Mycoplasma genitalium nucleic acid test

When suspected mycoplasma infection occurs, genital mycoplasma nucleic acid testing is needed. If it causes disease, it usually causes cervicitis, urethritis and pelvic inflammatory disease. These diseases have a great impact on our childbearing health. Generally, after diagnosis, treatment should be started as soon as possible to get rid of the harm caused by mycoplasma infection as soon as possible.

Mycoplasma genitalium (Mg) in relation to urethritis, cervicitis, and pelvic inflammatory disease (PID) and its treatment.

1. Urethritis and cervicitis

A 7-day course of doxycycline is ineffective for most Mg infections, with an average cure rate of 31%. The results of two randomized controlled trials on the treatment of urethritis showed that 1g of azithromycin taken once a day was significantly more effective than doxycycline, but resistance appeared earlier in the azithromycin treatment group. The average cure rate of azithromycin for male and female urethritis patients was 85%, but most recent experimental results show that the average cure rate of azithromycin is only 40%.

Patients who frequently use a 1 g daily regimen of azithromycin may develop macrolide-resistant strains, leading to treatment failure. Compared with the one-day regimen, the long-term treatment (azithromycin 500 mg on day 1 and 250 mg on days 2-4) regimen has better efficacy. However, even with long-term treatment regimens, treatment failure can still occur, and some reports indicate that approximately 50% of recent Mg infections are resistant strains. For patients who have failed treatment, moxifloxacin (400 mg/day x 7 days/10 days/14 days) has a good effect, with a cure rate of 100%. However, there are few clinical observation trials on moxifloxacin, and there have been reports of failure of 7-day moxifloxacin treatment in Japan, Canada, and the United States.

2. PID

There is no relevant data to confirm the value of Mg testing in patients with PID, and it is also unknown whether it can guide treatment, but this guideline believes that Mg testing in patients with PID is meaningful. Patients with refractory urethritis, cervicitis, and PID should undergo Mg testing. In patients with Mg infection, the 7/10-day moxifloxacin regimen is often ineffective, while the 14-day regimen has a higher clearance rate. Guidelines do not recommend Mg testing in asymptomatic people.

In addition, the spouses of patients with NGU, cervicitis, and PID who are infected with Mg should undergo Mg testing and treatment.