The disease, mycoplasma genitalium or Mgen, has no symptoms and most people don’t have a clue that they have the disease. There’s no test for it, which makes it hard for doctors to keep track of and diagnose. However, doctors believe the disease is even more common than gonorrhea and affects up to three percent population.
The disease is thought to render people infertile.
Although scientists discovered the bacterial infection in the 1980s, it wasn’t until 2015 that the Centers for Disease Control and Prevention acknowledged that it was an STD. There is growing concern that the infection will continue to spread, especially since it shows no symptoms and many strains are antibiotic-resistant.
Thus, treatment options are limited.
However, researchers from the Johns Hopkins Bloomberg School of Public Health are leading a trial to find a test that can detect the bacteria that causes Mgen.
Johns Hopkins Medicine Professor of Public Health and Pediatrics Dr. Maria Trent became involved with the work due to her interest in fertility preservation in high-risk youth. She started to consider the disease’s connection to PID (pelvic inflammatory disease) and how rampant the disease is.
Trent said the research shows that doctors must find a way to include regular Mgen testing into yearly routines.
SpeedX, an Australian-based company, has developed a test that could help identify the Mgen-causing bacteria. Trent is currently investigating that test, which is already in use in Australia, Europe, New Zealand and the UK. If Trent’s research determines the test is effective, she can attain FDA approval to use it in the U.S.
The test also looks for biomarkers connected to antibiotic resistance, which would let doctors know if a patient needs something more than the commonly prescribed azithromycin.
According to Colin Dever, SpeedX CEO, diagnostic testing wasn’t always available until genetic testing came along. He said now there is a way to determine if another line of treatment is necessary.
Clinical trials are being carried out in two locations – Albuquerque, N.M.’s TriCore Reference Laboratories and the University of Alabama in Birmingham.
Hologic is based in Massachusetts and is looking for FDA approval for another diagnostic test.
People who develop Mgen symptoms may think they have another STD such as gonorrhea or chlamydia. Women could experience vaginal discharge, pelvic pain, pain while having sex and even bleeding after sex. Men may experience painful urination and have a watery discharge.
Due to the lack of knowledge by doctors on Mgen, patients are not diagnosed correctly and are given antibiotics for other kinds of STDs. According to research, Mgen has been tied to infertility, but additional studies need to be done to ensure this conclusively.
Other studies show that Mgen can cause urethritis, which is inflammation in the urethra. The CDC has not confirmed if this is the reason men experience male infertility. Even less information for females is available, but what is known is that the bacteria can be found in the uterus lining or cervix, which can lead to pelvic inflammatory disease.
The CDC said PID still needs to be studied further.
A number of researchers feel women who have more than one or two cases of PID were not treated for the right STD. Many studies show infertile women had scarring of their fallopian tubes with antibodies connected to Mgen.
Again, further research is needed to make sure this is why infertility is happening for men and women.
While Mgen is believed to affect a minute number of people, it’s the high-risk population that is most at risk for catching it. Since Mgen has no outward symptoms and no standard test for it is available, people may not know that their reproductive system is being damaged. It’s the Mgen inflammation that does the damage to the reproductive system.
Thanks to the CDC’s decision to make Mgen an STD disease, more attention should be paid to it. Researchers say more information about Mgen could be found if there was a routine test for it. After all, doctors can’t treat mycoplasma if they can’t test for it.
Written by Mark Riegel, MD
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