Incidence of Mycoplasma Genitalium in Clients Seeking STI Services, Oakland County, MI

Background:  Mycoplasma genitalium (M. gen) was identified in the early 1980s.  It can cause male urethritis and has been seen with female cervicitis and pelvic inflammatory disease.  M. gen is slow-growing and fastidious, taking up to 6 months to culture.  The M. gen organism lacks a cell wall, rendering certain antibiotic treatments ineffective.

Methods:  From February 4 to February 29, 2016, a Nucleic Acid Amplified Test (NAAT) for M. gen. was added to standard STI testing for 500 patients presenting at OCHD clinics in Pontiac and Southfield.  Based on client volume, Southfield tested 334 patients and Pontiac tested 166 patients, with equal gender distribution.  Testing was performed in the OCHD Laboratory using analyte specific reagents on the Hologic Panther analyzer.  

Results:  58 of 500 (11.6%) samples tested were positive for M. gen.  The OCHD standard STI panel tests males and females for Chlamydia, Gonorrhea, Trichomonas and Syphilis.  Of the 500 samples tested, 45 were Chlamydia positive (9.0%), 17 were Trichomonas positive (3.4%), 11 were Gonorrhea positive (2.2%), and 11 were Syphilis positive (2.2%).  20 out of 31 (65.5%) of M. gen positive males were diagnosed with Non-Gonococcal Urethritis (NGU).

Conclusions:  Adding M. gen to a STI test panel should be considered.  M. gen had a higher incidence than the other STIs tested for, providing evidence that M. gen is an emerging STI. Due to the molecular properties of M. gen, antibiotics normally given for STIs can be ineffective, making it important to confirm a diagnosis of M. gen.   In order to monitor incidence and to ensure effective treatment, routine testing should be considered in high risk populations.  By adding M. gen to a STI panel, nonspecific NGU infection would be reduced due to identification of M. gen infection.