PASS Office Hours: Mgen Recap
During PASS’s Office Hours on July 7, 2026, the PASS Team, along with a number of passionate industry workers, discussed Mycoplasma Genitalium (Mgen) testing, treatment, antibiotic resistance, & more.
In this summary, we have included the most relevant answers to questions brought up in the meeting.
Thank you to everyone involved in the discussion, especially in regards to complex subjects, such as Mgen.
Question 1: What type of test is the Mgen test, and I was under the impression they were not approved by the FDA (only NAAT)?
PCR (Polymerase Chain Reaction) test is a type of NAAT (Nucleic Acid Amplification Test), and for ease we tend to use them interchangeably since more people are familiar with PCR testing due to COVID. The Mgen test is a TMA (Transcription-Mediated Amplification) test - there are key differences, but the technology is similar enough to lay people.
Question 2: I forget where I found this online, but do Mgen tests result in false negatives 10% of the time in men, and 30% of the time in women?
To answer, let’s talk about sensitivity vs. specificity.
All tests have sensitivity and specificity.
Sensitivity is the proportion of positive test results out of all truly positive samples.
Sensitivity is the ability to correctly identify those with the disease.
Specificity measures the proportion of negative results out of all truly negative samples.
So specificity refers to the test’s ability to correctly identify those without the disease.
However, false positives are more likely to occur in individuals with a lower bacterial load, and while we don’t entirely know the function of bacterial load and transmission risk for Mgen, in most diseases a lower bacterial load is associated with lower risk of both transmission and symptoms.
Question 3: What is your justification for recommending Mgen urine/genital testing, considering the points you made about antibiotics resistance and it often being advised that asymptomatic testing does more harm than good. Is it just because the community wants it?
The decision was made based on community interest combined with the unique obligations of occupational health that lead us towards making a policy, and the increase in the availability of testing and treatment that made us feel comfortable enough with implementing it.
Our Steps:
We received requests to do something about Mgen, and after conducting research we decided to take action.
Escalation efforts started with an educational campaign, which then moved to an optional screening program with a specific provider.
In 2023, a non-PASS partner testing facility began offering Mgen tests and publishing incidence data.
The high incidence rates created panic and discourse within the industry. We needed to address the problem of people’s concern; both because we wanted to quell their fears, but also because part of our job is to help mitigate legal risk. Now that this was regularly being tested for in a significant subset of the industry, production needed to be protected from the risk of transmission.
Considerations:
Public health authorities do not recommend regular screening or treatment of asymptomatic sexual partners.
This is something that can be managed in a personal sexual context as it is much simpler to control your sexual network, but would require a robust health surveillance program in order to pull off for the industry (PASS, or another central authority, would need to be keeping track of who was having sex with who, evaluating exposure timelines, and testing and treating all potential exposures).
HIV Comparisons:
Incidence is incredibly rare (someone in the industry tests positive for HIV less than once a year), transmission is even more rare (we have never had an HIV transmission on a PASS regulated set), and we can get the industry to comply with our stop work requests and answer our questions because the risk associated with HIV is so high.
Final Conclusion:
We knew in making the decision was going to create a lot of fringe cases that would have to be troubleshot individually, and that getting people into appropriate treatment would be essential - but felt more confident in this path because of the published clinical treatment guidance from the CDC that we could direct clinicians to.
Question 4: What about Ureaplasma?
In the case of Ureaplasma, there are no treatment guidelines - even if Ureaplasma had the same research and testing availability behind it as Mgen does, the lack of ability to direct clinicians to something would require us to find a different approach.
Question 5: If, in fact, treatment of asymptomatic cases is required to stop them spreading and becoming symptomatic cases, as we are a 'high risk' population in this industry, is there evidence that this works?
The data we have (albeit limited) shows a decrease in incidence after changes in screening policy for Mgen. However, the test data does not differentiate between symptomatic and asymptomatic cases and we cannot speak to whether our screening guidance has had any effect on them.
