TABLE 1.
Comparison of current recommendations from three published guidelines for the performance of diagnostic tests for M. genitalium
| NAAT testing recommendation | Indication in guideline |
||
|---|---|---|---|
| United Statesc | United Kingdomd | Europee | |
| Asymptomatic persons | No | No | Not specified |
| Test of cure following treatment of persons who test positive | Only if resistance testing is not available and moxifloxacin cannot be used | Yes, no earlier than 3 wks | Consider, no earlier than 3 wks |
| Sex partners of symptomatic persons who test positive | Yes | Yes | Yes |
| Resistance testing on all persons who test positive | Yes, if availablea | Yes (macrolide) | Yes (macrolide)b |
| Men | |||
| NGU | Yes, if persistent or recurrent after treatment | Yes | Yes |
| Epididymo-orchitis | Not specified | Consider | Yes, if aged <50 yrs |
| Sexually acquired proctitis | Consider if symptoms persist after treatment | Consider | Yes, if C. trachomatis and N. gonorrhoeae are excluded |
| Women | |||
| Mucopurulent cervicitis | Yes, if recurrent | Consider | Yes |
| Symptoms of PID | Consider | Yes | Yes |
| Intermenstrual or postcoital bleeding | Not specified | Yes | Yes |
| Dysuria with no other known etiology | Not specified | Not specified | Yes |
| Sexually acquired proctitis | Consider if symptoms persist after treatment | Consider | Yes, if C. trachomatis and N. gonorrhoeae are excluded |
| Termination of pregnancy | Not specified | Not specified | Consider |
a
In 2023, there are no FDA-cleared NAATs that incorporate resistance testing that are commercially available in the United States. Resistance testing for macrolides and fluoroquinolones is available through the UAB Diagnostic Mycoplasma Laboratory in Birmingham, AL, using validated laboratory-developed PCR assays.
b
Testing for parC mutations is not indicated on a routine basis but is useful after moxifloxacin treatment failure.
c
See reference 15.
d
See reference 78.
e
See reference 17.