Testing Timeline for Mycoplasma genitalium After Exposure
You should get tested for Mycoplasma genitalium now, as two weeks post-exposure is sufficient time for detection, and immediate testing allows for prompt treatment if positive.
Rationale for Immediate Testing
M. genitalium is detectable shortly after infection using nucleic acid amplification tests (NAATs), which are the most sensitive and specific diagnostic methods available 1, 2.
Your exposure occurred two weeks ago, which provides adequate time for the organism to establish infection at detectable levels in urine or urogenital specimens 3, 1.
Your partner's positive test 1.5 weeks ago confirms active infection at the time of your unprotected sexual contact, making transmission highly likely given M. genitalium's status as a sexually transmitted pathogen with high concordance rates among partners 4.
Testing Approach
First-void urine is the preferred specimen for men, as it provides optimal sensitivity for M. genitalium detection via NAAT 5, 6.
For women, vaginal swabs (self-collected or clinician-collected) are recommended as the primary specimen type 5, 6.
Testing should include resistance testing if available, as more than 50% of M. genitalium infections are macrolide-resistant, which significantly impacts treatment selection 2, 5.
Important Timing Considerations
Do not wait for symptoms to develop before testing, as M. genitalium infections are frequently asymptomatic in both men and women, yet still transmissible and capable of causing complications 2, 5.
The two-week timeframe since exposure is adequate for diagnostic testing, unlike the test-of-cure scenario where testing must be delayed 3-4 weeks post-treatment to avoid false results from dead organisms 7, 3, 1.
Treatment and Partner Management
If you test positive, treatment should be initiated promptly with a two-step regimen: doxycycline 100 mg twice daily for 7 days followed by either azithromycin 1g single dose (if macrolide-susceptible) or moxifloxacin 400 mg daily for 7 days (if macrolide-resistant or resistance status unknown) 2, 5.
Your partner should also be evaluated and treated if not already done, as untreated partners are the primary source of reinfection 7, 6.
Abstain from sexual activity until both you and your partner complete treatment and symptoms (if present) have resolved 8.
Common Pitfalls to Avoid
Do not assume you are uninfected just because you lack symptoms—asymptomatic carriage is common with M. genitalium 2, 5.
Do not delay testing thinking you need to wait longer—two weeks is sufficient for initial diagnostic testing, unlike the 3-4 week wait required after treatment 3, 1.
Do not accept empiric treatment without testing first unless you cannot return for results, as resistance patterns necessitate targeted therapy when possible 2, 5.