title: Mycoplasma genitalium, an emerging sexually transmitted pathogen.
abstract: Mycoplasma genitalium is a sexually transmitted organism associated with non-gonococcal urethritis in men and several inflammatory reproductive tract syndromes in women such as cervicitis, pelvic inflammatory disease, and infertility. There was evidence for an association of M. genitalium with endometritis and pelvic inflammatory disease (PID), but additional studies are necessary to confirm this. The evidence as to whether M. genitalium can cause adverse pregnancy outcomes such as preterm labor is conflicting. But the authors of some studies on M. genitalium as a cause of infertility have reported this association. This species is very difficult to culture; thus, nucleic acid amplification testing is the only method available for M. genitalium detection. The lack of a cell wall makes M. genitalium intrinsically resistant to antibiotics acting at this level, such as beta-lactams. The treatment of M. genitalium infections is not standardized. Macrolides are recommended, especially single-dose azithromycin; tetracyclines are responsible for a great number of therapeutic failures even no resistance mechanism has yet been demonstrated. Acquired resistance to macrolides and fluoroquinolones leading to therapeutic failure has also been reported. All this raises the issue of the most appropriate therapeutic management and requires drafting diagnostic and therapeutic guidelines for the treatment of M. genitalium infections.
authors.affiliation: USC Infections Humaines à Mycoplasmes et Chlamydiae, Université de Bordeaux, 33076 Bordeaux cedex, France. charles.cazanave@chu-bordeaux.fr
authors.forename: C
authors.initials: C
authors.lastname: Cazanave
authors.forename: L E
authors.initials: LE
authors.lastname: Manhart
authors.forename: C
authors.initials: C
authors.lastname: Bébéar
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002353:Carrier State / Q000453:epidemiology; D002986:Clinical Trials as Topic; D021821:Communicable Diseases, Emerging / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology / Q000635:transmission; D015897:Comorbidity; D019468:Disease Management; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D015658:HIV Infections / Q000453:epidemiology; D006801:Humans; D008297:Male; D009175:Mycoplasma Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology / Q000635:transmission; D045704:Mycoplasma genitalium / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification / Q000472:pathogenicity* / Q000648:ultrastructure; D007752:Obstetric Labor, Premature / Q000209:etiology; D000292:Pelvic Inflammatory Disease / Q000453:epidemiology / Q000382:microbiology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology / Q000382:microbiology; D015995:Prevalence; D012307:Risk Factors; D015231:Sexually Transmitted Diseases, Bacterial / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology / Q000635:transmission; D014526:Urethritis / Q000453:epidemiology / Q000382:microbiology; D002575:Uterine Cervicitis / Q000453:epidemiology / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents