A ‘silent spreader’ STI that can cause infertility is feared to be evolving into a superbug.
Mycoplasma genitalium, also known as M. genitalium or M. gen, has become resistant to all the antibiotics used to treat it so far.
The sexually transmitted infection was first discovered in London in the 1980s, but a test has only been available in the US since 2019. This means scientists don’t know exactly what the distribution is.
Some studies suggest that only one in 100 adults in the US is M. gen positive, but experts estimate that up to a fifth will have it at some point in their lives.
Bacterial infection has been linked to infertility, premature births and miscarriages, as well as cervical swelling and pelvic inflammatory disease.
There is growing concern that it cannot be treated because the STI has developed resistance to the most popular antibiotic used to treat STIs, azithromycin, as well as quinolones, macrolides and doxycycline.
Alternatives are available, but they cause serious side effects that make them unsuitable for pregnant women. And there are signs that he is becoming tolerant of them, too.
There are also fears that M. gen will become more common as STIs in general increase in the US. There were a record 2.5 million infections in 2021, up from an all-time high of 2.4 million in 2020.
Superbugs are estimated to contribute to around 7 million deaths a year, and some experts warn they should be taken as seriously as global warming.
Mycoplasma genitalium, also known as M. genitalium or M. gen, causes serious symptoms, including infertility, but is resistant to four different types of antibiotics. It is estimated that up to one in five sexually active Americans may have it
Professor Paul Hunter, an infectious disease expert at the University of East Anglia in England, told DailyMail.com that M. gen has “the strongest evidence that it causes adverse health outcomes” of any strain of mycoplasma genital
STIs are also “difficult to diagnose,” meaning they spread under the radar, he said.
“Doing something about it is not easy, as the infection is quite common and most infections do not cause adverse health outcomes.”
M. gen can cause painful, bleeding and swollen genitals, and even infertility in women.
But many people will show no symptoms and may carry 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 nearly doubled in women with M. gen, a 2021 analysis of 10 studies found.
In men, M. gen can cause urethritis, swelling and irritation of the urethra, making it painful to urinate, but more research is needed to establish the long-term effects of M. gen infection.
It can also cause abnormal discharge for both sexes.
Simon Clarke, associate professor of cellular microbiology at the University of Reading, told DailyMail.com that it is “entirely feasible” that M. gen could become completely resistant to antibiotics.
However, he said the multiple drug-resistant strains are likely “somehow”.
He said “silent spread” is the problem, as people “don’t know to get tested and pass it on to someone else”.
This means it will continue to become more dominant and doctors will continue to prescribe antibiotics to treat it, fueling antibiotic resistance and the potential for M. gen. become a superbug.
Superbugs are estimated to kill 7 million, either as co-infections or directly, each year.
It comes amid rising STI rates across the board. The rate of chlamydia, the most common STI in the US, has been increasing for more than 30 years
M. gen., chlamydia and gonorrhea can be asymptomatic, meaning the STI spreads silently. Gonorrhea rates peaked in the 1970s, but still remain high
But a major study last year found they are the main underlying cause of 1.2 million deaths worldwide each year.
That would make superbugs a bigger global killer than AIDS or malaria, which killed 860,000 and 640,000 that year, respectively. In comparison, Covid killed around 3.5 million people in 2021.
The Centers for Disease Control and Prevention (CDC) does not recommend routine screening for M. gen.
Because the test, known as the Aptima nucleic acid amplification test, was only approved in 2019, it has not been widely developed and doctors do not need to report cases of infection.
Patients will only be screened for M. gen after persistent symptoms and negative tests for other STIs.
This means that there is no clear picture of the spread of M. gen, 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 could be affecting as many as 20 percent of sexually active women and 17 percent of men between 15 and 24 years old.
By contrast, the most common STI in the US is chlamydia, with 5% of sexually active women aged 14 to 24 infected with the STI.
If common 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, the more likely it is to become resistant to it as well.
Apart from moxifloxacin, treatment options are limited.
The CDC currently recommends testing for antibiotic resistance before deciding which drugs to take, but these tests are not approved by the FDA.
Only a handful of specialized research centers can test whether the infection is resistant to an antibiotic.
Widely available versions of the test could take years, just like antibiotics that work.
Meanwhile, during the Centers for Disease Control and Prevention’s STD Prevention Conference on Monday, National STD Directors’ Coalition Executive Director David Harvey said the increase in STIs were “out of control”.
Rates of infection with STIs such as gonorrhea and syphilis have been rising for years, but last year syphilis cases reached their highest level since 1948.