Epidemiological and clinical rationale for screening and diagnosis of Mycoplasma genitalium infections

Extract

Mycoplasma genitalium has been the focus of basic scientific and synthetic biology research as the organism with the smallest genome of all known human bacterial pathogens. As a sexually transmitted organism, substantial clinical and epidemiologic evidence now exists that warrant further consideration of M. genitalium as a priority for diagnostic testing. In the early 1980's, M. genitalium was first identified from two men with symptomatic non-gonococcal urethritis (NGU) – an inflammatory syndrome most often attributed to infections with Neisseria gonorrhoeae or Chlamydia trachomatis. Since then, epidemiologic studies of clinical disease, several animal models, and the results of many basic scientific investigations point towards M. genitalium as a urogenital pathogen with significant implications for reproductive and sexual health. It is now unequivocally known that M. genitalium is found in approximately 15-25% of patients with NGU and in more than one third of non-chlamydial NGU cases.¹ Importantly, M. genitalium establishes both acute and chronic infections in the urogenital tract of men and women. This article aims to concisely address the rationale for continued investigation of M. genitalium as a sexually transmitted infection (STI) and for the implementation of diagnostic testing paradigms in the USA.