An emerging sexually transmitted infection that you’ve probably never heard of “could become the next superbug”, according to . What exactly is Mycoplasma genitalium, and how worried should we be?
M. genitalium is small bacteria that was first identified in 1981, and at that time it was unclear if it was a STI. Its true nature was only definitively confirmed in 2015 by which found the infection was more common in those who had had more partners or unprotected sex.
One reason it took so long to get the full picture of this infection is that it is very hard to detect. Commercial tests are only beginning to come on the market, so doctors haven’t been able to routinely screen for it.
Advertisement
We now know that around it, but the prevalence among people attending STI clinics can as high as to 38 per cent. It is actually one of the most common sexually transmitted bacterial infections in the UK and US, surpassed only by chlamydia.
Mostly harmless?
The majority of cases are symptomless and don’t seem to cause any harm, so the infection easily sails under the radar. But for some, the symptoms are similar to the STI chlamydia. Men might experience irritation in their penis or discharge, and painful urination. For women, the symptoms can include abdominal pain, pre-term birth and pelvic inflammatory disease (PID).
“M. genitalium probably causes around 3000 cases of PID in the UK,” says Paddy Horner, a clinician specialising in sexual health at the University of Bristol, UK. PID can lead to infertility in around 3 per cent of cases.
So on the scale of STI nastiness, M. genitalium is at the mild end. The real crisis with this bacteria is not so much it’s pathology, but it’s incredible talent for developing antibiotic resistance – hence all the ‘superbug’ headlines.
A superbug is a bacteria that has become resistant to many of the antibiotics used to treat it. The worry is that M. genitaliuam in on a path to becoming as hard to treat as the STI gonorrhoea, which has already gained superbug status with strains that are resistant to nearly all antibiotics.
Antibiotic resistance
Many strains of M. genitalium are resistant to commonly-used antibiotics called macrolides, which are often used for treating STIs such as chlamydia. According to resistance rates in the UK are 40 per cent, but are as high as 100 per cent in some countries.
The worry is that current treatment practices may be inadvertently creating strains that are resistant to both macrolides and other commonly-used antibiotics called quinolones. This report recommends changing the antibiotic treatment regime to minimise the development of antibiotic resistance.
“We don’t want to find, in ten or fifteen years’ time, that we’ve got predominantly dual-resistant organisms. That’s what the superbug would be,” says Horner. “M. genitalium doesn’t cause problems in most people. When it does, we want to make sure it’s treatable.”
