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Member Research and Reports

Member Research and Reports

Washington Researcher Outlines Priorities for Little-Known Sexually Transmitted Infection

Researchers are getting closer to understanding the long-term impact of Mycoplasma genitalium, the often asymptomatic sexually transmitted infection that bears some resemblance to other well-known Sexually Transmitted Infections (STIs) such as gonorrhea and chlamydia. Understanding the impact of this emerging pathogen is key to determining whether screening for it is needed and to informing treatment recommendations.

As part of an effort to determine whether it is time for a public health control program for M. genitalium, Dr. Lisa Manhart, professor in the departments of epidemiology and global health at the University of Washington School of Public Health, and Dr. Harold Wiesenfeld, associate professor in the department of obstetrics, gynecology & reproductive sciences at the University of Pittsburgh, summarized what is known about M. genitalium infection in women and outlined recommendations for future research to better understand the implications of M. genitalium on women’s health.

The articles, presented in a supplement to the Journal of Infectious Diseases, share the outcomes of a 2016 National Institutes of Allergy and Infectious Diseases-funded Technical Consultation that brought together M. genitalium researchers to review the current knowledge and concerns around the pathogen. Other articles in the supplement summarize what is known about pathogenesis, infections in men, diagnostic assays, treatment and antimicrobial resistance, and criteria for developing public health control programs.

“We reached a tipping point in our research on M. genitalium where there was finally enough data to figure out if we needed a public health response,” said Dr. Manhart. “The goal of the consultation was to review the evidence and make some recommendations about whether a national control program in the US was appropriate.”

M. genitalium can cause inflammation in the urethra (urethritis) in men and is associated with female reproductive tract syndromes. Compared to more commonly known STIs in the United States, M. genitalium is more prevalent than Neisseria gonorrhoeae, but less than Chlamydia trachomatis.

[Photo: Dr. Manhart]

Dr. Manhart and the researchers from the technical consultation identified four main consensus recommendations for future research on M. genitalium before providing recommendations to the public. First, researchers need to design clinical trials to determine whether to recommend widespread screening for asymptomatic M. genitalium and treatment to improve reproductive health in women. Second, there is a need for more effective antibiotics given the widespread antibiotic resistance in M. genitalium. Third, diagnostic tests that include the detection of resistance genes to a spectrum of antibiotic drug classes must be developed and made broadly available. Fourth, basic science research is needed to identify new antibiotic targets, potential vaccine targets, and better understand the life cycle of M. genitalium in reproductive tract tissues.

Drs. Manhart, David Martin from Tulane University and chief, section of Infectious d iseases Louisiana State University Health Sciences Center, and Kimberly Workowski, professor of medicine in the department of medicine at Emory, co-organized the consultation and co-edited the supplement.

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