25 Mar 2021

Screening warning over stubborn STI

Expanding screening could build resistance to antibiotics: Study
New research from the Melbourne Sexual Health Centre has revealed that screening asymptomatic patients for Mycoplasma genitalium (MG) could be counterproductive to controlling the infection in men who have sex with men.

Sexual health physician and Monash University Associate Professor Jason Ong said the study, conducted with international experts in MG research, showed that expanding screening from the current recommendation of only testing MG among symptomatic men who have sex with men, could build resistance to antibiotics.

“MG has a rising rate of antimicrobial resistance, so while screening asymptomatic patients may reduce the overall prevalence of the infection, it can lead to a higher proportion of antibiotic resistant MG,” he said.

“This is particularly prevalent when using treatment regimens with lower effectiveness, which is quite common.”

MG, is a sexually transmitted, small and pathogenic bacterium that lives on the skin cells of the urinary and genital tracts in humans. It can cause further complications, particularly in women with an infection of the reproductive organs, called pelvic inflammatory disease, which can make it hard to get pregnant.
Symptoms include a burning or stinging sensation when urinating in men while pain during sex or bleeding afterwards are symptoms in women.

Associate Professor Ong said the growing resistance of MG to antibiotics posed a significant challenge and would continue to do so unless screening and treatment is done following the most precise advice.

“The treatment efficacy of antibiotics such as azithromycin has continued to decrease over time and we’re also seeing the emergence of resistance to the second-line antibiotics.

“This poses the question of whether MG could become untreatable in the near future."

Monash University sexual health physician Professor Catriona Bradshaw said antibiotics are often given to people when they have genital symptoms, before knowing the precise cause.

“This practice has resulted in rising antimicrobial resistance in MG and other STIs like gonorrhoea. Best practice is to use diagnostic tests that also provide information on antimicrobial resistance for STIs,” she said.

See more:

Jason J. Ong, Luanqi Ruan Aaron G. Lim, Catriona S. Bradshaw,David Taylor-Robinson, Magnus Unemo, Patrick J. Horner, Peter Vickerman, Lei Zhang. Impact of screening on the prevalence and incidence ofMycoplasmagenitaliumand its macrolide resistance in men who have sex with menliving in Australia: A mathematical model. EClinicalMedicine 3 March 2021.

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