USC Infections Humaines à Mycoplasmes et Chlamydiae, Université de Bordeaux, 33076 Bordeaux cedex, France.
Med Mal Infect. 2012 Sep;42(9):381-92. doi: 10.1016/j.medmal.2012.05.006. Epub 2012 Sep 10.
Mycoplasma genitalium is a sexually transmitted organism associated with non-gonococcal urethritis in men and several inflammatory reproductive tract syndromes in women such as cervicitis, pelvic inflammatory disease, and infertility. There was evidence for an association of M. genitalium with endometritis and pelvic inflammatory disease (PID), but additional studies are necessary to confirm this. The evidence as to whether M. genitalium can cause adverse pregnancy outcomes such as preterm labor is conflicting. But the authors of some studies on M. genitalium as a cause of infertility have reported this association. This species is very difficult to culture; thus, nucleic acid amplification testing is the only method available for M. genitalium detection. The lack of a cell wall makes M. genitalium intrinsically resistant to antibiotics acting at this level, such as beta-lactams. The treatment of M. genitalium infections is not standardized. Macrolides are recommended, especially single-dose azithromycin; tetracyclines are responsible for a great number of therapeutic failures even no resistance mechanism has yet been demonstrated. Acquired resistance to macrolides and fluoroquinolones leading to therapeutic failure has also been reported. All this raises the issue of the most appropriate therapeutic management and requires drafting diagnostic and therapeutic guidelines for the treatment of M. genitalium infections.
生殖支原体是一种性传播病原体，与男性非淋菌性尿道炎以及女性几种炎症性生殖道综合征相关，如宫颈炎、盆腔炎和不孕。有证据表明生殖支原体与子宫内膜炎和盆腔炎（PID）有关，但需要更多的研究来证实这一点。关于生殖支原体是否会导致早产等不良妊娠结局的证据存在矛盾。但是，一些关于生殖支原体导致不孕的研究作者已经报告了这种关联。这种物种非常难以培养；因此，核酸扩增检测是检测生殖支原体的唯一方法。由于缺乏细胞壁，生殖支原体对作用于该水平的抗生素（如β-内酰胺类）具有内在的耐药性。生殖支原体感染的治疗尚未标准化。推荐使用大环内酯类药物，尤其是单剂量阿奇霉素；尽管尚未证明存在耐药机制，但四环素类药物导致了大量治疗失败。也有报道称，生殖支原体对大环内酯类和氟喹诺酮类药物的获得性耐药导致治疗失败。所有这些都提出了最合适的治疗管理问题，并需要制定诊断和治疗指南来治疗生殖支原体感染。
