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2017 ; 216
(suppl_2
): S396-S405
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Mycoplasma genitalium Infection in Men
#MMPMID28838074
Horner PJ
; Martin DH
J Infect Dis
2017[Jul]; 216
(suppl_2
): S396-S405
PMID28838074
show ga
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.
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