Association of mycoplasma genitalium persistence in the urethra with recurrence of nongonococcal urethritis

Background. Most patients with recurrent symptomatic nongonococcal urethritis receive negative test results for Chlamydia trachomatis and Ureaplasma urealyticum, and the cause of such recurrence usually is unknown. Goal: To assess the association of Mycoplasma genitalium with recurrent nongonococcal urethritis. Study Design: In this study, 72 men with nongonococcal urethritis were treated with levofloxacin. Before and after treatment. symptoms and signs were assessed and first-pass urine was examined for C trachomatis, M genitalium, U urealyticum, and Mycoplasma hominis by polymerase chain reaction- based assays. Results: In 6 of 45 men who had no symptoms and no evidence of inflammation after treatment, nongonococcal urethritis recurred. Of these 6 men, 5 had positive test results for M genitalium before levofloxacin treatment, which remained positive afterward. After the second treatment for recurrent nongonococcal urethritis, one man was still had a positive test result for the mycoplasma and experienced a subsequent recurrence. Conclusions: This study suggests that the persistence of M genitalium in the urethra may be associated with recurrence of nongonococcal urethritis.