be associated with inflammation of the cervix (cervicitis) and pelvic inflammatory disease (PID); in men, it may be associated particularly with urethritis. Many people with the infection may have no symptoms.
How is Mycoplasma genitalium transmitted?
Transmission occurs mainly through sexual contact. The infection can be passed to a partner even when there are no symptoms. The current sexual partners of people who test positive should also be assessed by a healthcare professional.
What are the symptoms of Mycoplasma genitalium?
Symptoms may vary depending on the site of infection. Some people may have no symptoms at all.
Possible symptoms in men:
- Burning or pain when urinating
- Irritation or itching in the urethra
- Discharge from the penis
Possible symptoms in women:
- Discharge or bleeding after intercourse due to inflammation of the cervix
- Burning when urinating
- Pain in the lower abdomen or pelvic area
These symptoms can also occur with other infections; M. genitalium cannot be diagnosed based on symptoms alone. Medical assessment should be sought if there is pelvic pain or persistent symptoms.
Who may be advised to have an M. genitalium test?
Testing is considered particularly in people diagnosed with urethritis and those with findings suggestive of PID. In cases of persistent or recurrent cervicitis, a doctor may request testing after other possible causes have been investigated. Routine screening for M. genitalium is not recommended for everyone without symptoms; unnecessary testing and antibiotic use may contribute to the development of resistance.
How is it diagnosed?
Molecular tests such as PCR/NAAT are used to detect M. genitalium. Because the organism grows slowly, culture is not a suitable method for routine diagnosis. The sample type is determined according to the person's anatomy, symptoms and the validated sample acceptance criteria of the test used. First-catch urine in men and vaginal swabs in women are among the commonly used samples. Routine testing of throat samples is not recommended; rectal testing is considered only in specific clinical situations.
The Wellcare STI PCR panel is intended to detect M. genitalium. A PCR test that detects the organism does not automatically indicate antibiotic resistance. Whether the panel also tests for resistance mutations should be specified separately in the test details. For information about sample types and the test, you can visit our STI PCR page.
How is M. genitalium treated?
Treatment is determined by a doctor based on antibiotic resistance and the person's clinical condition. Guidelines use a sequential treatment approach in suitable patients: treatment to reduce the bacterial load may be given initially; the subsequent antibiotic is selected according to test results, such as those for macrolide resistance. As antibiotic resistance is a significant concern in M. genitalium, indiscriminate or incomplete antibiotic use may reduce treatment success. In particular, single-dose azithromycin treatment should not be started without medical advice.
Treatment options may differ during pregnancy or breastfeeding. In these situations, decisions about medication must be made by a doctor. As some antibiotics, such as moxifloxacin, may have serious side effects, a doctor should decide whether to use them and provide the necessary information.
Partner assessment and follow-up after treatment
A doctor should assess the need for testing and treatment of the current partners of a person diagnosed with M. genitalium. The doctor's advice on avoiding sexual contact during treatment and while symptoms persist should be followed.
Routine follow-up testing after treatment is not recommended for everyone. Repeat testing may be needed if symptoms persist or ongoing infection is suspected. The timing of repeat testing is important; PCR performed immediately after treatment ends may detect residual genetic material and give a misleading result.