How Do I Get Tested for Mycoplasma Genitalium?

Urine Test Cup
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Question: How Do I Get Tested for Mycoplasma Genitalium?

Answer: Usually with urine tests or a swab

Mycoplasma, known as MG, is now recognized to be an extremely common STD. However, even if you have signs of a sexually transmitted infection, very few doctors are going to test you for Mycoplasma genitalium right off the bat. It's not a screening on most doctors' lists. Instead, it tends to be assumed in certain circumstances.

For example, if you have symptoms of urethritis or cervicitis but don't have either gonorrhea or chlamydia, your doctor may just treat you for Mycoplasma presumptively.That's because MG the most common cause of those symptoms other than those two diseases. In addition, antibiotic treatment for MG is relatively safe, if not always effective. Therefore, there's thought to be little reason to put it off. (This is true despite the fact that there is some evidence of antibiotic-resistant mycoplasma.) 

Sometimes, however, more comprehensive testing is done when you have symptoms that suggest you have some form of bacterial urethritis. In these cases, your healthcare provider will take a urine sample and/or one or more swab samples from your penis or vagina. Those samples will be sent to a laboratory. There, tests will be run to determine what infection is causing your discomfort.

It requires very specific tests to find Mycoplasma.

For example, if your doctor doesn't test your urine for bacterial DNA, it is unlikely that he will detect a Mycoplasma infection. It is almost impossible to grow the bacterium from swabs outside of a research laboratory. (I can say from personal experience,it's also almost impossible to do so inside of a research laboratory.) However, even with urine testing, the doctor has to look for Mycoplasma.

That doesn't always happen.

Your provider may also do additional tests to rule out other sexually transmitted infections. For example, they might look for syphilis or other conditions that frequently occur simultaneously with urethritis/cervicitis. That is done because people who have one STI are generally at risk for more. Co-infections are not uncommon when people are having risky sex

Sources:

Anagrius C et al. "Mycoplasma genitalium: prevalence, clinical significance, and transmission" Sex Transm Infect 2005; 81: 458-462

Falk L, Enger M, Jensen JS. Time to eradication of Mycoplasma genitalium after antibiotic treatment in men and women. J Antimicrob Chemother. 2015 Nov;70(11):3134-40. doi: 10.1093/jac/dkv246.

Manhart LE, Jensen JS, Bradshaw CS, Golden MR, Martin DH. Efficacy of Antimicrobial Therapy for Mycoplasma genitalium Infections. Clin Infect Dis. 2015 Dec 15;61 Suppl 8:S802-17. doi: 10.1093/cid/civ785.

Tosh AK et al. "Mycoplasma genitalium among adolescent women and their partners." J Adolesc Health. 2007 May;40(5):412-7.

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