Mycoplasma genitalium in males with nongonococcal urethritis - Prevalence and clinical efficacy of eradication

Background: Mycoplasma genitalium is regarded as a potential pathogen of th e human urogenital tract based on prevalence findings of several European s tudies. Goal: To determine the prevalence of M genitalium in urethral specimens of symptomatic patients with nongonococcal urethritis and from asymptomatic pa tients attending a sexually transmitted disease clinic in Milan, and to ver ify the clinical efficacy of M genitalium eradication by antibiotic treatme nt. Study Design: From May 1998 to late April 1999, a routine analysis for M ge nitalium by DNA amplification (polymerase chain reaction) was performed in patients attending the Institute of Dermatological Science in Milan, The au thors examined urethral swabs from 178 symptomatic and 23 asymptomatic male s, M genitalium-positive patients were clinically and microbiologically tes ted after treatment with either doxycycline or azithromycin. Results: Among males with nongonococcal urethritis, M genitalium was detect ed in 14.0% of patients as the only agent; in 15.1% of patients in associat ion with Chlamydia trachomatis and/or Ureaplasma urealyticum; and in 1 asym ptomatic patient, In all symptomatic M genitalium-positive patients, antibi otic treatment eradicated the infection and cured clinical symptoms. Conclusion: These data reveal the high prevalence of M genitalium in sympto matic patients, the rarity of asymptomatic carriers, the high susceptibilit y to antibiotic treatment, and the clinical efficacy of M genitalium eradic ation, Moreover, data confirm the etiologic role of M genitalium in inflamm atory processes of the human urogenital tract in the Mediterranean area.