Mycoplasma genitalium in Males With Nongonococcal Urethritis

Gambini, D; Decleva, Irene; Lupica, L.; Ghislanzoni, Massimo; Cusini, Marco; Alessi, Elvio

doi:10.1097/00007435-200004000-00008

Cited by 70 publications

(54 citation statements)

References 13 publications

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“…Furthermore, the development and use of quantitative PCR assays for M. genitalium have shown greater M. genitalium DNA loads in urine from men with NGU than in urine from those without the disease (98,100). It is noteworthy that the association between mycoplasma and disease is even stronger for acute nonchlamydial NGU (NCNGU) (2,9,14,19,24,30,35,40,47,55,58,74,84,95,105,108,113,120,133,144,147,149,164,182,185,211,217,232,235) (Fig. 3), with the mycoplasma being found in more than one-third of men with such disease, indicating that M. genitalium and C. trachomatis act as separate causes of the condition.…”

Section: Acute Nongonococcal Urethritismentioning

confidence: 99%

Mycoplasma genitalium: from Chrysalis to Multicolored Butterfly

2011

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SUMMARY The history, replication, genetics, characteristics (both biological and physical), and factors involved in the pathogenesis of Mycoplasma genitalium are presented. The latter factors include adhesion, the influence of hormones, motility, possible toxin production, and immunological responses. The preferred site of colonization, together with current detection procedures, mainly by PCR technology, is discussed. The relationships between M. genitalium and various diseases are highlighted. These diseases include acute and chronic nongonococcal urethritis, balanoposthitis, chronic prostatitis, and acute epididymitis in men and urethritis, bacterial vaginosis, vaginitis, cervicitis, pelvic inflammatory disease, and reproductive disease in women. A causative relationship, or otherwise strong association, between several of these diseases and M. genitalium is apparent, and the extent of this, on a subjective basis, is presented; also provided is a comparison between M. genitalium and two other genital tract-orientated mollicutes, namely, Mycoplasma hominis , the first mycoplasma of human origin to be discovered, and Ureaplasma species. Also discussed is the relationship between M. genitalium and infertility and also arthritis in both men and women, as is infection in homosexual and immunodeficient patients. Decreased immunity, as in HIV infections, may enhance mycoplasmal detection and increase disease severity. Finally, aspects of the antimicrobial susceptibility and resistance of M. genitalium , together with the treatment and possible prevention of mycoplasmal disease, are discussed.

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Section: Acute Nongonococcal Urethritismentioning

confidence: 99%

Mycoplasma genitalium: from Chrysalis to Multicolored Butterfly

2011

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“…These aspects of antibiotic susceptibility, added to the fact that M. genitalium has the ability to invade epithelial cells 61 , and in this protected environment multiply and persist 62 , might account for it sometimes continuing to be found in the urethra or other sites, especially following treatment with one of the tetracyclines. In this regard, one group of investigators recorded that doxycycline (200 mg per day for 7 days) or azithromycin (1 g single dose) were equally effective in eradicating the mycoplasma and curing the symptoms of NGU when assessed one week later 63 . However, this has not been the experience of all investigators.…”

Section: Antibiotic Susceptibility and Treatmentmentioning

confidence: 99%

Mycoplasma genitalium - an up-date

Taylor‐Robinson

2002

Int J STD AIDS

145

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Summary:Mycoplasma genitalium was ® rst isolated from men with non-gonococcal urethritis (NGU) more than 20 years ago. Use of polymerase chain reaction technology has shown it to be a cause of acute NGU and probably chronic NGU, almost independently of Chlamydia trachomatis, but there is no substantial evidence that it causes acute or chronic prostatitis. In women, M. genitalium is not associated with bacterial vaginosis, but it is strongly associated with cervicitis and endometritis and serologically with salpingitis and tubal factor infertility. Further studies may show M. genitalium to be associated, perhaps causally, with epididymoorchitis, neonatal disease and reactive arthritis. Furthermore, its potential for enhancing HIV transmission needs to be explored. M. genitalium is susceptible to various broad-spectrum antibiotics, but M. genitalium-associated diseases are probably best treated with azithromycin.

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“…Similarly, we analyzed mgpB sequences from cervical specimens from a persistently infected woman (21 months) and identified 17 different mgpB variants within a single infecting M. genitalium strain, confirming that mgpB heterogeneity occurs over the course of a natural infection. These observations support the hypothesis that recombination occurs between the mgpB gene and MgPar sequences and that the resulting antigenically distinct MgPa variants may contribute to immune evasion and persistence of infection.Mycoplasma genitalium has been identified as a possible cause of several reproductive tract disease syndromes including urethritis in men and mucopurulent cervicitis, endometritis, pelvic inflammatory disease, and tubal factor infertility in women (3,6,7,18,23,28,30,34,35,41,48,52,55,56). When untreated (or inappropriately treated), this organism persists at infected sites as demonstrated by its association with chronic nongonococcal urethritis in men (22, 53) and its persistence for months, if not years, in the lower genital tract of women (C. R. Cohen, M. Nosek, A. Meier, S. G. Astete, S. Iverson-Cabral, N. R. Mugo, and P. A. Totten, submitted for publication).…”

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Intrastrain Heterogeneity of the mgpB Gene in Mycoplasma genitalium Is Extensive In Vitro and In Vivo and Suggests that Variation Is Generated via Recombination with Repetitive Chromosomal Sequences

Iverson-Cabral¹,

et al. 2006

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Mycoplasma genitalium is associated with reproductive tract disease in women and may persist in the lower genital tract for months, potentially increasing the risk of upper tract infection and transmission to uninfected partners. Despite its exceptionally small genome (580 kb), approximately 4% is composed of repeated elements known as MgPar sequences (MgPa repeats) based on their homology to the mgpB gene that encodes the immunodominant MgPa adhesin protein. The presence of these MgPar sequences, as well as mgpB variability between M. genitalium strains, suggests that mgpB and MgPar sequences recombine to produce variant MgPa proteins. To examine the extent and generation of diversity within single strains of the organism, we examined mgpB variation within M. genitalium strain G-37 and observed sequence heterogeneity that could be explained by recombination between the mgpB expression site and putative donor MgPar sequences. Similarly, we analyzed mgpB sequences from cervical specimens from a persistently infected woman (21 months) and identified 17 different mgpB variants within a single infecting M. genitalium strain, confirming that mgpB heterogeneity occurs over the course of a natural infection. These observations support the hypothesis that recombination occurs between the mgpB gene and MgPar sequences and that the resulting antigenically distinct MgPa variants may contribute to immune evasion and persistence of infection.Mycoplasma genitalium has been identified as a possible cause of several reproductive tract disease syndromes including urethritis in men and mucopurulent cervicitis, endometritis, pelvic inflammatory disease, and tubal factor infertility in women (3,6,7,18,23,28,30,34,35,41,48,52,55,56). When untreated (or inappropriately treated), this organism persists at infected sites as demonstrated by its association with chronic nongonococcal urethritis in men (22, 53) and its persistence for months, if not years, in the lower genital tract of women (C. R. Cohen, M. Nosek, A. Meier, S. G. Astete, S. Iverson-Cabral, N. R. Mugo, and P. A. Totten, submitted for publication). The longevity of M. genitalium infection in the human reproductive tract suggests that this pathogen may have mechanism(s) to modulate or evade the host immune response.At 580 kb, the M. genitalium G-37 T genome is one of the smallest of any self-replicating cellular organism (9, 17, 49), yet 4% of the fully sequenced genome consists of repeated elements (43) designated as MgPa repeats or MgPar sequences (17). These repeat sequences are so named because they are composed of partial, incomplete copies of the mgpB gene, which encodes the MgPa protein that mediates attachment to various cell types, including the ciliated epithelium of human fallopian tubes (8). Although there is only a single mgpB expression site, there are nine distinct MgPar sequences found throughout the genome (17). The MgPa protein is antigenic and elicits an immune response in animal models (25, 37) and in women with tubal factor infertility (6). The presence...

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Mycoplasma genitalium in Males With Nongonococcal Urethritis

Cited by 70 publications

References 13 publications

Mycoplasma genitalium: from Chrysalis to Multicolored Butterfly

Mycoplasma genitalium: from Chrysalis to Multicolored Butterfly

Mycoplasma genitalium - an up-date

Intrastrain Heterogeneity of the mgpB Gene in Mycoplasma genitalium Is Extensive In Vitro and In Vivo and Suggests that Variation Is Generated via Recombination with Repetitive Chromosomal Sequences

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