Guidelines
Mycoplasma genitalium STI

Mycoplasma genitalium STI

General Information

Mycoplasma genitalium is a newly-described but well established STI pathogen with clinical manifestations very similar to those caused by Chlamydia trachomatis. Island Health is now testing for M. genitalium routinely.

In males it causes acute and persistent urethritis. In females it is usually asymptomatic but may cause cervicitis and/or PID. It is also associated with infertility and adverse pregnancy outcomes.

Testing

Island Health is now utilizing a molecular assay that tests for four STI pathogens on all samples that request testing for any STI pathogen. All requests for Chlamydia trachomatis and/or Neisseria gonorrhoea and/or Trichomonas vaginalis and/or Mycoplasma genitalium will result in testing for all four pathogens. The new combined assay will be referred to as the STI Pathogen Panel and this is now the preferred order.

Preferred testing specimen varies by syndrome:

  • A vaginal swab (can be self collected) is preferred in women
  • First catch urine can also be done in women but it is somewhat less sensitive than vaginal swab
  • First catch urine is preferred in men; a urethral swab can also be collected

Assessment and Treatment of Contacts

All contacts within the last 60 days, regardless of symptoms or signs, should be treated, preferably after a sample is obtained for testing.

If testing is impossible, treatment is still recommended for all contacts.

Please submit all samples to an Island Health laboratory and not LifeLabs as Island Health performs the testing in-house. Please state "M. genitalium contact follow-up" on the requisition.

Test of Cure

Patients and contacts that have tested positive should be retested for M. genitalium no sooner than 3 weeks after azithromycin completion. If still positive, treat with:

Patients who have failed azithromycin and have contraindications to moxifloxacin or have failed moxifloxacin should be referred to an STI specialist.