Despite years of public health campaigns extolling the benefits of safe sex and regular testing, several common, curable sexually transmitted infections (STIs) have remained just that – incredibly common. In fact, sobering reports from the Centers For Disease Control and Prevention (CDC) show that infection rates for the world’s four most prevalent STIs – chlamydia, gonorrhea, trichomoniasis, and syphilis – are surging to record highs in the US.
But what few people outside of epidemiologists may know is that there is another sexually transmittable pathogen circulating in the US at levels comparable to, and in some regions, greater than that of gonorrhea.
It’s called Mycoplasma genitalium, or Mgen, and you might have already been exposed without knowing it.
First identified in the 1980s, scientists have since linked genital Mgen infections to urethritis (inflammation of the urethra) in men, but we still understand very little about the potential long-term complications of the disease in men or women, such as whether or not it may cause fertility problems similar to untreated gonorrhea or chlamydia. The research on Mgen is so inconclusive, notes The Baltimore Sun, that the CDC didn’t even acknowledge it as an STI of consequence until 2015.
Per the agency’s assessment, the existing evidence on Mgen suggests that it may play a role in inflammation of the female reproductive tract and infertility. Studies have shown that Mgen is more common in the reproductive tract of women with cervicitis than those without, and similar observations have been made for women with pelvic inflammatory disease (PID). Several investigations have also revealed that women with fallopian tube issues that prevent pregnancy are more likely to have antibodies against Mgen than fertile women.
Despite uncertainty about the seriousness of Mgen infections, we have established that treating them is a challenge – international research has demonstrated that the bacteria are increasingly resistant to both first- and second-line antibiotics. As of now, there is no clear winner in terms of an effective medication protocol.
Though everyone agrees that additional investigations on Mgen are sorely needed, conducting epidemiological studies has been challenging for one simple reason: There was no validated test for detecting Mgen in patients until quite recently.
Created by the Australian company SpeeDx, a urine-based test platform called the ResistancePlus MG assay was approved for use in Europe, Australia, and New Zealand in 2016. In September of this year, the company initiated a multi-site US clinical trial aimed at securing FDA approval.
"This test is an exciting new development that will increase the precision of patient care for patients impacted by Mycoplasma genitalium – a common sexually transmitted infection with limited treatment options,” Dr Maria Trent, a trial investigator and professor at Johns Hopkins Medicine, said in a statement.
Another company, the Massachusetts-based Hologic, is currently evaluating a different test candidate for US use.
In addition to aiding research into treatment options, Mgen test developers hope that their platforms will help bring the STI into the public eye and make it a bigger priority for government-run health agencies. (Currently, the CDC does not even require physicians to report cases of Mgen for nationwide surveillance projects, as it does for most STDs.)
"How can you talk about treating mycoplasma if you don't have a way to test for it," Charlotte Gaydos, Trent’s colleague at Johns Hopkins, said to The Baltimore Sun. "We have our fingers crossed that we get approval."