Mycoplasma genitalium From Basic Science to Public Health Implications: Results of a National Institute of Allergy and Infectious Diseases Technical Consultation

Mycoplasma genitalium was first isolated from a man with urethritis in 1981. Efforts over the following 10 years to replicate this feat were unsuccessful because the organism turned out to be very difficult to propagate in vitro from clinical specimens using artificial media alone. We now know that inoculating specimens onto cell cultures significantly improves the chances of isolation, but even under the best of circumstances, it may be weeks before the organism can be identified. It was the advent of M. genitalium–specific polymerase chain reaction–based diagnostic tests in the early 1990s that resulted in substantial advances in our knowledge of M. genitalium infections in humans. The accumulation of this body of data over the last 25 years and the need to crystalize the public health significance of this sexually transmitted pathogen led our Sexually Transmitted Infections Clinical Trials Group to organize a National Institutes of Health–sponsored Technical Consultation focused on this organism, clinical management of the infections it causes, and, most important, its public health significance. The results of this effort are described in detail in the seven artices constituting this Journal supplement. These papers provide an overview of current knowledge of M. genitalium microbiology and the host response to infection, clinical manifestations in women and men, diagnostic technology, difficulties in devising treatment strategies, and, finally, current thinking concerning the appropriate public health response to M. genitalium infection. The concluding article briefly summarizes the high points of the meeting and, importantly, lists consensus recommendations for future research directions. I and my coeditors, Dr Lisa Manhart and Dr Kimberly Workowski, hope that you will find the information contained herein thought provoking and useful.

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