Mycoplasma genitalium: What is MG and what are the symptoms of the STI that could become a superbug?

Mycoplasma genitalium: What is MG and what are the symptoms of the STI that could become a superbug?
Mycoplasma genitalium: What is MG and what are the symptoms of the STI that could become a superbug?

An emerging sexually transmitted disease could become a ‘superbug’ and make 3,000 women infertile a year unless it is tackled, warn experts.

There are fears mycoplasma genitalium (MG) is going misdiagnosed as it presents similar symptoms to chlamydia.

The confusion and a lack of test kits means it is being treated with incorrect drug doses – building up antibiotic resistance which could see it soon become untreatable.

The British Association of Sexual Health and HIV (BASHH) has issued NICE-approved draft guidelines for the treatment and diagnosis of MG. It also tells people how best to spot the disease, which is said to affect around one in 100 people in the UK. It says that although awareness of MG is low, it is in fact more prevalent than gonorrhoea.

BASHH spokesperson Paddy Horner, who developed the guidelines, said: “We can’t afford to continue with the approach we have followed for the past 15 years as this will undoubtedly lead to a public health emergency with the emergence of MG as a superbug.”

He called on the Government to make funding available for testing “to prevent a public health emergency waiting to happen and which is already spiralling out of control”.

The infection has been around since the 1980s, but was only identified as a STD in November 2015 after a study found a link between the bacteria and having sex.

What are the symptoms and risks of MG?

An MG infection often has no symptoms, warns BASHH. When patients do show signs, they are similar to those associated with chlamydia and gonorrhoea.

For women, it can cause pain during sex and pain in the pelvic area below the belly button. If left untreated, the risks include pelvic inflammatory disease (PID) – an infection of the organs of a women’s reproductive system – which can lead to infertility.

It can also lead to cervicitis – inflammation and irritation of the cervix causing post coital bleeding – and in pregnant women, premature birth.

In men it can cause watery discharge from the penis and burning, stinging, or pain when urinating.

In addition, MG may also increase the risk of HIV acquisition and transmission.

How can I be tested?

Although tests for MG have been developed – carried out by swab or a urine sample – they are not currently available at all clinics.

A survey carried out by BASHH revealed that only one in 10 public health commissioners in England plan to provide testing for the infection within the next year. Its guidelines recommend that patients with symptoms are correctly diagnosed using an accurate MG test, treated correctly then followed up to make sure they are cured.

The body is not recommending screening of all sexually active patients, given that most asymptomatic infections probably resolve spontaneously without causing disease.

If a patient presents with signs of MG, a doctor can send samples to Public Health England’s lab to get a diagnostic result.

The best way to prevent the disease is to practice safe sex, Public Health England urges.

Can it be cured?

MG is best treated by a seven-day course of the antibiotic doxycycline, followed by a course of azithromycin. It can also be treated by an antibiotic called macrolides, but the guidelines warned that MG is becoming increasingly resistant to it.

According to a paper in The Lancet in March, treatment is “increasingly challenging with resistant cases requiring costly drugs, which often have limited availability and are associated with rare, but serious, side-effects”.

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