Mycoplasma

  • Mycoplasma is an STI caused by a bacterium. Most people have no symptoms from a mycoplasma infection. In people who do have symptoms, these often clear up on their own without treatment, and there is no strong evidence that this is harmful. For these reasons, we at ZIZ are cautious about advising people to test for mycoplasma.  

    In practice, the only two groups for whom testing is appropriate are men who have tested negative for chlamydia and gonorrhoea but still have symptoms in the penis four weeks after testing, and their regular sexual partners. 

  • Mycoplasma is an STI caused by the bacterium Mycoplasma genitalium.

  • You can get mycoplasma through sex without a condom (penis–vagina, penis–anus). Using a condom is very effective at preventing mycoplasma. 

  • At ZIZ we are cautious about testing for mycoplasma, which is why we find it fairly often when we do test for it. 

    The detection rate for mycoplasma at ZIZ is around 20%, so about one in five. 

    In studies in the Netherlands where people were tested for mycoplasma at the same time as chlamydia and gonorrhoea, the detection rate was lower, at 4.5%, so one in 22. 
     

  • Yes, having had an infection does not protect you against a new one. 

  • In men, mycoplasma mainly causes pain or a burning sensation when urinating. You may also notice a mucus-like discharge from your penis, especially in the morning.

  • The association between mycoplasma and symptoms in the penis in men has been confirmed in studies. For symptoms in women, the results are less clear-cut. Some studies find a link, others do not. 

  • In men, we test for mycoplasma in the urine. It is important that we collect the first part of the urine stream and that, ideally, you have not urinated for 1 hour beforehand. Women take a swab from the vagina themselves. We then test for the presence of mycoplasma using a PCR test. What is unique about ZIZ is that we use one of the fastest PCR tests available. This means we have a result within two hours and know straight away whether there is antibiotic resistance. 

  • We advise only testing for mycoplasma if you still have symptoms in the penis four weeks after a negative test for chlamydia and gonorrhoea, or if mycoplasma has been found in your regular sexual partner. 

  • Treating mycoplasma can be quite difficult: 

    - The first choice is a five-day course of azithromycin. However, there is a lot of resistance to this antibiotic. For this reason, at ZIZ we always test straight away whether the mycoplasma we find is sensitive to this antibiotic. This is the case in only 30% of infections. 

    - If there is resistance to azithromycin, we treat with moxifloxacin for seven days. Some mycoplasma bacteria are resistant to this medicine too. The chance of this treatment working is around 80–90%. 

    - If treatment with moxifloxacin does not work either, there are two further options, but even then the chance of cure is not 100%. 

    In short: in some cases it is a real challenge to treat a mycoplasma infection successfully. 

  • It is only useful to tell your regular sexual partner if you are a man with symptoms. 

  • We only advise testing again if you still have symptoms 3–4 weeks after treatment, 

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