Mycoplasma genitalium infection in the female reproductive system: Diseases and treatment

Abstract

Mycoplasma genitalium is a newly emerged sexually transmitted disease pathogen and an independent risk factor for female cervicitis and pelvic inflammatory disease. The clinical symptoms caused by M. genitalium infection are mild and easily ignored. If left untreated, M. genitalium can grow along the reproductive tract and cause salpingitis, leading to infertility and ectopic pregnancy. Additionally, M. genitalium infection in late pregnancy can increase the incidence of preterm birth. M. genitalium infections are often accompanied by co-infection with other sexually transmitted pathogens (Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis) and viral infections (Human Papilloma Virus and Human Immunodeficiency Virus). A recent study suggested that M. genitalium plays a role in tumor development in the female reproductive system. However, few studies endorsed this finding. In recent years, M. genitalium has evolved into a new “superbug” due to the emergence of macrolide-and fluoroquinolone-resistant strains leading to frequent therapy failures. This review summarizes the pathogenic characteristics of M. genitalium and the female reproductive diseases caused by M. genitalium (cervicitis, pelvic inflammatory disease, ectopic pregnancy, infertility, premature birth, co-infection, reproductive tumors, etc.), as well as its potential relationship with reproductive tumors and clinical treatment.

Prevalence and incidence of Mycoplasma genitalium infection: a systematic review protocol

“…1 This flask-shaped bacterium invades the reproductive tracts of men and women, binding to endothelial cells of the host, causing cytokine production and, subsequently, an inflammatory response. 2 This inflammatory response leads to cervicitis in women and urethritis in men. 2,3 M. genitalium was discovered after urethritis in men and cervicitis in women did not respond to the antibiotics prescribed for a presumed infection of gonorrhea or chlamydia, which are the most common sexually transmitted infections (STIs) that cause urethritis and cervicitis.…”

“…2 This inflammatory response leads to cervicitis in women and urethritis in men. 2,3 M. genitalium was discovered after urethritis in men and cervicitis in women did not respond to the antibiotics prescribed for a presumed infection of gonorrhea or chlamydia, which are the most common sexually transmitted infections (STIs) that cause urethritis and cervicitis. 2 Due to the slow-moving, fastidious nature of this bacterium, even with an active infection, both men and women with M. genitalium may remain asymptomatic.…”

“…2,3 M. genitalium was discovered after urethritis in men and cervicitis in women did not respond to the antibiotics prescribed for a presumed infection of gonorrhea or chlamydia, which are the most common sexually transmitted infections (STIs) that cause urethritis and cervicitis. 2 Due to the slow-moving, fastidious nature of this bacterium, even with an active infection, both men and women with M. genitalium may remain asymptomatic. 2 A 2019 study involving 3300 participants from the United States reported the prevalence of M. genitalium infection as 10.3% at the urogenital site.…”

“…2 Due to the slow-moving, fastidious nature of this bacterium, even with an active infection, both men and women with M. genitalium may remain asymptomatic. 2 A 2019 study involving 3300 participants from the United States reported the prevalence of M. genitalium infection as 10.3% at the urogenital site. 4 A similar, smaller study in France concluded the prevalence of M. genitalium to be 11% in their population.…”

“…6 Like other STIs, M. genitalium has been linked to an increased likelihood of human immunodeficiency virus (HIV) acquisition. 2 One meta-analysis performed in 2009 reported a strong association between M. genitalium and HIV, with an odds ratio of 2.01 [95% CI 1.44-2.79]. 7 M. genitalium can enhance HIV viral replication, likely due to the fact that mycoplasma cells can adhere to HIV-infected lymphocytes, triggering viral production or release.…”