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REVIEW (Open Access)
Contents Vol 19(4)

Mycoplasma genitalium: enhanced management using expanded resistance-guided treatment strategies

Emma L. Sweeney https://orcid.org/0000-0002-3199-6432 A * , David M. Whiley A B , Gerald L. Murray C D E and Catriona S. Bradshaw F G
+ Author Affiliations
- Author Affiliations

A Faculty of Medicine, The University of Queensland Centre for Clinical Research, The University of Queensland, Brisbane, Qld, Australia.

B Pathology Queensland Central Laboratory, Brisbane, Qld, Australia.

C Murdoch Children’s Research Institute, Parkville, Vic., Australia.

D Women’s Centre for Infectious Diseases, The Royal Women’s Hospital, Parkville, Vic., Australia.

E Department of Obstetrics and Gynaecology, The University of Melbourne, Parkville, Vic., Australia.

F Melbourne Sexual Health Centre, Alfred Hospital, Carlton, Vic., Australia.

G Central Clinical School, Monash University, Melbourne, Vic., Australia.

* Correspondence to: e.l.sweeney@uq.edu.au

Handling Editor: Jane Hocking

Sexual Health - https://doi.org/10.1071/SH22012
Submitted: 19 January 2022  Accepted: 18 March 2022   Published online: 27 May 2022

© 2022 The Author(s) (or their employer(s)). Published by CSIRO Publishing. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)

Abstract

Mycoplasma genitalium is an emerging sexually transmitted bacterium that is gaining attention because of the impact escalating antimicrobial resistance (AMR) is having on patient management. Of additional concern is that increased availability of testing appears to be resulting in screening practices that are not supported by clinical guidelines. This results in increasing numbers of asymptomatic M. genitalium infections being identified, which when combined with AMR issues, creates significant challenges for patients and clinicians. Rapidly rising levels of AMR, coupled with limited alternative treatment options, means patients can enter cycles of complex antimicrobial regimens that may cause more harm than the infection itself. In this review, we discuss the emergence of AMR and the implication for treatment practices, highlight the recommendations for testing but not screening for M. genitalium, and discuss expansion of individualised treatment strategies, to curb the emergence of resistance and improve outcomes for patients. We also provide suggestions for future research on the transmission and spread of resistance, to enhance global surveillance of this antimicrobial resistant pathogen and inform the revision of local and international treatment strategies.

Keywords: antimicrobials, antimicrobial resistance, enhanced patient management, individualised treatment, mycoplasma genitalium, resistance-guided treatment, STIs, treatment failure.


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