September 29, 2022
A little understood sexually transmitted disease that can cause infertility has the makings of a superbug, scientists fear, leading some to call for more research.
Mycoplasma genitalium, also known as M. genitalium or M. gen., can cause genital pain, bleeding and swelling. It has been linked to infertility and miscarriage. Though it isn't a newly discovered bacteria, it doesn't get as much attention as other STDs like gonorrhea, syphilis or chlamydia, experts say.
When left untreated, M. gen. can lead to severe complications – a swelling and irritation of the urethra in men, and cervical swelling, pelvic inflammatory disease and infertility in women. Pregnant women are at risk of preterm birth, amd miscarriage, according to Healthline.
Like other bacterial infections, it can be treated with antibiotics, but scientists have been warning since 2017 that M. gen. has grown resistant to azithromycin – the primary drug used to treat it – and that it may evolve into a superbug.
Hard-to-treat superbugs are major public health concern in the U.S. According to the CDC, more than 2.8 million antimicrobial-resistant infections occur each year, causing more than 35,000 deaths.
M. gen.'s estimated prevalence in developed countries is only about 1% on the general population. But because the first commercially available test for M. gen. wasn't approved by the U.S. Food and Drug Administration until 2019, many cases have probably gone undetected, scientists say. It is most likely a more common infection than previously thought.
As many as 20% of sexually active women and 16.5% of men ages 15 to 25 may be infected, Lisa Manhart, a professor of epidemiology at the University of Washington, told NBC News.
There are other antibiotics besides azithromycin that can be used to treat M. gen., including monifloxacin, but if the bacteria learns to evade these drugs, there will be few treatment options left. Monifloxacin is associated with severe side effects and is not recommended for pregnant women.
The CDC recommends doctors test for antibiotic resistance before deciding which drugs to prescribe. But these tests are not yet FDA-approved and only a few research centers have the capability to test for antibiotic resistance.
Another obstacle to understanding the pathogenesis of this bacteria is that it grows slowly and requires hyper-specific conditions to thrive in a lab setting, studies have shown.
With commercially available testing for antibiotic resistance and the development of new antibiotics still years away, scientists say there needs to be a push for more studies to fill in any knowledge gaps about M. gen.
The best way people can protect themselves is to practice safe sex strategies and be aware of any potential symptoms of an infection, scientists say.
Symptoms of an M. gen. infection include pain and discomfort while urinating and abnormal discharges. Some women also may experience pain and bleeding after sex. Many cases, however, do not cause symptoms.