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Mycoplasma genitalium Infection in Men.

Abstract Mycoplasmagenitalium is one of the major causes of nongonococcal urethritis (NGU) worldwide but an uncommon sexually transmitted infection (STI) in the general population. The risk of sexual transmission is probably lower than for Chlamydia trachomatis. Infection in men is usually asymptomatic and it is likely that most men resolve infection without developing disease. The incubation period for NGU caused by Mycoplasma genitalium is probably longer than for NGU caused by C. trachomatis. The clinical characteristics of symptomatic NGU have not been shown to identify the pathogen specific etiology. Effective treatment of men and their sexual partner(s) is complicated as macrolide antimicrobial resistance is now common in many countries, conceivably due to the widespread use of azithromycin 1 g to treat STIs and the limited availability of diagnostic tests for M. genitalium. Improved outcomes in men with NGU and better antimicrobial stewardship are likely to arise from the introduction of diagnostic M. genitalium nucleic acid amplification testing including antimicrobial resistance testing in men with symptoms of NGU as well as in their current sexual partner(s). The cost effectiveness of these approaches needs further evaluation. The evidence that M. genitalium causes epididymo-orchitis, proctitis, and reactive arthritis and facilitates human immunodeficiency virus transmission in men is weak, although biologically plausible. In the absence of randomized controlled trials demonstrating cost effectiveness, screening of asymptomatic men cannot be recommended.
PMID
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Authors

Mayor MeshTerms
Keywords

Mycoplasma genitalium

antimicrobial resistance

men

nongonococcal urethritis

nucleic acid amplification test

Journal Title the journal of infectious diseases
Publication Year Start




PMID- 28838074
OWN - NLM
STAT- MEDLINE
DA  - 20170825
DCOM- 20170905
LR  - 20170906
IS  - 1537-6613 (Electronic)
IS  - 0022-1899 (Linking)
VI  - 216
IP  - suppl_2
DP  - 2017 Jul 15
TI  - Mycoplasma genitalium Infection in Men.
PG  - S396-S405
LID - 10.1093/infdis/jix145 [doi]
AB  - Mycoplasmagenitalium is one of the major causes of nongonococcal urethritis (NGU)
      worldwide but an uncommon sexually transmitted infection (STI) in the general
      population. The risk of sexual transmission is probably lower than for Chlamydia 
      trachomatis. Infection in men is usually asymptomatic and it is likely that most 
      men resolve infection without developing disease. The incubation period for NGU
      caused by Mycoplasma genitalium is probably longer than for NGU caused by C.
      trachomatis. The clinical characteristics of symptomatic NGU have not been shown 
      to identify the pathogen specific etiology. Effective treatment of men and their 
      sexual partner(s) is complicated as macrolide antimicrobial resistance is now
      common in many countries, conceivably due to the widespread use of azithromycin 1
      g to treat STIs and the limited availability of diagnostic tests for M.
      genitalium. Improved outcomes in men with NGU and better antimicrobial
      stewardship are likely to arise from the introduction of diagnostic M. genitalium
      nucleic acid amplification testing including antimicrobial resistance testing in 
      men with symptoms of NGU as well as in their current sexual partner(s). The cost 
      effectiveness of these approaches needs further evaluation. The evidence that M. 
      genitalium causes epididymo-orchitis, proctitis, and reactive arthritis and
      facilitates human immunodeficiency virus transmission in men is weak, although
      biologically plausible. In the absence of randomized controlled trials
      demonstrating cost effectiveness, screening of asymptomatic men cannot be
      recommended.
CI  - (c) The Author 2017. Published by Oxford University Press for the Infectious
      Diseases Society of America. All rights reserved. For permissions, e-mail:
      [email protected]
FAU - Horner, Patrick J
AU  - Horner PJ
AD  - School of Social and Community Medicine, University of Bristol.
AD  - Bristol Sexual Health Centre, University Hospitals Bristol NHS Trust.
AD  - National Institute for Health Research Health, Protection Research Unit in
      Evaluation of Interventions in partnership with Public Health England, University
      of Bristol, United Kingdom.
FAU - Martin, David H
AU  - Martin DH
AD  - Department of Epidemiology, Tulane University School of Public Health.
AD  - Department of Medicine, Louisiana State University Health Sciences Center, New
      Orleans.
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - J Infect Dis
JT  - The Journal of infectious diseases
JID - 0413675
RN  - 0 (Anti-Bacterial Agents)
RN  - 0 (Macrolides)
RN  - 83905-01-5 (Azithromycin)
SB  - AIM
SB  - IM
MH  - Anti-Bacterial Agents/therapeutic use
MH  - Azithromycin/therapeutic use
MH  - Drug Resistance, Bacterial
MH  - Female
MH  - Humans
MH  - Macrolides/therapeutic use
MH  - Male
MH  - Male Urogenital Diseases/drug therapy/*microbiology
MH  - Mycoplasma Infections/*drug therapy
MH  - Mycoplasma genitalium/*isolation & purification
MH  - Nucleic Acid Amplification Techniques
MH  - Sexual Partners
MH  - Urethritis/drug therapy/*microbiology
OTO - NOTNLM
OT  - Mycoplasma genitalium
OT  - antimicrobial resistance
OT  - men
OT  - nongonococcal urethritis
OT  - nucleic acid amplification test
EDAT- 2017/08/26 06:00
MHDA- 2017/09/07 06:00
CRDT- 2017/08/26 06:00
AID - 4040968 [pii]
AID - 10.1093/infdis/jix145 [doi]
PST - ppublish
SO  - J Infect Dis. 2017 Jul 15;216(suppl_2):S396-S405. doi: 10.1093/infdis/jix145.