Overview
Mycoplasma genitalium is a bacterium that can cause genitourinary infections in both men and women 1. Infections can be asymptomatic or lead to symptoms such as urethritis, cervicitis, and pelvic inflammatory disease 1.Diagnosis
Diagnosis is typically made via nucleic acid amplification testing (NAAT) 1.
Resistance-associated mutations (RAMs) can impact treatment efficacy 1.
Prevalence of M. genitalium* infection in people with HIV (PWH) was 12% 1.
Prevalence in PWH varied by geographic region, with the highest observed in North America (20%) 1.
Prevalence was highest in female sex workers living with HIV (20%) 1.
Prevalence in PWH was lower than HIV preexposure prophylaxis users and female sex workers, but higher than men who have sex with men in the community 1.Management
Macrolide resistance-mediating mutations (MRMMs) were present in 36% of PWH tested for resistance 1.
Quinolone resistance-determining regions (QRDRs) mutations were present in 25% of PWH tested for resistance 1.
Multidrug resistance with MRMMs and QRDRs mutations was present in 20% of PWH tested for resistance 1.Special Populations
Prevalence in people with HIV (PWH) was 12% 1.
Prevalence in PWH varied by geographic region 1.
Prevalence was highest in female sex workers living with HIV (20%) 1.
Prevalence in PWH was lower than HIV preexposure prophylaxis users and female sex workers, but higher than men who have sex with men in the community 1.Key Recommendations
Testing for M. genitalium infection is recommended in specific populations, including people with HIV 1.
Resistance testing, particularly for macrolide and quinolone resistance, should be considered due to high rates of resistance mutations in some populations 1.
Treatment strategies should account for potential resistance patterns 1.References
1 Zhang R, Chung SL, Lee SS, Wong NS. Prevalence and resistance patterns of Mycoplasma genitalium infection in people with HIV: a systematic review and meta-analysis. AIDS (London, England) 2025. link