Mycoplasma genitalium

Overview

  • Asymptomatic screening for M. genitalium is not currently recommended due to lack of knowledge regarding its natural history, rising antimicrobial resistance and increasing complexities around access to effective treatments.
  • Established cause of urethritis, cervicitis and pelvic inflammatory disease (PID) and associated with preterm delivery. Evidence suggests a role in tubal factor infertility and proctitis although studies do not show a strong and consistent association.
  • Antimicrobial resistance that impacts on available treatments is increasing globally and is particularly prevalent in our region. Azithromycin (macrolide) resistance exceeds 60% in Australia in the majority of cases and exceeds 80% in men who have sex with men. Fluoroquinolone resistance is also rising and approaching 20% in many urban settings impacting on the efficacy of moxifloxacin. 
  • Use of macrolide-resistance assays and resistance guided therapy for M. genitalium have been shown to improve first-line cure from 60 to >90% .