Mycoplasma genitalium, a Sexually Transmitted Infection, identified in 1% of the British population Interview with:
Dr Pam Sonnenberg 

Reader in Infectious Disease Epidemiology
Research Department of Infection & Population Health
University College London

MedicalResearch: What is the background for this study? What are the main findings?

Dr. Sonnenberg:  This study strengthens growing evidence that Mycoplasma genitalium (MG) is a sexually transmitted infection (STI). Analyses of over 4500 of urine samples from Britain’s third National Survey of Sexual Attitudes and Lifestyles (Natsal-3) showed that MG was prevalent in up to 1% of the general population aged 16-44, who had reported at least one sexual partner. Prevalence was much higher in those who had reported more than four sexual partners in the past year – 5.2% in men and 3.1% in women. Absence of the infection in over 200 16-17 year olds who had not had vaginal, anal, or oral sex provided further evidence that MG is transmitted sexually. The study also analysed risk factors for  Mycoplasma genitalium, such as ethnicity, number of partners, and areas of deprivation. There were strong associations with risky sexual behaviours, with similar behavioural risk factors to other known STIs. The authors found that men of Black ethnicity and those living in the most deprived areas were more likely to test positive for MG. Over 90% of Mycoplasma genitalium in men and over two-thirds of MG cases in women were in those aged 25–44 years; an age group who would not be included in STI prevention measures currently aimed at young people in Britain. Interestingly, the majority of participants who tested positive for MG did not report any STI symptoms in the last month. Over half of women did not report any symptoms, but among those who did, bleeding after sex was most common. Over 90% of MG positive men did not report any symptoms.

MedicalResearch: What should clinicians and patients take away from your report?

Dr. Sonnenberg:  Only testing those who are currently symptomatic would miss the majority of infections. However, it may be that MG does not cause illness in all individuals in whom the infection is detected. Laboratory testing for Mycoplasma genitalium is not yet widely available in the UK. National clinical guidelines currently recommend syndromic management for patients with symptoms consistent with MG infection where other causes have been excluded. As for all STIs, prevention measures promoting increased condom use and a reduction in sexual risk behaviours are likely to play an important role in efforts to control MG.

MedicalResearch: What recommendations do you have for future research as a result of this study?

Dr. Sonnenberg:  Further research is needed to understand the clinical implications of infection, natural history and possible longer-term complications. This information, together with information on resistance patterns to guide antibiotic choice, will inform recommendations on how to test for and manage MG infection. It will also determine the role of MG testing in routine clinical practice and infection control.


Pam Sonnenberg, Catherine A. Ison, Soazig Clifton, Nigel Field, Clare Tanton,Kate Soldan, Simon Beddows, Sarah Alexander, Rumena Khanom,Pamela Saunders, Andrew J. Copas, Kaye Wellings, Catherine H. Mercer,and Anne M. Johnson

Epidemiology of Mycoplasma genitalium in British men and women aged 16–44 years: evidence from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3)

Int. J. Epidemiol. first published online November 3, 2015 doi:10.1093/ije/dyv194

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Dr Pam Sonnenberg (2015). New Sexually Transmitted Infection Mycoplasma genitalium Identified