
When health experts start using words like 'superbug' and 'nightmare to get rid of', it's time to sit up and pay attention.
That's exactly what's happening with Mycoplasma genitalium, a sexually transmitted infection that most Australians have never heard of—but one that's causing serious headaches for our healthcare system.
While you might think this is just another health concern for younger generations, the reality is that between 2.1 per cent and 13 per cent of Australians are affected by this infection, depending on the population tested, and the implications stretch far beyond individual health to affect families and our entire healthcare system.
In this article
Why this 'invisible' infection affects everyone
Mycoplasma genitalium affects approximately 1 per cent of young adults aged 18-27, but rises to 15-25 per cent in men with symptomatic conditions and up to 15 per cent of women with pelvic inflammatory disease. But here's what makes this particularly concerning for Australian families: the infection is largely silent.
The majority of people infected with Mycoplasma genitalium show no symptoms, meaning infected individuals often don't know they're carrying it. This creates a ripple effect through relationships and families, potentially affecting reproductive health and requiring complex, expensive treatments when finally detected.
'It's transmitted in the same ways as chlamydia, and it causes similar symptoms, but it acquires antibiotic resistance very easily'
The superbug reality: Why treatment has become so difficult
What makes Mycoplasma genitalium truly alarming isn't just its prevalence—it's how resistant it's become to standard treatments. In Australia, azithromycin resistance now exceeds 60 per cent in most cases and reaches as high as 80 per cent in some populations.
To put this in perspective, when a first-line antibiotic fails 6-8 times out of 10, we're dealing with a genuine medical crisis. This widespread resistance has prompted doctors to shift towards alternative treatments like moxifloxacin, but resistance to this backup option is also emerging.
The personal stories shared online paint a stark picture of this treatment challenge. Patients report needing multiple rounds of different antibiotics, suffering serious side effects, and in some cases, being unable to clear the infection despite repeated treatment attempts.
The testing dilemma: Why doctors don't recommend routine screening
Here's where the situation becomes particularly complex—and where understanding the medical reasoning becomes crucial for families trying to navigate healthcare decisions.
Current clinical guidelines explicitly state that routine testing for Mycoplasma genitalium is not recommended, with testing only advised for symptomatic patients or those who've had contact with known infected individuals.
Medicare Coverage for Mycoplasma genitalium Testing
Testing for Mycoplasma genitalium is covered by Medicare when:
• Requested by a doctor for symptomatic patients
• Part of contact tracing after exposure to infected partner
• Performed at bulk-billing GP clinics, sexual health centres, or Aboriginal Medical Services
The pathology component is generally bulk-billed, though there may be consultation fees at private practices.
This might seem counterintuitive—why wouldn't we test for a potentially serious infection? The answer lies in understanding the broader public health implications.
Current guidelines discourage screening because of rising antimicrobial resistance and the complexities associated with treatment. Mathematical modelling shows that expanding screening beyond symptomatic individuals could reduce overall infection rates but would likely increase the prevalence of drug-resistant strains.
Australia's innovative approach: Leading the world in smart treatment
Despite the challenges, Australia is actually at the forefront of managing this superbug effectively. In 2013, Australia introduced a resistance-guided therapy strategy, making it one of the first countries to implement this approach.
Did you know?
Did you know?
Australia's resistance-guided therapy approach, introduced in 2013, involves testing the specific strain of Mycoplasma genitalium to determine which antibiotics will be most effective before starting treatment. This targeted approach significantly improves cure rates and helps prevent further resistance development.
The costs for this approach are calculated based on Medicare Benefits Schedule and Pharmaceutical Benefits Schedule rates, and research shows it's cost-effective. The resistance-guided approach actually saves money in the healthcare system while improving patient outcomes.
What this means for Australian families
While Mycoplasma genitalium primarily affects sexually active individuals, its impact extends to families in several important ways:
- Healthcare system strain: The complexity of treating resistant infections puts pressure on specialist services and increases healthcare costs for everyone.
- Reproductive health implications: The infection can cause serious reproductive tract complications including infertility and pregnancy complications, affecting family planning across generations.
- Informed healthcare decisions: Understanding why doctors make certain recommendations about testing helps families navigate healthcare conversations more effectively.
Key Takeaways: Why routine testing isn't always better
- Testing without symptoms can identify infections that might not need treatment
- Unnecessary treatment accelerates antibiotic resistance
- Current approach focuses resources on those most likely to benefit
- Resistance-guided therapy provides better outcomes when treatment is needed
Supporting family members and understanding prevention
For families concerned about this issue, the focus should be on supporting informed healthcare decisions rather than demanding specific tests. Healthcare providers emphasise education about safe practices, regular appropriate screening based on individual risk factors, and open communication about sexual health.
STI testing, including for Mycoplasma genitalium when medically indicated, is free at bulk-billing GP clinics, Aboriginal Medical Services, and sexual health clinics for those with Medicare cards.
The bigger picture: Public health in action
This situation offers a valuable lesson in how modern public health decisions are made. Rather than simply testing everyone for everything, health authorities weigh multiple factors: individual benefit, community impact, healthcare resource allocation, and long-term consequences.
The approach recognises that laboratories and healthcare providers have a responsibility as 'diagnostic stewards' to ensure testing provides genuine clinical benefit and doesn't create problems of uncertain value.
The Mycoplasma genitalium challenge demonstrates that sometimes the most responsible approach involves restraint—testing smartly rather than testing broadly, and treating strategically rather than reactively.
What This Means For You
Understanding complex health issues like Mycoplasma genitalium helps us all become better healthcare consumers and more informed family members. While we might not be directly affected, supporting evidence-based approaches to public health challenges benefits everyone in our community.
What questions do you have about how public health decisions affect your family's healthcare options? Have you encountered situations where understanding the 'why' behind medical recommendations helped you make better healthcare decisions?
Original Article
https://www.news.com.au/lifestyle/h...8d6f940000fed83fd945b9da4f1ea2?from=rss-basic
Mycoplasma genitalium in the Far North Queensland backpacker population: An observational study of prevalence and azithromycin resistance—PMC
Cited text: In Australia, the prevalence of M. genitalium rages from 2.1—13 per cent depending on the population tested [3—6].
Excerpt: the reality is that between 2.1 per cent and 13 per cent of Australians are affected by this infection, depending on the population tested
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6112622/
The Rise in STIs Post-COVID | Clinical Labs—Australian Clinical Labs
Cited text: The prevalence of Mycoplasma genitalium in young adults (18-27 years old) is estimated to be approximately 1 per cent, but is as high as 15-25 per cent in men with sy...
Excerpt: Mycoplasma genitalium affects approximately 1 per cent of young adults aged 18-27, but rises to 15-25 per cent in men with symptomatic conditions and up to 15 per cent of women with pelvic inflammatory disease
https://www.clinicallabs.com.au/about-us/doctor-media-releases/the-rise-in-stis-post-covid/
Mycoplasma genitalium Management in Adults—NCBI Bookshelf
Cited text: Diagnosis was difficult until molecular tests, such as NAAT, became available.
Excerpt: The majority of people infected with Mycoplasma genitalium show no symptoms
https://www.ncbi.nlm.nih.gov/books/NBK583532/
The Rise in STIs Post-COVID | Clinical Labs—Australian Clinical Labs
Cited text: In Australia, the current resistance rate of azithromycin exceeds 60 per cent in the majority of cases and is even as high as 80 per cent in the MSM population.
Excerpt: In Australia, azithromycin resistance now exceeds 60 per cent in most cases and reaches as high as 80 per cent in some populations
https://www.clinicallabs.com.au/about-us/doctor-media-releases/the-rise-in-stis-post-covid/
The Rise in STIs Post-COVID | Clinical Labs—Australian Clinical Labs
Cited text: Azithromycin (macrolide) resistance is widespread, prompting a shift towards alternative regimens like moxifloxacin. However, resistance to moxifloxac...
Excerpt: This widespread resistance has prompted doctors to shift towards alternative treatments like moxifloxacin, but resistance to this backup option is also emerging
https://www.clinicallabs.com.au/about-us/doctor-media-releases/the-rise-in-stis-post-covid/
Mycoplasma genitalium Management in Adults—NCBI Bookshelf
Cited text: M. genitalium bacteria have no cell wall and can take months to grow in culture; thus, traditional methods of diagnosis with gram stain or culture are...
Excerpt: Current clinical guidelines explicitly state that routine testing for Mycoplasma genitalium is not recommended, with testing only advised for symptomatic patients or those who've had contact with known infected individuals
https://www.ncbi.nlm.nih.gov/books/NBK583532/
Mycoplasma genitalium Management in Adults—NCBI Bookshelf
Cited text: The specimen and site of optim
Excerpt: Current clinical guidelines explicitly state that routine testing for Mycoplasma genitalium is not recommended, with testing only advised for symptomatic patients or those who've had contact with known infected individuals
https://www.ncbi.nlm.nih.gov/books/NBK583532/
Impact of screening on the prevalence and incidence of Mycoplasma genitalium and its macrolide resistance in men who have sex with men living in Australia: A mathematical model—eClinicalMedicine
Cited text: Current international and national guidelines discourage screening of asymptomatic MSM for MG due to limited knowledge regarding the natural history o...
Excerpt: Current guidelines discourage screening because of rising antimicrobial resistance and the complexities associated with treatment.
https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(21)00059-6/fulltext
Impact of screening on the prevalence and incidence of Mycoplasma genitalium and its macrolide resistance in men who have sex with men living in Australia: A mathematical model—eClinicalMedicine
Cited text: Our dynamic transmission model of MG calibrated to data from MSM in Melbourne provides further evidence to support these recommendations and their con...
Excerpt: Current guidelines discourage screening because of rising antimicrobial resistance and the complexities associated with treatment.
https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(21)00059-6/fulltext
Paying for diagnostic testing | healthdirect
Cited text: Medicare covers the costs of most pathology tests.
Excerpt: In 2013, Australia introduced a resistance-guided therapy strategy, making it one of the first countries to implement this approach
https://www.healthdirect.gov.au/paying-for-diagnostic-testing
Paying for diagnostic testing | healthdirect
Cited text: These tests can be expensive.
Excerpt: In 2013, Australia introduced a resistance-guided therapy strategy, making it one of the first countries to implement this approach
https://www.healthdirect.gov.au/paying-for-diagnostic-testing
Paying for diagnostic testing | healthdirect
Cited text: Usually, the doctor ordering the tests will explain if there will be a cost involved.
Excerpt: The costs for this approach are calculated based on Medicare Benefits Schedule and Pharmaceutical Benefits Schedule rates
https://www.healthdirect.gov.au/paying-for-diagnostic-testing
Paying for diagnostic testing | healthdirect
Cited text: ...
Excerpt: The resistance-guided approach actually saves money in the healthcare system while improving patient outcomes
https://www.healthdirect.gov.au/paying-for-diagnostic-testing
Mycoplasma genitalium | STI Guidelines Australia
Cited text: Mycoplasma genitalium infection and female reproductive tract disease: a meta-analysis.
Excerpt: The infection can cause serious reproductive tract complications including infertility and pregnancy complications
https://sti.guidelines.org.au/sexually-transmissible-infections/mycoplasma-genitalium/
Mycoplasma genitalium | STI Guidelines Australia
Cited text: Symptoms, Sites, and Significance of Mycoplasma genitalium in Men Who Have Sex with Men. Emerg Infect Dis 2019;25:719-27.
Excerpt: The infection can cause serious reproductive tract complications including infertility and pregnancy complications
https://sti.guidelines.org.au/sexually-transmissible-infections/mycoplasma-genitalium/
Should we routinely test for Mycoplasma genitalium when testing for other sexually transmitted infections? | The Medical Journal of Australia
Cited text: 2.
Excerpt: Healthcare providers emphasise education about safe practices, regular appropriate screening based on individual risk factors, and open communication about sexual health
https://www.mja.com.au/journal/2020...plasma-genitalium-when-testing-other-sexually
Item 73072 | Medicare Benefits Schedule
Cited text: Medicare Benefits Schedule · Search Results for Item 73072
Excerpt: STI testing, including for Mycoplasma genitalium when medically indicated, is free at bulk-billing GP clinics, Aboriginal Medical Services, and sexual health clinics for those with Medicare cards
https://www9.health.gov.au/mbs/fullDisplay.cfm?type=item&qt=ItemID&q=73072
Item 73072 | Medicare Benefits Schedule
Cited text:
Excerpt: STI testing, including for Mycoplasma genitalium when medically indicated, is free at bulk-billing GP clinics, Aboriginal Medical Services, and sexual health clinics for those with Medicare cards
https://www9.health.gov.au/mbs/fullDisplay.cfm?type=item&qt=ItemID&q=73072
Mycoplasma genitalium Management in Adults—NCBI Bookshelf
Cited text: 2013;8(4):e61481.
Excerpt: The approach recognises that laboratories and healthcare providers have a responsibility as 'diagnostic stewards' to ensure testing provides genuine clinical benefit and doesn't create problems of uncertain value
https://www.ncbi.nlm.nih.gov/books/NBK583532/
Standard Asymptomatic Checkup | STI Guidelines Australia
Cited text: 2016;2016:5758387.
Excerpt: The approach recognises that laboratories and healthcare providers have a responsibility as 'diagnostic stewards' to ensure testing provides genuine clinical benefit and doesn't create problems of uncertain value
https://sti.guidelines.org.au/standard-asymptomatic-checkup/
Standard Asymptomatic Checkup | STI Guidelines Australia
Cited text: STI in times of PrEP: high prevalence of chlamydia, gonorrhea, and mycoplasma at different anatomic sites in men who have sex with men in Germany.
Excerpt: The approach recognises that laboratories and healthcare providers have a responsibility as 'diagnostic stewards' to ensure testing provides genuine clinical benefit and doesn't create problems of uncertain value
https://sti.guidelines.org.au/standard-asymptomatic-checkup/