Abstract Mycoplasma genitalium is a fastidious slow-growing bacterium that can be found in the lower urogenital tract of a small percentage of sexually active men and women in the general population. Its carriage in asymptomatic persons, particularly women, contributes to delayed diagnosis, spread of infection, and chronicity in some individuals. Thanks to improved detection methods, there is evidence that M genitalium is an important urogenital pathogen in causing inflammatory disease in men and women, which may have implications in infertility, pregnancy outcomes, and risk for HIV-1 acquisition. As more is learned about M genitalium and its pathogenic potential, laboratory testing to identify people with infections caused by this organism and selection of appropriate treatment regimens become increasingly important. However, these are challenging and complex matters due to the inherent difficulties in its detection in clinical specimens, rapidly escalating antimicrobial resistance, and limited classes of antimicrobial agents that are likely to be effective. The use of nucleic acid amplification tests that have the capability for detecting mutations conferring drug resistance in treatment decisions, referred to as resistance-guided treatment, is now recommended by public health organizations in multiple countries where such testing is available and has the potential to improve treatment outcomes.
Waites et al. (Fri,) studied this question.