What is Mycoplasma genitalium? Mycoplasmas belong to the family Mycoplasmataceae, but differ from other bacteria in the absence of a cell wall. Mycoplasma genitalium is a type of bacteria that is sexually transmitted. Mycoplasma genitalium infection can cause vaginal (vaginal) itching, burning when urinating, and bleeding of the skin around the vagina in women, and urethral discharge or burning when urinating in men. Mycoplasma genitalium is the cause of several types of infections, including forms of bacterial vaginosis and non-gonococcal urethritis. The organism is also associated with pelvic inflammatory disease and has been linked to other infections once attributed to other bacteria. What are the symptoms of mycoplasma genitalium infection? In general, most cases of Mycoplasma genitalium infection do not cause symptoms. If symptoms do occur, they are mostly non-specific and easily confused with symptoms of other sexually transmitted infections (STIs), such as chlamydia and gonorrhea. Symptoms of Mycoplasma genitalium also differ significantly between women and men: Symptoms in women Vaginal itching; Burning when urinating; Pain during intercourse; Bleeding between periods or after sex; In case of bacterial vaginosis, unpleasant odor after sex and changes in vaginal discharge; Symptoms in men Urethral discharge Burning with urination Mycoplasma genitalium is the second most common cause of non-gonococcal urethritis in men after chlamydia. How is mycoplasma genitalium infection diagnosed? There is no approved blood test to diagnose Mycoplasma genitalium infection. The nucleic acid amplification test (NAAT) is the standard test used for diagnosis. NAAT uses urine and swab samples from the urethra (opening of the penis), part of the cervix, or vagina, and gives results after 24 to 48 hours. If NAAT is not available at a particular clinic, a health care provider may diagnose Mycoplasma genitalium simply based on the fact that urethritis or cervicitis is persistent or recurrent. Studies show that 40% of these cases in men and up to 30% in women are caused by Mycoplasma genitalium infection. Syndromic treatment occurs when all cases of STIs that fit a certain symptom profile are treated in the same way without knowing their true cause. Specialists who diagnose Mycoplasma genitalium infection based on symptoms alone and treat it accordingly may be right, but not always. This means that some people may have a completely different infection that requires a completely different treatment. If the infection is identified from the beginning, the correct treatment could be started earlier. What is the treatment for Mycoplasma genitalium infection? Mycoplasma genitalium is usually treated with antibiotics.In the past, the most common form of treatment was a single dose of 1 gram (g) of azithromycin. But evidence shows increased resistance to azithromycin in populations where it is widely used. This means that the bacteria has mutated so that this drug is no longer effective. Today, Mycoplasma genitalium from an infected patient is tested to see if the bacteria has mutated into a variant that is resistant to azithromycin. The results of this study dictate the recommended treatment: When Mycoplasma genitalium is not resistant – 100 milligrams (mg) of doxycycline twice daily for seven days, followed by an initial dose of 1 gram of azithromycin, then 500 milligrams of azithromycin daily for the next three days; When Mycoplasma genitalium is resistant – 100 milligrams of doxycycline twice a day for seven days, followed by 400 milligrams of moxifloxacin once a day for seven days. References: 1. Centers for Disease Control and Prevention. Sexually transmitted infections treatment guidelines 2. Horner PJ, Martin DH. Mycoplasma genitalium Infection in Men 3. Bradshaw CS, Jensen JS, Tabrizi SN, et al. Azithromycin failure in Mycoplasma genitalium urethritis 4. Verywell Health. Diagnosis and Treatment of Mycoplasma Genitalium