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Epidemiology
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Prevalence of Mycoplasma genitalium in different population groups: systematic review andmeta-analysis
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  • Published on: 24 July 2018
    Research on Mycoplasma genitalium is more important than expanding testing
    • Nicola Low, Professor of Epidemiology and Public Health, Institute of Social and Preventive Medicine University of Bern, Mittelstrasse 43, 3012 Bern, Switzerland

    Prevalence of Mycoplasma genitalium

    Response to: Taylor-Robinson D and Ong J

    Authors: Nicola Low, Lukas Baumann, Manuel Cina, Myrofora Goutaki, Hammad Ali, Dianne Egli-Gany

    Correspondence to: Nicola Low, Professor of Epidemiology and Public Health, Institute of Social and Preventive Medicine, University of Bern, Mittelstrasse 43, 3012 Bern, Switzerland. nicola.low@ispm.unibe.ch; Tel: +41 31 631 30 92

    Title: Research on Mycoplasma genitalium is more important than expanding testing

    We are glad that Taylor-Robinson and Ong offer some support for the conclusion of our systematic review,1 that asymptomatic populations, in the community or in clinics, should not be tested routinely for M. genitalium. The first British Association of Sexual Health and HIV (BASHH) guideline about the management of Mycoplasma genitalium, published on 8th July 2018, supports this conclusion.2 We would like to clarify, however, that the absence of evidence for clinical and public health benefit of screening3 and the harm of inducing de novo mutations and spreading resistance to macrolide antimicrobials4 are more important than economic considerations.

    Taylor-Robinson and Ong’s statement that “testing worldwide should continue to support or modify this conclusion”5 could lead to pro...

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    Conflict of Interest:
    None declared.
  • Published on: 12 July 2018
    Prevalence of Mycoplasma genitalium
    • David Taylor-Robinson, Emeritus Professor of Genitourinary Microbiology and Medicine Imperial College London
    • Other Contributors:
      • Jason J Ong, Associate Professor. Epidemiologist

    The work by Baumann et al.(1) is valuable because it indicates populations for which screening for Mycoplasma genitalium (MG)) is not worthwhile economically. However, as molecular detection tests are now available commercially, testing worldwide should continue to support or modify this conclusion and so help in the development of management guidelines and also provide data for MG modelling.
    Another aspect of infection which requires more attention is the precise role of MG in balanoposthitis, epididymitis,, chronic prostatitis, reactive arthritis, and, of course, pelvic inflammatory disease, all of which, apart from chronic prostatitis, have some association with MG (2).
    In addition, it is noteworthy that Mycoplasma pneumoniae (MP), which infects the respiratory tract, and is also responsible for some autoimmune side effects, does so in early childhood without causing disease. The latter usually occurs as an immunological response to reinfection later in life. MG is different genomically from MP but has much in common antigenically and might behave in a similar way to MP. Could asymptomatic MG infection, which is seen occasionally, be an example of this? Potentiation or even inhibition of MG infection in the genital tract by MP infection in the respiratory tract earlier in life is also possible. This idea is not supported by studies in mice, but the human situation might be quite different. In this regard, use of an existing specific serological test for MG m...

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    Conflict of Interest:
    None declared.