Mycoplasma genitalium is a sexually transmitted infection (STI) that spreads through unprotected sexual contact. This bacterium infects the urinary, genital, and sometimes rectal tracts.
Mycoplasma Overview
Mycoplasma is a genus of bacteria notable for a unique characteristic: they lack a cell wall, unlike most other bacteria. This absence makes them resistant to common antibiotics that target cell wall synthesis, such as penicillin. Not all Mycoplasma species are sexually transmitted; for example, Mycoplasma pneumoniae is a known cause of respiratory infections. However, M. genitalium is increasingly recognized as an emerging public health concern due to its growing prevalence and potential for complications if left untreated.
Transmission and Common Manifestations
Mycoplasma genitalium is primarily transmitted through sexual contact, including vaginal and anal intercourse. There is also evidence suggesting transmission through oral sexual contact, though this is considered less common. This bacterial infection can spread from one person to another when engaging in sexual activity without barrier protection, such as condoms.
A significant challenge with M. genitalium infections is their often asymptomatic nature. Many individuals carrying the bacteria may not experience any noticeable symptoms, which can lead to delayed diagnosis and unintentional transmission to partners.
When symptoms do appear, they can be similar to those of other common STIs like chlamydia or gonorrhea, making clinical differentiation difficult without specific testing.
In men, common manifestations include urethritis, an inflammation of the urethra, which can cause symptoms such as watery discharge from the penis and painful urination. Some men may also experience testicular pain or discomfort in the rectum if the infection is present there.
In women, M. genitalium can cause cervicitis (inflammation of the cervix) or urethritis, leading to symptoms like unusual vaginal discharge, painful urination, or bleeding between periods or after sex. Pelvic or lower abdominal pain may also occur in women.
Detection and Management
Diagnosing Mycoplasma genitalium primarily relies on Nucleic Acid Amplification Tests (NAATs). These tests detect the genetic material of the bacteria and can be performed on urine samples or swabs collected from the vagina, cervix, or rectum, depending on the site of potential infection. Given the often asymptomatic nature of the infection, testing is crucial for accurate identification.
Treatment for M. genitalium typically involves antibiotics. However, a significant and growing concern is the increasing antibiotic resistance of M. genitalium strains, particularly to commonly used macrolide antibiotics like azithromycin. This resistance complicates treatment, often requiring sequential use of different antibiotics or alternative regimens. Due to this challenge, healthcare providers may recommend retesting after treatment to confirm the eradication of the infection. Furthermore, partner notification and treatment are important to prevent reinfection and limit further spread of the bacteria within the community.
Unaddressed Infections and Outcomes
If Mycoplasma genitalium infections are left untreated, they can lead to several health complications.
In women, untreated M. genitalium can progress to Pelvic Inflammatory Disease (PID). PID is an infection of the reproductive organs that can result in chronic pelvic pain, an increased risk of ectopic pregnancy (where a fertilized egg implants outside the uterus), and infertility due to scarring of the fallopian tubes.
For men, an untreated M. genitalium infection can lead to epididymitis, which is an inflammation of the epididymis, a tube located at the back of the testicles. While not as extensively studied as in women, untreated infections may also be linked to male infertility in some cases.
Additionally, there is a potential association between M. genitalium during pregnancy and adverse outcomes, such as preterm birth or miscarriage. Early detection and appropriate treatment are therefore important to help prevent these long-term health issues.