Researchers have reported increasing evidence that Mycoplasma genitalium (MG) is in fact, a sexually transmitted infection. The findings are based on Britain’s third National Survey of Sexual Attitudes and Lifestyles and were published in the International Journal of Epidemiology.

Researchers at University College London analyzed 4,507 urine samples from the survey (Natsal-3), and found that MG was present in 1.2% of men and 1.3% of women aged 16–44 who had reported at least 1 sexual partner. 

The ratio of sexual partners with increased likelihood of infection correlates with other STI’s. MG was prevalent in 5.2% of men and 3.1% of women who reported >4 sexual partners in the past year. The possibility of MG being a sexually transmitted infection is further supported by the absence of infection in >200 people aged 16–17 years who had not had vaginal, anal, or oral sex.  Most of the MG (90%) cases in men and over two-thirds of MG cases in women were in the 25–44 year age group. 

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Interestingly, among those who tested positive for MG, over half of the women and over 90% of the men did not report any symptoms in the past month. “These findings suggest that only testing those who are currently symptomatic would miss the majority of infections. However, further research is needed to understand the clinical implications of infection and possible longer-term complications,” stated Dr. Pam Sonnenberg, lead author of the paper. Researchers also found that black males, and those living in most deprived areas, were more likely to test positive for MG. 

MG lacks a cell wall which means antibiotics that target cell wall biosynthesis (eg, beta-lactams including penicillins and cephalosporins) are rendered ineffective. Most treatment for MG infections will be in the context of managing urethritis, cervicitis, and pelvic inflammatory disease. Antibiotics used for syndromic management include doxycycline, azithromycin, and moxifloxacin.

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