Mycoplasma genitalium (Mgen) is a bacterial sexually transmitted infection (STI) that has gained increasing attention from public health officials and researchers. It infects the genital tract and spreads through sexual contact. Understanding Mgen’s global prevalence helps assess its public health significance and the challenges associated with its management. This article explores Mgen’s prevalence, difficulties in tracking its spread, and the broader implications of its presence.
Mgen’s Global Presence
Mgen is a prevalent STI across various populations worldwide. In general adult populations in countries with high human development, the average prevalence is estimated at 1.3%. However, rates differ significantly based on geography and risk factors. For example, a U.S. study found Mgen prevalence at 16.1% in females and 17.2% in males seeking care.
Among young adults and high-risk groups, Mgen is particularly common. One U.S. study found a 1.0% prevalence among young adults, higher than gonorrhea in that population. Other research indicates rates exceeding 24% in young adult men and 25% in adolescent and young adult women, generally decreasing in older age groups. In specific high-risk cohorts, such as men who have sex with men (MSM) or women in STI clinics, prevalence can range from 7.0% to over 50%. Mgen is often as common as, or more common than, other well-known STIs like Chlamydia or Gonorrhea in some demographics.
Challenges in Tracking Mgen
Accurately measuring Mgen’s true prevalence and tracking its spread is difficult due to several factors. A significant challenge is the high rate of asymptomatic infections. Most infected individuals experience no symptoms, meaning they can unknowingly transmit the infection. For example, studies show 93% of Mgen infections among men who have sex with men were asymptomatic.
A second hurdle is the lack of routine screening tests in many regions. Unlike Chlamydia or Gonorrhea, Mgen is not typically included in standard STI screening panels. Testing is often recommended only when other STIs are ruled out, or in cases of persistent urethritis, cervicitis, or pelvic inflammatory disease. This contributes to underdiagnosis, as many cases remain undetected.
Specialized diagnostic methods are required to identify Mgen. The bacterium is slow-growing and difficult to culture, making traditional bacterial culture impractical. Nucleic acid amplification tests (NAATs) are the preferred and often only effective method for detection, as they identify the bacterium’s genetic material. While NAATs are highly sensitive, their availability can vary, complicating widespread testing and surveillance.
Impact of Widespread Mgen
The widespread presence of Mgen contributes to significant public health and individual implications. A concern is the increasing prevalence of antibiotic resistance. Mgen has developed resistance to commonly used antibiotics, particularly macrolides like azithromycin, with rates reaching over 60% in some areas. This resistance complicates treatment, often requiring multiple courses of different antibiotics, and can lead to treatment failures.
For individuals, Mgen infection is linked to various reproductive and sexual health issues. In men, it causes non-gonococcal urethritis, an inflammation of the urethra. In women, Mgen is associated with cervicitis (inflammation of the cervix) and pelvic inflammatory disease (PID), an infection of the upper reproductive organs. PID can lead to complications such as infertility, ectopic pregnancy, and chronic pelvic pain. Mgen’s prevalence highlights the need for increased awareness, targeted testing strategies, and new, effective treatments to address its global health impact.