The sexually transmitted disease mycoplasma genitalium, which some news reports say could become the next superbug, is showing up in the Lowcountry and across the U.S. MUSC Health obstetrician and gynecologist David Soper, a nationally recognized expert in obstetrical and gynecological infectious diseases, calls it “the new kid on the block.”
“It’s only a superbug because it’s a bacterium that lacks a cell wall, which makes it resistant to penicillin and similar agents,” Soper said. “But it can be treated with other antibiotics, such as azithromycin. It’s not a superbug when it comes to virulence. The disease it’s associated with appears to be on the milder side.”
He said MG seems to be more common than gonorrhea but less common than chlamydia, two better known sexually transmitted infections. The Centers for Disease Control and Prevention has called MG an emerging issue.
Soper, a professor in the College of Medicine at the Medical University of South Carolina, said MG affects both men and women. “Symptoms include urethral discharge, some burning with urination, vaginal discharge and mild lower abdominal pain. It is a sexually transmitted infection requiring genital to genital contact.”
Some people don’t have any symptoms at all, Soper said. They don’t know they have it until it causes other problems, including pelvic inflammatory disease, which can lead to infertility.
It’s a reminder that MG can be tricky. In fact, some researchers have called it a moving target because it’s so good at becoming resistant to treatments. Soper has seen that as well. “Macrolides, like azithromycin, are effective, but resistance is starting to be observed,” he said. Macrolides are a category of antibiotics that include Biaxin (clarithromycin), Zithromax (azithromycin) and erythromycin.
Soper, who has written more than 100 scientific publications about infectious diseases in obstetrics and gynecology, said no current recommendations suggest screening for MG is valuable. “More studies are required before specific recommendations can be made.”
But MG is on doctors’ and nurses’ radars. They know it can show up in people with other STDs. “Much of the time, antibiotics used to treat chlamydia, like doxycycline or azithromycin, will also treat mycoplasma genitalium, so even if testing is not performed for the microorganism, the patient still receives appropriate treatment,” Soper said. “Likewise, sex partners are commonly treated with similar antibiotics, accomplishing the same result.”
When typical antibiotics fail to ease persistent urogenital symptoms, Soper said, it can be a sign that MG is present and doctors need to shift to the drugs known to work on the STD. Reports suggest between 1 and 3 percent of young adults in the U.S. have MG. The best way to prevent it? “Safe sex, especially the use of condoms,” Soper said.