Mycoplasma genitalium
| Mycoplasma genitalium | ||||||||||||||
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| File:Mycoplasma genitalium.gif | ||||||||||||||
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| Mycoplasma genitalium Tully et al., 1983 |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Dima Nimri, M.D. [2]
Overview
Classification
Historical Perspective
- Mycoplasma genitalium is the 11th Mycoplasma species of human origin.[1]
- In 1980, 13 men were tested for non-gonoccal urethritis (NGU). Mycoplasma genitalium was isolated from 2 of those 13 men.[2][3][4]
- In the early 1990s, polymerase chain reaction (PCR) was developed, which allowed for diagnosis of Mycoplasma genitalium.[2][4][5]
- Since 1993, the role of Mycoplasma genitalium as a cause of non-gonococcal urethritis has appeared in literature following the advances in polymerase chain reaction (PCR).[5]
Pathophysiology
Pathogenesis
Mode of Transmission
- Mycoplasma genitalium is recognized as a sexually transmitted disease (STD) with the mode of transmission being through direct genital-to-genital contact and subsequent inoculation of infected secretions. Transmission of Mycoplasma genitalium has also been implicated in penile-anal intercourse. [2]
- Mycoplasma genitalium is less likely to be transmitted via oro-genital contact, as carriage in the oropharynx is low. [2]
- Whether or not Mycoplasma genitalium is vertically transmitted from mother to newborn is yet to be studied. However, the bacterium has been isolated from the respiratory tract of newborns. [2]
Incubation Period
The incubation period of Mycoplasma genitalium is unknown yet.[6]
Infectious Dose
The infectious dose of Mycoplasma genitalium is unknown yet.[6]
Factors facilitating the pathogenesis of Mycoplasma genitalium
The following virulence factors have been implicated in the pathogenesis of Mycoplasma genitalium: [1][2][7]
- Adhesion molecules: Mycoplasma genitalium has the ability to attach to different types of cells, including red blood cells, respiratory cells, fallopian tube cells, as well as sperm cells. It is believed that the attachment to sperm cells facilitates the spread of Mycoplasma genitalium to the female genital tract. MgPa, a major adhesion in attachment protein complex, facilitates not only adhesion to epithelial cells, but also the motility of Mycoplasma genitalium.
- Intracellular localization: Mycoplasma genitalium is a facultative intracellular organism and this allows for its survival both inside and outside of cells.
- Antigenic variation: Mycoplasma genitalium is able to generate surface lipoprotein with high frequency, which helps it evade the human immune system.
- Toxins: Mycoplasma genitalium has a calcium-dependent membrane associated nuclease known as MG-186. MG-186 is capable of degrading host cell nucleic acid, hence providing a source of nucleotides for the growth and pathogenesis of Mycoplasma genitalium.
- Enzymes: Glyceraldehyde 3-phosphate dehydrogenase (GADPH) acts as a ligand to the receptors mucin and fibronectin, found on vaginal and cervical epithelium.
- Immunological response: Mycoplasma genitalium possesses an immunogenic protein, MG-309, which secretes pro-inflammatory cytokines, such as IL-6 and IL-8. MG-309 exerts its effect via attaching to a toll-like receptor, hence activating nuclear factor kappa B (NF-kB)
Genetics
Associated Conditions
Gross Pathology
Microscopic Pathology
Causes
Differentiating Mycoplasma genitalium infection from other diseases
Epidemiology and Demographics
Risk Factors
There several risk factors that have been identified with Mycoplasma genitalium infection. These risk factors include:[2][4][8]
- High risk sexual behavior, defined as having >3 new sexual partners in the past year
- Being engaged in sexual contact with persons with STDs, particularly Mycoplasma genitalium
- Non-white race
- Having a black partner
- Young age (<20 years old)
- Smoking
- Having less than high school education
- Having an annual income of less than $10,000
- Risk factors specific to females includes:
- Frequent douching
- Proliferative phase of the menstrual cycle
- History of spontaneous miscarriage
- Undergoing procedures that breach the cervical barrier
- Use of Depo-Provera for contraception
Screening
Natural history, Complications and Prognosis
History
Physical Examination
Laboratory Findings
X-Ray
CT
Other Imaging Findings
Other Diagnostic Studies
Medical Therapy
Surgical Therapy
Primary Prevention
Secondary Prevention
References
- ↑ 1.0 1.1 Taylor-Robinson D, Jensen JS (2011). "Mycoplasma genitalium: from Chrysalis to multicolored butterfly". Clin. Microbiol. Rev. 24 (3): 498–514. doi:10.1128/CMR.00006-11. PMC 3131060. PMID 21734246.
- ↑ 2.0 2.1 2.2 2.3 2.4 2.5 2.6 Jensen JS, Cusini M, Gomberg M, Moi H (2016). "Background review for the 2016 European guideline on Mycoplasma genitalium infections". J Eur Acad Dermatol Venereol. doi:10.1111/jdv.13850. PMID 27605499.
- ↑ "Sexually Transmitted Diseases: Summary of 2015 CDC Treatment Guidelines". J Miss State Med Assoc. 56 (12): 372–5. 2015. PMID 26975162.
- ↑ 4.0 4.1 4.2 Manhart LE, Critchlow CW, Holmes KK, Dutro SM, Eschenbach DA, Stevens CE, Totten PA (2003). "Mucopurulent cervicitis and Mycoplasma genitalium". J. Infect. Dis. 187 (4): 650–7. doi:10.1086/367992. PMID 12599082.
- ↑ 5.0 5.1 Ross JD, Jensen JS (2006). "Mycoplasma genitalium as a sexually transmitted infection: implications for screening, testing, and treatment". Sex Transm Infect. 82 (4): 269–71. doi:10.1136/sti.2005.017368. PMC 2564705. PMID 16877571.
- ↑ 6.0 6.1 Public Health Agency of Canada http://www.phac-aspc.gc.ca/lab-bio/res/psds-ftss/mycoplasma-genitalium-eng.php Accessed on Oct 6, 2016.
- ↑ Sethi S, Singh G, Samanta P, Sharma M (2012). "Mycoplasma genitalium: an emerging sexually transmitted pathogen". Indian J. Med. Res. 136 (6): 942–55. PMC 3612323. PMID 23391789.
- ↑ Hancock EB, Manhart LE, Nelson SJ, Kerani R, Wroblewski JK, Totten PA (2010). "Comprehensive assessment of sociodemographic and behavioral risk factors for Mycoplasma genitalium infection in women". Sex Transm Dis. 37 (12): 777–83. doi:10.1097/OLQ.0b013e3181e8087e. PMC 4628821. PMID 20679963.