Mycoplasma genitaliuminfection

### What you need to know Mycoplasma genitalium has been dubbed the latest superbug by the media.1 While the inference that this sexually transmitted infection is untreatable is incorrect, the relative ease by which M genitalium develops resistance is of great concern and presents challenges in treatment. This practice pointer provides an overview of M genitalium infection including practical advice for non-specialists on diagnosis and management. M genitalium is the smallest known self replicating bacterium.2 It lacks a cell wall and hence cannot be detected on Gram staining of a specimen.2 M genitalium is predominantly found in the genitourinary tract of both sexes. It evades the adaptive immune system by establishing intracellular infection (possibly due to its tip-like structure), but also by antigenic and phase variation of its surface-expressed proteins.23 M genitalium infection may persist for months or years in asymptomatic individuals. It is found in genital specimens of 15-25% of men with non-gonococcal urethritis2 and 10-13% of women with pelvic inflammatory disease.45 Although the pathological consequences of M genitalium infection are thought mainly to be due to host response, M genitalium has been shown to directly cause cilial damage in human fallopian cell culture.26 The prevalence of M genitalium …