Mycoplasma genitalium Infection in Men

Patrick J Horner, David H Martin

Research output: Contribution to journalReview article (Academic Journal)

40 Citations (Scopus)
228 Downloads (Pure)

Abstract

Mycoplasmagenitalium is one of the major causes of nongonococcal urethritis (NGU) worldwide but an uncommon sexually transmitted infection (STI) in the general population. The risk of sexual transmission is probably lower than for Chlamydia trachomatis. Infection in men is usually asymptomatic and it is likely that most men resolve infection without developing disease. The incubation period for NGU caused by Mycoplasma genitalium is probably longer than for NGU caused by C. trachomatis. The clinical characteristics of symptomatic NGU have not been shown to identify the pathogen specific etiology. Effective treatment of men and their sexual partner(s) is complicated as macrolide antimicrobial resistance is now common in many countries, conceivably due to the widespread use of azithromycin 1 g to treat STIs and the limited availability of diagnostic tests for M. genitalium. Improved outcomes in men with NGU and better antimicrobial stewardship are likely to arise from the introduction of diagnostic M. genitalium nucleic acid amplification testing including antimicrobial resistance testing in men with symptoms of NGU as well as in their current sexual partner(s). The cost effectiveness of these approaches needs further evaluation. The evidence that M. genitalium causes epididymo-orchitis, proctitis, and reactive arthritis and facilitates human immunodeficiency virus transmission in men is weak, although biologically plausible. In the absence of randomized controlled trials demonstrating cost effectiveness, screening of asymptomatic men cannot be recommended.

Original languageEnglish
Article numberjix145
Pages (from-to)S396-S405
Number of pages10
JournalJournal of Infectious Diseases
Volume216
Issue numbersuppl_2
DOIs
Publication statusPublished - 15 Jul 2017

Keywords

  • Anti-Bacterial Agents
  • Azithromycin
  • Drug Resistance, Bacterial
  • Female
  • Humans
  • Macrolides
  • Male
  • Male Urogenital Diseases
  • Mycoplasma Infections
  • Mycoplasma genitalium
  • Nucleic Acid Amplification Techniques
  • Sexual Partners
  • Urethritis
  • Journal Article
  • Review

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