Question 1: How does CDC recommend testing for Mycoplasma genitalium?
Answer: At present, it is difficult to test for M. genitalium. Culture is difficult due to strict growth requirements, and is usually only available at research sites. Several authors report nucleic acid amplification test (NAAT) testing using commercially available research-use-only analytes with the APTIMA platform, or in-house polymerase chain reaction (PCR) testing. However, none of these is FDA cleared. NAAT can be performed on urine for men and women, and with cervical or vaginal swabs in women.
Question 2: When do we treat women for Mycoplasma genitalium?
Answer: Clinicians might suspect M. genitalium in women with persistent or recurrent cervicitis who test negative for chlamydia and gonorrhea. Additionally, men with persistent or recurrent urethritis who fail to respond to treatment may have M. genitalium. In the absence of available testing, some clinicians may choose empiric treatment with a longer course of azithromycin or with moxifloxicin.
Question 3: Are there tests in development for Mycoplasma? When would we use them, and at what body sites?
Answer: It is possible that nucleic acid amplification testing (NAAT) for M. genitalium will be commercially developed in the future. NAAT can be performed on urine for men and women, and with cervical or vaginal swabs in women.
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