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Mycoplasma genitalium should be more accurately identified in non-gonococcal urethritis in men and treated accordingly in future, with development of a potentially superior test, claims a validation study.
This PCR test is less susceptible to the effects of gene polymorphisms and can be used as an alternative to or to confirm the MgPa PCR test, whose target is a major cell surface adhesin. It was devised and optimised on the basis of targeting the 16S ribosomal RNA (rRNA) gene. Specificity was confirmed by synthesis of a 341 base pair complementary sequence with DNA isolated from each of nine M genitalium type strains but not from 22 other microorganisms associated with the urogenital tract. The new test performed as well as MgPa PCR in sensitivity tests with twofold and tenfold dilutions of DNA isolated from one M genitalium type strain and slightly better at identifying M genitalium DNA in urine specimens from men with non-gonococcal urethritis (9/54 v 8/54). Heminested MgPa gene PCR confirmed the nine positive results.
Clinical specimens were first catch urine specimens from consecutive men attending one genitourinary clinic in the UK with confirmed non-gonococcal urethritis.
Mycoplasma genitalium is significantly associated with non-gonococcal urethritis in men independently of Chlamydia trachomatis and seems to be linked to cervicitis and endometriosis in women. Diagnosis depends on PCR tests as culturing is unreliable, and these target the MgPa adhesin or the 16S rRNA gene. Polymorphisms have been reported for the MgPa gene but are less likely in the 16S rRNA gene.
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