Mycoplasma genitalium in Males With Nongonococcal Urethritis

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Abstract
Background: Mycoplasma genitaliumis regarded as a potential pathogen of the human urogenital tract based on prevalence findings of several European studies. Goal: To determine the prevalence ofM genitaliumin urethral specimens of symptomatic patients with nongonococcal urethritis and from asymptomatic patients attending a sexually transmitted disease clinic in Milan, and to verify the clinical efficacy ofM genitaliumeradication by antibiotic treatment. Study Design: From May 1998 to late April 1999, a routine analysis forM genitaliumby DNA amplification (polymerase chain reaction) was performed in patients attending the Institute of Dermatological Science in Milan. The authors examined urethral swabs from 178 symptomatic and 23 asymptomatic males.M genitalium-positive patients were clinically and microbiologically tested after treatment with either doxycycline or azithromycin. Results: Among males with nongonococcal urethritis,M genitaliumwas detected in 14.0% of patients as the only agent; in 15.1% of patients in association withChlamydia trachomatisand/orUreaplasma urealyticum;and in 1 asymptomatic patient. In all symptomaticM genitalium-positive patients, antibiotic treatment eradicated the infection and cured clinical symptoms. Conclusion: These data reveal the high prevalence ofM genitaliumin symptomatic patients, the rarity of asymptomatic carriers, the high susceptibility to antibiotic treatment, and the clinical efficacy ofM genitaliumeradication. Moreover, data confirm the etiologic role ofM genitaliumin inflammatory processes of the human urogenital tract in the Mediterranean area.