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Graphical Abstract

 Graphical abstract 

infections are enabled by multiple virulence factors, both intracellular and expressed on the cholesterol-containing phospholipid membrane. Intracellular accessory proteins form the tip structure, which adheres to epithelial cells via the transmembrane adhesion complex of Nap proteins, P110 and P140. Protein M binds to the Fab region of immunoglobulins with a high affinity to both λ and κ chains, enabling immune system evasion. Membrane lipoproteins and extracellular polymeric substances help in biofilm formation, which is thought to facilitate infection persistence.

 

 

Abstract

is characterized by a small genome and a lack of a cell wall, contributing to its unique biology. It is associated with reproductive tract infections, including non-gonococcal urethritis and pelvic inflammatory disease. It is nearly as common as chlamydia in most studies from high-income countries. The emergence of antimicrobial resistance in raises concern about the long-term efficacy of current therapeutic strategies. Understanding its genomic intricacies and pathogenic mechanisms is crucial for developing targeted interventions to address the growing public health impact of this elusive microbe.

Funding
This study was supported by the:
  • European Society of Clinical Microbiology and Infectious Diseases
    • Principle Award Recipient: L BeetonMichael
  • This is an open-access article distributed under the terms of the Creative Commons Attribution License. This article was made open access via a Publish and Read agreement between the Microbiology Society and the corresponding author’s institution.
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2025-04-04
2025-04-27
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References

  1. Taylor-Robinson D, Tully JG, Furr PM, Cole RM, Rose DL et al. Urogenital mycoplasma infections of man: a review with observations on a recently discovered mycoplasma. Isr J Med Sci 1981; 17:524–530 [PubMed]
    [Google Scholar]
  2. Tully JG, Cole RM, Taylor-Robinson D, Rose DL. A newly discovered mycoplasma in the human urogenital tract. Lancet 1981; 317:1288–1291 [View Article]
    [Google Scholar]
  3. Jensen JS, Uldum SA, Søndergård-Andersen J, Vuust J, Lind K. Polymerase chain reaction for detection of Mycoplasma genitalium in clinical samples. J Clin Microbiol 1991; 29:46–50 [View Article]
    [Google Scholar]
  4. Falk L, Jensen JS. Mycoplasma genitalium prevalence, symptoms, signs and treatment efficacy among attendees at a swedish STD outpatient clinic. Int J STD AIDS 2001; 12:107
    [Google Scholar]
  5. Horner PJ, Gilroy CB, Thomas BJ, Naidoo RO, Taylor-Robinson D. Association of Mycoplasma genitalium with acute non-gonococcal urethritis. Lancet 1993; 342:582–585 [View Article] [PubMed]
    [Google Scholar]
  6. Jensen JS, Orsum R, Dohn B, Uldum S, Worm AM et al. Mycoplasma genitalium: a cause of male urethritis?. Genitourin Med 1993; 69:265–269 [View Article] [PubMed]
    [Google Scholar]
  7. Manhart LE, Critchlow CW, Holmes KK, Dutro SM, Eschenbach DA et al. Mucopurulent cervicitis and Mycoplasma genitalium. J Infect Dis 2003; 187:650–657 [View Article] [PubMed]
    [Google Scholar]
  8. Uno M, Deguchi T, Komeda H, Hayasaki M, Iida M et al. Mycoplasma genitalium in the cervices of Japanese women. Sex Transm Dis 1997; 24:284–286 [View Article]
    [Google Scholar]
  9. Hjorth SV, Björnelius E, Lidbrink P, Falk L, Dohn B et al. Sequence-based typing of Mycoplasma genitalium reveals sexual transmission. J Clin Microbiol 2006; 44:2078–2083 [View Article] [PubMed]
    [Google Scholar]
  10. Bradshaw CS, Jensen JS, Tabrizi SN, Read TRH, Garland SM et al. Azithromycin failure in Mycoplasma genitalium urethritis. Emerg Infect Dis 2006; 12:1149–1152 [View Article] [PubMed]
    [Google Scholar]
  11. Falk L, Fredlund H, Jensen JS. Tetracycline treatment does not eradicate Mycoplasma genitalium. Sex Transm Infect 2003; 79:318–319 [View Article] [PubMed]
    [Google Scholar]
  12. Hamasuna R, Osada Y, Jensen JS. Antibiotic susceptibility testing of Mycoplasma genitalium by TaqMan 5’ nuclease real-time PCR. Antimicrob Agents Chemother 2005; 49:4993–4998 [View Article] [PubMed]
    [Google Scholar]
  13. Sonnenberg P, Ison CA, Clifton S, Field N, Tanton C et al. Epidemiology of Mycoplasma genitalium in British men and women aged 16–44 years: evidence from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3). Int J Epidemiol 2015; 44:1982–1994 [View Article] [PubMed]
    [Google Scholar]
  14. Taylor-Robinson D, Jensen JS. Mycoplasma genitalium: from Chrysalis to multicolored butterfly. Clin Microbiol Rev 2011; 24:498–514 [View Article] [PubMed]
    [Google Scholar]
  15. Jensen JS, Bradshaw C. Management of Mycoplasma genitalium infections - can we hit a moving target?. BMC Infect Dis 2015; 15:343 [View Article] [PubMed]
    [Google Scholar]
  16. Wikstrom A. Mycoplasma genitalium: a common cause of persistent urethritis among men treated with doxycycline. Sex Transm Infect 2006; 82:276–279 [View Article]
    [Google Scholar]
  17. Gnanadurai R, Fifer H. Mycoplasma genitalium: a review. Microbiology 2020; 166:21–29 [View Article]
    [Google Scholar]
  18. García-Morales L, González-González L, Querol E, Piñol J. A minimized motile machinery for Mycoplasma genitalium. Mol Microbiol 2016; 100:125–138 [View Article] [PubMed]
    [Google Scholar]
  19. Fraser CM, Gocayne JD, White O, Adams MD, Clayton RA et al. The minimal gene complement of Mycoplasma genitalium. Science 1995; 270:397–403 [View Article] [PubMed]
    [Google Scholar]
  20. Su CJ, Baseman JB. Genome size of Mycoplasma genitalium. J Bacteriol 1990; 172:4705–4707 [View Article] [PubMed]
    [Google Scholar]
  21. Razin S. The minimal cellular genome of mycoplasma. Indian J Biochem Biophys 1997; 34:124–130 [PubMed]
    [Google Scholar]
  22. Yueyue W, Feichen X, Yixuan X, Lu L, Yiwen C et al. Pathogenicity and virulence of Mycoplasma genitalium: unraveling Ariadne’s thread. Virulence 2022; 13:1161–1183 [View Article] [PubMed]
    [Google Scholar]
  23. Beeton ML, Chalker VJ, Jones LC, Maxwell NC, Spiller OB. Antibiotic resistance among clinical ureaplasma isolates recovered from neonates in England and Wales between 2007 and 2013. Antimicrob Agents Chemother 2016; 60:52–56 [View Article] [PubMed]
    [Google Scholar]
  24. Chalker VJ, Sharratt MG, Rees CL, Bell OH, Portal E et al. Tetracycline resistance mediated by tet(M) has variable integrative conjugative element composition in Mycoplasma hominis strains isolated in the United Kingdom from 2005 to 2015. Antimicrob Agents Chemother 2021; 65:e02513-20 [View Article] [PubMed]
    [Google Scholar]
  25. Jensen JS, Cusini M, Gomberg M, Moi H, Wilson J et al. 2021 European guideline on the management of Mycoplasma genitalium infections. Acad Dermatol Venereol 2022; 36:641–650 [View Article]
    [Google Scholar]
  26. Jensen JS, BjÖrnelius E, Dohn B, Lidbrink P. Comparison of first void urine and urogenital swab specimens for detection of Mycoplasma genitalium and Chlamydia trachomatis by polymerase chain reaction in patients attending a sexually transmitted disease clinic. Sex Transm Dis 2004; 31:499–507 [View Article]
    [Google Scholar]
  27. Van Der Pol B, Waites KB, Xiao L, Taylor SN, Rao A et al. Mycoplasma genitalium detection in urogenital specimens from symptomatic and asymptomatic men and women by use of the cobas TV/MG test. J Clin Microbiol 2020; 58: [View Article]
    [Google Scholar]
  28. Read TRH, Murray GL, Danielewski JA, Fairley CK, Doyle M et al. Symptoms, sites, and significance of Mycoplasma genitalium in men who have sex with men. Emerg Infect Dis 2019; 25:719–727 [View Article] [PubMed]
    [Google Scholar]
  29. Lillis RA, Nsuami MJ, Myers L, Martin DH. Utility of urine, vaginal, cervical, and rectal specimens for detection of Mycoplasma genitalium in women. J Clin Microbiol 2011; 49:1990–1992 [View Article] [PubMed]
    [Google Scholar]
  30. Waites KB, Crabb DM, Ratliff AE, Geisler WM, Atkinson TP et al. Latest advances in laboratory detection of Mycoplasma genitalium. J Clin Microbiol 2023; 61:e0079021 [View Article] [PubMed]
    [Google Scholar]
  31. WHO Laboratory Biosafety Manual, 4th Edn Geneva: WHO; 2020
    [Google Scholar]
  32. Soni S, Horner P, Rayment M, Pinto-Sander N, Naous N et al. British Association for Sexual Health and HIV national guideline for the management of infection with Mycoplasma genitalium (2018). Int J STD AIDS 2019; 30:938–950 [View Article] [PubMed]
    [Google Scholar]
  33. Machalek DA, Tao Y, Shilling H, Jensen JS, Unemo M et al. Prevalence of mutations associated with resistance to macrolides and fluoroquinolones in Mycoplasma genitalium: a systematic review and meta-analysis. Lancet Infect Dis 2020; 20:1302–1314 [View Article]
    [Google Scholar]
  34. Jensen JS, Bradshaw CS, Tabrizi SN, Fairley CK, Hamasuna R. Azithromycin treatment failure in Mycoplasma genitalium-positive patients with nongonococcal urethritis is associated with induced macrolide resistance. Clin Infect Dis 2008; 47:1546–1553 [View Article] [PubMed]
    [Google Scholar]
  35. Lau A, Bradshaw CS, Lewis D, Fairley CK, Chen MY et al. The efficacy of azithromycin for the treatment of genital Mycoplasma genitalium: a systematic review and meta-analysis. Clin Infect Dis 2015; 61:1389–1399 [View Article] [PubMed]
    [Google Scholar]
  36. Murray GL, Bodiyabadu K, Danielewski J, Garland SM, Machalek DA et al. Moxifloxacin and sitafloxacin treatment failure in Mycoplasma genitalium infection: association with parC mutation G248T (S83I) and concurrent gyrA mutations. J Infect Dis 2020; 221:1017–1024 [View Article] [PubMed]
    [Google Scholar]
  37. Murray GL, Plummer EL, Bodiyabadu K, Vodstrcil LA, Huaman JL et al. gyrA mutations in Mycoplasma genitalium and their contribution to moxifloxacin failure: time for the next generation of resistance-guided therapy. Clin Infect Dis 2023; 76:2187–2195 [View Article] [PubMed]
    [Google Scholar]
  38. Le Roy C, Touati A, Balcon C, Garraud J, Molina JM et al. Identification of 16S rRNA mutations in Mycoplasma genitalium potentially associated with tetracycline resistance in vivo but not selected in vitro in M. genitalium and Chlamydia trachomatis. J Antimicrob Chemother 2021; 76:1150–1154 [View Article]
    [Google Scholar]
  39. Taylor-Robinson D, Furr PM, Tully JG, Barile MF, Møller BR. Animal models of Mycoplasma genitalium urogenital infection. Isr J Med Sci 1987; 23:561–564 [PubMed]
    [Google Scholar]
  40. Aparicio D, Scheffer MP, Marcos-Silva M, Vizarraga D, Sprankel L et al. Structure and mechanism of the Nap adhesion complex from the human pathogen Mycoplasma genitalium. Nat Commun 2020; 11:2877 [View Article] [PubMed]
    [Google Scholar]
  41. Ma L, Jensen JS, Mancuso M, Hamasuna R, Jia Q et al. Genetic variation in the complete MgPa operon and its repetitive chromosomal elements in clinical strains of Mycoplasma genitalium. PLoS One 2010; 5:e15660 [View Article] [PubMed]
    [Google Scholar]
  42. Ma L, Jensen JS, Myers L, Burnett J, Welch M et al. Mycoplasma genitalium: an efficient strategy to generate genetic variation from a minimal genome. Mol Microbiol 2007; 66:220–236 [View Article] [PubMed]
    [Google Scholar]
  43. Jensen JS, Blom J, Lind K. Intracellular location of Mycoplasma genitalium in cultured vero cells as demonstrated by electron microscopy. Int J Exp Pathol 1994; 75:91–98 [PubMed]
    [Google Scholar]
  44. Baczynska A, Funch P, Fedder J, Knudsen HJ, Birkelund S et al. Morphology of human Fallopian tubes after infection with Mycoplasma genitalium and Mycoplasma hominis—in vitro organ culture study. Hum Reprod 2007; 22:968–979 [View Article]
    [Google Scholar]
  45. Fernández-Huerta M, Serra-Pladevall J, Esperalba J, Moreno-Mingorance A, Fernández-Naval C et al. Single-locus-sequence-based typing of the mgpB gene reveals transmission dynamics in Mycoplasma genitalium. J Clin Microbiol 2020; 58:e01886-19 [View Article] [PubMed]
    [Google Scholar]
  46. Guiraud J, Helary M, Le Roy C, Elguero E, Pereyre S et al. Molecular typing reveals distinct Mycoplasma genitalium transmission networks among a cohort of men who have sex with men and a cohort of women in France. Microorganisms 2022; 10:1587 [View Article] [PubMed]
    [Google Scholar]
  47. Peretz A, Tameri O, Azrad M, Barak S, Perlitz Y et al. Mycoplasma and Ureaplasma carriage in pregnant women: the prevalence of transmission from mother to newborn. BMC Pregnancy Childbirth 2020; 20:456 [View Article] [PubMed]
    [Google Scholar]
  48. Jensen JS, Unemo M. Antimicrobial treatment and resistance in sexually transmitted bacterial infections. Nat Rev Microbiol 2024; 22:435–450 [View Article] [PubMed]
    [Google Scholar]
  49. Wood GE, Bradshaw CS, Manhart LE. Update in epidemiology and management of Mycoplasma genitalium infections. Infect Dis Clin North Am 2023; 37:311–333 [View Article]
    [Google Scholar]
  50. Baumann L, Cina M, Egli-Gany D, Goutaki M, Halbeisen FS et al. Prevalence of Mycoplasma genitalium in different population groups: systematic review andmeta-analysis. Sex Transm Infect 2018; 94:255–262 [View Article] [PubMed]
    [Google Scholar]
  51. Napierala Mavedzenge S, Weiss HA. Association of Mycoplasma genitalium and HIV infection: a systematic review and meta-analysis. AIDS 2009; 23:611–620 [View Article] [PubMed]
    [Google Scholar]
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