Assessment of Mycoplasma genitalium infection

Mycoplasma genitalium can cause the following syndromesLis, 2015Manhart, 2022Ong, 2023Taylor-Robinson, 2011:

Testing for M. genitalium is only recommended for people with specific symptoms and syndromes (eg cervicitis, pelvic inflammatory disease [PID], persistent urethritis) and ongoing sexual partners of patients with confirmed symptomatic infectionManhart, 2022. Do not otherwise screen for M. genitalium in asymptomatic peopleManhart, 2022.

Note: Testing for M. genitalium is only recommended for symptomatic people and ongoing sexual partners of patients with confirmed symptomatic infection.

M. genitalium infection is detected by nucleic acid amplification testing (NAAT) (eg polymerase chain reaction [PCR]), which should include a molecular test for macrolide resistance mutations, if available. For females1, self-collected2 vaginal and rectal swab samples are preferred over first-pass3 urine samples for testing. For males4, a first-pass urine sample is preferred. A rectal swab is indicated in males engaging in receptive anal sex and can be self-collectedLatimer, 2020Read and Murray, 2019. A throat swab is not indicated because pharyngeal infection is uncommonLatimer, 2020Read and Murray, 2019.

Perform investigations for other sexually transmissible infections (STIs) (including HIV, syphilis and Neisseria gonorrhoeae).

Contact tracing for testing and treatment of asymptomatic M. genitalium infection is only recommended for ongoing sexual partners of patients with a confirmed symptomatic M. genitalium infection because the harm–benefit profile of antibiotic therapy is unclear; see STI contact tracing.

For general principles of STI management, including investigations and counselling, and considerations for children in whom a STI is identified, see Principles of STI management.

1 In this topic, the term ‘female’ is used to include all people presumed female at birth.Return
2 For information on methods of self-collection of vaginal and rectal swab samples, see the diagnosis section of the relevant condition in the Australian STI Management Guidelines for Use in Primary Care. Return
3 A first-pass urine specimen is the first part of the urine stream, and can be collected at any time of the day; see the diagnosis section of the relevant condition in the Australian STI Management Guidelines for Use in Primary Care for more information.Return
4 In this topic, the term ‘male’ is used to include all people presumed male at birth.Return