A ‘silent spreading’ STD that can cause infertility is feared to develop into a superbug.
Mycoplasma genitalium, also known as M. genitalium or M. gene, is on its way to becoming resistant to every antibiotic used to treat it.
The sexually transmitted infection was first discovered in London in the 1980s, but a test has only been available in the US since 2019.
It means scientists don’t know exactly how widespread it is.
Some studies suggest that only one in 100 adults in the US is positive for the virus, but experts estimate that as many as a fifth will get it at some point in their lives.
The bacterial infection has been linked to infertility, preterm birth, and miscarriage, as well as cervical swelling and pelvic inflammatory disease.
There are growing concerns that it will become untreatable as the STI has developed resistance to the most popular antibiotic used to treat STIs, azithromycin, as well as quinolone, macrolide, and doxycycline.
Alternatives are available, but they cause serious side effects that make them unsuitable for pregnant women. And there are signs that it is already becoming tolerant for them too.
There are also fears that M. gene will become more prevalent as STDs generally increase in the US.
In 2021 there were a record 2.5 million infections, up from 2.4 million in 2020, itself a record high.
In 2018, CDC estimated that there were nearly 68 million STDs in the US on any given day that year.
Superbugs are estimated to contribute to about 7 million deaths each year, with some experts warning that they should be taken as seriously as global warming.
Mycoplasma genitalium, also known as M. genitalium or M. gene, causes severe symptoms, including infertility, but is resistant to four different types of antibiotics. It is estimated that up to one in five sexually active US citizens could have it
What is M. gen.?
Mycoplasma genitalium, also known as M. genitalium or M. gen., is a sexually transmitted disease.
It is a bacterial infection that infects the urinary tract and genitals of men and women.
First discovered in London in the 1980s, it is passed on through sexual contact.
Babies can also get the infection from their mothers before they are born through the amniotic fluid.
It is more common in young people and also in people who have unprotected sex and have multiple sexual partners (although this applies to all STIs).
The infection is similar to chlamydia, but it is caused by a different bacteria.
Past M. gen. cases may have been mistaken for and treated as chlamydia, allowing it to gradually develop resistance to various antibiotics.
However, it is possible to have both infections.
A test for M. gen. has only been available in the US since 2019.
Routine screening is not recommended by CDC.
- Bleeding and swollen genitals
- Urethritis, swelling and irritation of the urethra, making urination painful
- Abnormal discharge
- Cervical swelling
- Pelvic inflammatory disease (PID) in women, causing abdominal pain and bleeding after sex
Professor Paul Hunter, an infectious disease expert at the University of East Anglia in England, told DailyMail.com: ‘This is one of a small number of genital mycoplasmas, including M. gen., M. hominis and some related ureaplasmas, M. gene. . has had the strongest evidence that it causes adverse health outcomes.”
The STI is also “difficult to diagnose,” meaning it’s spreading under the radar, he said.
“Doing something about it is not easy, because the infection is quite common and most infections have no adverse health effects.”
M. gene can cause painful, bleeding and swollen genitals and even infertility in women.
But many people will not show any symptoms at all and may wear it for years without realizing it.
It can be transmitted through genital-to-genital contact, such as unprotected vaginal or anal sex, as well as mother-to-baby transmission even before birth.
The risk of preterm birth increased almost twofold in women with M. gen., and analysis of 10 studies published in the journal Sexually Transmitted Infection in May through 2021.
In males, M. gen. may cause urethritis, swelling, and irritation of the urethra, making it painful to urinate, but more research is needed to determine the long-term effects of M. gen. infection.
It can also cause abnormal discharge for both sexes.
Simon Clarke, an associate professor of cellular microbiology at the University of Reading, told DailyMail.com that it is “completely feasible” that M. gen. become completely resistant to antibiotics.
However, he said multiple drug-resistant strains are likely “far away.”
He said the ‘silent spread’ is the problem because people ‘don’t know to get tested and they’re spreading it to someone else’.
This means it will become increasingly dominant and doctors will continue to prescribe antibiotics to treat it, fueling antibiotic resistance and the potential for M. gene. to become a top performer.
It comes amid rising STI rates across the board. The rate of chlamydia, the most common STI in the US, has been rising for more than 30 years
M. gen., chlamydia, and gonorrhea can all be asymptomatic, meaning the STI spreads quietly. Gonorrhea rates peaked in the 1970s, but still remain high
What is Antibiotic Resistance?
Antibiotics have been dispensed unnecessarily by doctors for decades, fueling once-harmless bacteria to become superbugs.
The World Health Organization (WHO) has previously warned that if nothing is done the world will be heading for a ‘post-antibiotic’ era.
It claimed that common infections, such as chlamydia, will become deadly without immediate solutions to the growing crisis.
Bacteria can become resistant to drugs if people take the wrong dose of antibiotics or if they are administered unnecessarily.
Former UK Chief Medical Officer Dame Sally Davies claimed in 2016 that the threat of antibiotic resistance is as serious as terrorism.
Figures estimate that by 2050, superbugs will kill 10 million people each year, with patients succumbing to once-harmless bugs.
Around 700,000 people worldwide already die each year as a result of resistant infections, including tuberculosis (TB), HIV and malaria.
Concerns have been repeatedly raised that drugs will stop working in years to come if antibiotics stop working.
In addition to existing drugs becoming less effective, only one or two new antibiotics have been developed in the past 30 years.
In September 2017, the WHO warned that antibiotics were ‘running out’, as a report showed a ‘serious lack’ of new drugs in the development pipeline.
Without antibiotics, cesarean sections, cancer treatments and hip replacements become incredibly “risky,” it was said at the time.
Superbugs are estimated to kill 7 million each year, either as co-infection or directly.
But last year, a large study found they are the leading underlying cause of 1.2 million annual deaths worldwide.
This would make superbugs a bigger global killer than AIDS or malaria, which killed 860,000 and 640,000 that year, respectively. By comparison, Covid killed an estimated 3.5 million people in 2021.
The Centers for Disease Control and Prevention (CDC) recommends routine screening for M. gene. does not indicate and does not indicate why.
Because the test, known as the Aptima Nucleic Acid Amplification Test, was not approved until 2019, it has not been widely rolled out and doctors are not required to report cases of infection.
Patients are only screened for M. gene. after persistent complaints and negative tests for other STDs.
This means that there is no clear picture of how widespread M. gene. or who it affects the most.
But Lisa Manhart, a professor of epidemiology at the University of Washington School of Public Health, told NBC News that M. gen. can affect up to 20 percent of sexually active women and 17 percent of men between the ages of 15 and 24.
In contrast, the most common STI in the US is chlamydia, with 5 percent of sexually active women aged 14-24 being infected with the STI.
If regular antibiotics don’t work, doctors may use moxifloxacin.
This works, but causes significant side effects, including nausea, diarrhea, dizziness and vomiting.
This means that it is not a suitable treatment for everyone, especially pregnant women.
And the more moxifloxacin is used to treat M. gen. treatment, the more likely it will become resistant to it.
Other than moxifloxacin, treatment options are limited.
The CDC currently recommends testing for antibiotic resistance before deciding which drugs to take, but these tests have not been approved by the FDA.
Only a handful of specialized research centers can test whether the infection is resistant to an antibiotic.
Commonly available versions of the test can take years, as can antibiotics that work.
Meanwhile, David Harvey, executive director of the National Coalition of STD directors, said at Monday’s Centers for Disease Control and Prevention sexually transmitted disease prevention conference that the rise in STDs had “got out of control.”
Infection rates for STDs, including gonorrhea and syphilis, have been rising for years, but last year syphilis cases hit their highest since 1948.