Mycoplasmas, particularly Mycoplasma genitalium (M. genitalium) and Mycoplasma hominis (M. hominis), are small microorganisms that can colonize the human urogenital tract. While they share some characteristics, they differ significantly in terms of pathogenicity and their clinical roles.
Mycoplasma genitalium
M. genitalium is an emerging sexually transmitted pathogen often associated with infections such as urethritis, cervicitis, and pelvic inflammatory disease (PID). Untreated infections can lead to severe complications, including tubal infertility, preterm births, and miscarriages.
Symptoms
Heavy vaginal discharge
Dysuria (painful urination)
Lower abdominal pain
Dyspareunia (pain during intercourse)
Contact bleeding/mid-cycle bleeding
Transmission M. genitalium is primarily transmitted through sexual contact, including among men who have sex with men (MSM). Vertical transmission from mother to child during childbirth is also possible.
Diagnosis and Bacteriological Approach
The diagnosis of M. genitalium relies on nucleic acid amplification tests (NAAT), such as PCR, which are highly sensitive and specific. These tests can also detect macrolide resistance, an increasingly important factor due to rising resistance rates.
Mycoplasma hominis
In contrast to M. genitalium, M. hominis is generally considered a commensal organism, meaning it lives harmlessly on the body. However, in some women, M. hominis can be associated with bacterial vaginosis, particularly when found in large quantities, often alongside Gardnerella vaginalis.
Cervical-Vaginal Smear (CVS) and Mycoplasma
The cervical-vaginal smear (CVS) is a key microbiological test used to evaluate vaginal flora and detect urogenital infections. While M. hominis may be found in cases of bacterial vaginosis, its pathogenic role is limited. However, M. genitalium is not detected by Gram staining or standard culture methods, making CVS unsuitable for its screening. Molecular methods such as PCR are necessary for accurate identification of M. genitalium.
Conclusion
M. genitalium and M. hominis play very different roles in reproductive health. While M. genitalium requires close attention due to its high pathogenic potential, M. hominis is often harmless and does not typically require treatment except in specific circumstances. The cervical-vaginal smear remains a crucial tool for detecting microbial imbalances but is limited in detecting Mycoplasma genitalium infections.
Kind regards,
Dr. Sandra Yene Amougui
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