MYCOPLASMA GENITALIUM

PATHOGEN SAFETY DATA SHEET - INFECTIOUS SUBSTANCES

SECTION I - INFECTIOUS AGENT

NAME: Mycoplasma genitalium

SYNONYM OR CROSS REFERENCE: G37 strain, non-gonococcal urethritis (NGU), non-chlamydial non-gonococcal urethritis (NCNGU), mucopurulent cervicitis (MPC) ⁽¹⁾.

CHARACTERISTICS: M. genitalium is an intracellular urogenital tract gram negative flask shaped bacterium, which belongs to the Mycoplasmataceae family, in the Mollicutes class ^(1-3). It is the smallest Mollicutes (0.2 µm in diameter), and lacks the genes coding for the cell wall, leading it to a parasitic and saprophytic existence ⁽²⁾. Instead of a cell wall, M. genitalium possess a three-layered membrane containing sterol, which is taken up from the environment. M. genitalium uses the UGA codon to code for tryptophan rather than a stop codon ⁽¹⁾. M. genitalium metabolize glucose. This internal pathogen grows better in a foetal calf serum containing medium. On SP4 culture medium, M. genitalium produce colonies with a “fried eggs” appearance after 50 days. Growth is accelerated to 14 days by adding 0.25 mg/ml ciprofloxacin to reduce contamination by other microorganism.

SECTION II - HAZARD IDENTIFICATION

PATHOGENICITY/TOXICITY: M. genitalium is the major cause of NGU and NCNGU in men, with dysuria and/or non-spontaneous discharge ^{(1, 4)}. MPC is the female equivalent of NGU, characterized by the presence of yellow or green exudates from the cervix ⁽³⁾. M. genitalium is also suspected to be a cause of pelvic inflammatory disease, which is an inflammation of the feminine upper genital tract, with pelvic pain, abnormal vaginal discharge, itching, bleeding and/or odour. M. genitalium infections may be asymptomatic. M. genitalium may play a minor role in bacterial vaginosis, adverse outcomes of pregnancy, and infertility ⁽¹⁾. M. genitalium is also known to facilitate HIV transmission ⁽⁵⁾.

EPIDEMIOLOGY: M. genitalium is of worldwide prevalence as it can be found in 1% of adults between 18 and 27 years old and in 7% of women of all ages ⁽⁵⁾. For women, multiple sexual partners, miscarriage, smoking, and douching are considered risk factors.

HOST RANGE: Humans are the only known host for M. genitalium, although colonization in other animals is theoretically possible ⁽³⁾.

INFECTIOUS DOSE: Unknown.

MODE OF TRANSMISSION: M. genitalium is principally transmitted by sexual contact ⁽⁵⁾.

INCUBATION PERIOD: Unknown.

COMMUNICABILITY: Person-to-person transmission occurs primarily through sexual contact, although the transmission rates are low ⁽⁶⁾.

SECTION III - DISSEMINATION

RESERVOIR: Humans; animals may theoretically contain the pathogen ⁽³⁾.

ZOONOSIS: No zoonotic transmissions have been reported for this pathogen, but it is theoretically possible ⁽³⁾.

VECTORS: None.

SECTION IV – STABILITY AND VIABILITY

DRUG SUSCEPTIBILITY: M. genitalium is susceptible to tetracyclines, macrolides, and quinolones ⁽⁷⁾. Azithromycin, fluoroquinolones, and moxifloacin also have high efficacy against infection ⁽⁸⁾.

SUSCEPTIBILITY TO DISINFECTANTS: Phenolic disinfectants, 1% sodium hypochlorite, 70% ethanol, formaldehyde, glutaraldehyde, iodophore, and peracedic acid are effective against M. genitalium ⁽⁹⁾.

PHYSICAL INACTIVATION: M. genitalium is inactivated by UV, microwave, gamma radiation, moist heat (121°C for at least 20 min) and dry heat (165-170°C for 2 h) ^(10-13).

SURVIVAL OUTSIDE HOST: If protected from evaporation, M. genitalium can survive for one hour in liquid specimen ⁽¹⁴⁾.

SECTION V – FIRST AID / MEDICAL

SURVEILLANCE: Monitor for symptoms. Infection can be confirmed with ELISA, immunoblots, microbial culture, and PCR ⁽¹⁴⁾, although many methods do not provide the level of sensitivity needed for confident diagnosis. Infections are highly difficult to diagnose because of the tricky cultivation of M. genitalium based on its fastidious nature.

Note: All diagnostic methods are not necessarily available in all countries.

FIRST AID/TREATMENT: Administer appropriate drug therapy ⁽⁷⁾. Azithromycin treatment is often well-tolerated by patients and yields good results in eradicating pathogens for nongonococcal urethritis ⁽¹⁵⁾.

IMMUNIZATION: None available.

PROPHYLAXIS: None available.

SECTION VI - LABORATORY HAZARDS

LABORATORY-ACQUIRED INFECTIONS: None have been reported to date.

SOURCES/SPECIMENS: M. genitalium may be found in semen, urine, prostatic secretion, amniotic fluid, and urogenital tract swab ⁽¹⁶⁾.

PRIMARY HAZARDS: Laboratory workers should avoid accidental parenteral inoculation and ingestion ⁽¹⁴⁾.

SPECIAL HAZARDS: None.

SECTION VII – EXPOSURE CONTROLS / PERSONAL PROTECTION

RISK GROUP CLASSIFICATION: Risk Group 2 ⁽¹⁷⁾.

CONTAINMENT REQUIREMENTS: Containment Level 2 facilities, equipment, and operational practices for work involving infectious or potentially infectious materials, animals, or cultures.

PROTECTIVE CLOTHING: Lab coat. Gloves when direct skin contact with infected materials or animals is unavoidable. Eye protection must be used where there is a known or potential risk of exposure to splashes ⁽¹⁸⁾.

OTHER PRECAUTIONS: All procedures that may produce aerosols, or involve high concentrations or large volumes should be conducted in a biological safety cabinet (BSC). The use of needles, syringes, and other sharp objects should be strictly limited. Additional precautions should be considered with work involving animals or large scale activities ⁽¹⁸⁾.

SECTION VIII – HANDLING AND STORAGE

SPILLS: Allow aerosols to settle and, wearing protective clothing, gently cover spill with paper towels and apply an appropriate disinfectant, starting at the perimeter and working towards the centre. Allow sufficient contact time before clean up ⁽¹⁸⁾.

DISPOSAL: Decontaminate all wastes that contain or have come in contact with the infectious organism before disposing by autoclave, chemical disinfection, gamma irradiation, or incineration.

STORAGE: The infectious agent should be stored in leak-proof containers that are appropriately labelled.

SECTION IX – REGULATORY AND OTHER INFORMATION

REGULATORY INFORMATION: The import, transport, and use of pathogens in Canada is regulated under many regulatory bodies, including the Public Health Agency of Canada, Health Canada, Canadian Food Inspection Agency, Environment Canada, and Transport Canada. Users are responsible for ensuring they are compliant with all relevant acts, regulations, guidelines, and standards.

UPDATED: November 2010

PREPARED BY: Pathogen regulation directorate, Public Health Agency of Canada.

Although the information, opinions and recommendations contained in this Pathogen Safety Data Sheet are compiled from sources believed to be reliable, we accept no responsibility for the accuracy, sufficiency, or reliability or for any loss or injury resulting from the use of the information. Newly discovered hazards are frequent and this information may not be completely up to date.

Copyright ©
Public Health Agency of Canada, 2010
Canada

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