give 2-3 examples with source
what is the epidemiology of the pathogen M. genitalium
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Mycoplasma genitalium is a member of genital mycoplasmas, which is emerging as an important causative agent of sexually transmitted infections both in males and females. The advent of polymerase chain reaction and other molecular methods have made studies on M. genitalium more feasible, which is otherwise a difficult organism to isolate. Besides Chlamydia trachomatis, M. genitalium is now an important and established cause of non gonococcal urethritis (NGU) in men, more so in persistent and recurrent NGU. Multiple studies have also shown a positive association of M. genitalium with mucopurulent cervicitis and vaginal discharge in females as well. The evidences for M. genitalium pelvic inflammatory diseases and infertility are quite convincing and indicate that this organism has potential to cause ascending infection. Lack of clear association with M. genitalium has been reported for bacterial vaginosis and adverse pregnancy outcomes. Diagnosis of M. genitalium infections is performed exclusively using nucleic acid amplification tests (NAATs), owing to poor or slow growth of bacterium in culture. Although there are no
Answer:
Mycoplasma genitalium is a member of genital mycoplasmas, which is emerging as an important causative agent of sexually transmitted infections both in males and females. The advent of polymerase chain reaction and other molecular methods have made studies on M. genitalium more feasible, which is otherwise a difficult organism to isolate. Besides Chlamydia trachomatis, M. genitalium is now an important and established cause of non gonococcal urethritis (NGU) in men, more so in persistent and recurrent NGU. Multiple studies have also shown a positive association of M. genitalium with mucopurulent cervicitis and vaginal discharge in females as well. The evidences for M. genitalium pelvic inflammatory diseases and infertility are quite convincing and indicate that this organism has potential to cause ascending infection. Lack of clear association with M. genitalium has been reported for bacterial vaginosis and adverse pregnancy outcomes. Diagnosis of M. genitalium infections is performed exclusively using nucleic acid amplification tests (NAATs), owing to poor or slow growth of bacterium in culture. Although there are no guidelines available regarding treatment, macrolide group of antimicrobials appear to be more effective than tetracyclines. The present review provides an overview of the epidemiology, pathogenesis, clinical presentation and management of sexually transmitted infections due to M. genitalium.
Keywords: Emerging infection, Mycoplasma genitalium, non-gonococcal urethritis, sexually transmitted diseases
Introduction
According to the WHO there are an estimated 448 million new cases of sexually transmitted infections (STIs) which are acquired worldwide annually1. If diagnosed in time, these infections can be treated easily with minimal morbidity as well as decreased economic burden. Mycoplasma genitalium is an emerging cause of STIs and has been implicated in urogenital infections of men and women around the world. More than 25 years after its initial isolation from men with non-gonococcal urethritis (NGU)2, M. genitalium is now recognized as an important aetiologic agent of acute and persistent male NGU and is responsible for approximately 20-35 per cent of non-chlamydial NGU cases3,4. The role of this organism in male urogenital disease was a significant advancement in our knowledge of STIs, but its role in the inflammatory reproductive tract diseases of women is still not very clear5.
The risk factors for M. genitalium infection are typical as for any STI. Researchers in various study groups of women and men aged 21-23 yr identified behavioural risk factors for M. genitalium infection6: higher number of partners, younger age during first intercourse, having a partner with infection symptoms, coinfection with other sexually transmitted pathogens like Chlamydia trachomatis6. Manhart et al7 showed that the prevalence of M. genitalium increased by 10 per cent for every additional sexual partner. Asymptomatic carrier state7 is also a serious epidemiological problem because of transmission to sexual partners and may be vertical transmission from mother to the newborn. Some investigators have reported infection as common as chlamydial infection and trichomoniasis, and more common than gonorrhoea8,9.
In studies conducted in Denmark, the prevalence of infection was 2.3 and 1.1 per cent in women and men, respectively9. Takahashi et al10 demonstrated the positivity rate of M. genitalium DNA in urine from asymptomatic healthy young Japanese men as 1 per cent; among female students in Japan the prevalence of M. genitalium was 2.8 per cent6. Tosh et al showed high prevalence rate of 13.6 per cent in young (14-17 yr of age) sexually active women who tested positive for M. genitalium11. Among women and men reporting to an STD clinic in Seattle, M. genitalium was detected in 14 and 9 per cent cases, respectively12. Table gives a chronological account of important studies reporting geographic prevalence of M. genitalium.