Mycoplasma Genitalium: Risk factors and clinical manifestation

Risk factors and clinical manifestation of Mycoplasma genitalium.

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Risk factors

Reported risk factors for M. genitalium:

Transmission

M. genitalium is transmitted sexually and is rarely detected in sexually inexperienced individuals. Studies demonstrate concordant infection status between partners Footnote 5, Footnote 6, and some evidence shows indistinguishable strain types between partnersFootnote 7.

Clinical manifestations

There is insufficient information to define the incubation period of M. genitalium infection Footnote 8.

Signs, symptoms and sequelae

Females

Females are often asymptomatic. When present, signs and symptoms may include Footnote 9:

Available data suggest:

There is insufficient evidence to determine an association with ectopic pregnancy Footnote 10.

The severity of signs and symptoms in M. genitalium-associated PID may be similar to that of chlamydia-associated PID Footnote 13.

Males

M. genitalium has been widely implicated as an etiologic agent of acute, persistent and recurrent urethritis Footnote 10, Footnote 11, Footnote 14, Footnote 15, Footnote 16.

A Swedish sexually transmitted infections (STI) clinic study found that 73% of men with M. genitalium had symptomatic urethritis (e.g. urethral discharge, dysuria) in comparison to 40% of men with C. trachomatis Footnote 17. This is consistent with findings from another STI clinic study Footnote 12.

There is insufficient evidence to determine whether M. genitalium causes epididymitis or proctitis Footnote 18.

Available evidence does not support M. genitalium infection as a cause of male infertility Footnote 19.

References

Footnote 1

Cazanave C, Manhart L, Bébéar C. Mycoplasma genitalium, an emerging sexually transmitted pathogen. Médecine et maladies infectieuses. 2012;42(9):381-392.

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Footnote 2

Mobley VL, Hobbs MM, Lau K, Weinbaum BS, Getman DK, Sena AC. Mycoplasma genitalium infection in women attending a sexually transmitted infection clinic: Diagnostic specimen type, coinfections, and predictors. Sex Transm Dis. 2012;39(9):706-709. doi: 10.1097/OLQ.0b013e318255de03 [doi].

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Footnote 3

Svenstrup HF, Dave SS, Carder C, et al. A cross-sectional study of mycoplasma genitalium infection and correlates in women undergoing population-based screening or clinic-based testing for chlamydia infection in london. BMJ Open. 2014;4(2):e003947-2013-003947. doi: 10.1136/bmjopen-2013-003947 [doi].

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Footnote 4

Hancock EB, Manhart LE, Nelson SJ, Kerani R, Wroblewski JK, Totten PA. Comprehensive assessment of sociodemographic and behavioral risk factors for mycoplasma genitalium infection in women. Sex Transm Dis. 2010;37(12):777-783. doi: 10.1097/OLQ.0b013e3181e8087e [doi].

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Footnote 5

Manhart LE, Kay N. Mycoplasma genitalium: Is it a sexually transmitted pathogen? Curr Infect Dis Rep. 2010;12(4):306-313.

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Footnote 6

Su R. Genital infections with mycoplasma genitalium. HONG KONG JOURNAL OF DERMATOLOGY & VENEREOLOGY. 2010;18(1):16-24.

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Footnote 7

Hjorth SV, Bjornelius E, Lidbrink P, et al. Sequence-based typing of mycoplasma genitalium reveals sexual transmission. J Clin Microbiol. 2006;44(6):2078-2083. doi: 44/6/2078 [pii].

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Footnote 8

Weinstein SA, Stiles BG. A review of the epidemiology, diagnosis and evidence-based management of mycoplasma genitalium. Sexual Health. 2011;8(2):143-158.

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Footnote 9

Falk L, Fredlund H, Jensen JS. Signs and symptoms of urethritis and cervicitis among women with or without mycoplasma genitalium or chlamydia trachomatis infection. Sex Transm Infect. 2005;81(1):73-78. doi: 81/1/73 [pii].

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Footnote 10

Manhart LE, Broad JM, Golden MR. Mycoplasma genitalium: Should we treat and how? Clinical Infectious Diseases. 2011;53(suppl_3):S129-S142.

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Footnote 11

Lis R, Rowhani-Rahbar A, Manhart LE. Mycoplasma genitalium infection and female reproductive tract disease: A meta-analysis. Clinical Infectious Diseases. 2015;61(3):418-426.

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Footnote 12

Anagrius C, Lore B, Jensen JS. Mycoplasma genitalium: Prevalence, clinical significance, and transmission. Sex Transm Infect. 2005;81(6):458-462. doi: 81/6/458 [pii].

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Footnote 13

Short VL, Totten PA, Ness RB, Astete SG, Kelsey SF, Haggerty CL. Clinical presentation of mycoplasma genitalium infection versus neisseria gonorrhoeae infection among women with pelvic inflammatory disease. Clinical Infectious Diseases. 2009;48(1):41-47.

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Footnote 14

Ballard RC, Fehler HG, Htun Y, Radebe F, Jensen JS, Taylor-Robinson D. Coexistence of urethritis with genital ulcer disease in south africa: Influence on provision of syndromic management. Sex Transm Infect. 2002;78(4):274-277.

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Footnote 15

Hoosen A, le Roux M, Adam A. P3-S1. 23 mycoplasma genitalium in south african men with and without symptoms of urethritis: Diagnosis and bacterial load. Sex Transm Infect. 2011;87(Suppl 1):A275-A275.

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Footnote 16

Thurman A, Musatovova O, Perdue S, Shain R, Baseman J, Baseman J. Mycoplasma genitalium symptoms, concordance and treatment in high-risk sexual dyads. Int J STD AIDS. 2010;21(3):177-183.

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Footnote 17

Falk L, Fredlund H, Jensen JS. Symptomatic urethritis is more prevalent in men infected with mycoplasma genitalium than with chlamydia trachomatis. Sex Transm Infect. 2004;80(4):289-293. doi: 10.1136/sti.2003.006817 [doi].

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Footnote 18

Francis SC, Kent CK, Klausner JD, et al. Prevalence of rectal trichomonas vaginalis and mycoplasma genitalium in male patients at the san francisco STD clinic, 2005-2006. Sex Transm Dis. 2008;35(9):797-800. doi: 10.1097/OLQ.0b013e318177ec39 [doi].

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Footnote 19

Kjærgaard N, Kristensen B, Hansen ES, et al. Microbiology of semen specimens from males attending a fertility clinic. APMIS. 1997;105(7‐12):566-570.

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