日本性感染症学会誌 Journal of Japanese Society for Sexually Transmitted Infections

Objective: This study aimed to clarify the epidemiology and treatment effectiveness of Mycoplasma genitalium infection in gynecological practice through a retrospective analysis. Methods: We analyzed 717 female patients who underwent screening for sexually transmitted infections between April 2023 and October 2024. In addition, treatment outcomes were evaluated in 172 M. genitalium-positive cases diagnosed between April 2022 and March 2024. Results: The positive rate of M. genitalium was 12.4%, second only to Chlamydia trachomatis (19.2%). Most positive cases occurred in women in their 20s. Co-infection rates were 14.9% with C. trachomatis and 11.9% with Trichomonas vaginalis. In the treatment cohort, azithromycin monotherapy exhibited a low cure rate of 65.3%, whereas combination therapies, such as minocycline plus sitafloxacin or moxifloxacin plus doxycycline, achieved cure rates exceeding 97%. Conclusion: M. genitalium infection is prevalent among young women and frequently coexists with other sexually transmitted infections. The limited effectiveness of azithromycin highlights the importance of selecting treatment regimens that consider antimicrobial resistance. Comprehensive screening and combination therapies are essential for the successful management of M. genitalium infection, particularly in gynecological and perinatal care settings.