High Prevalence of Multidrug-Resistant Mycoplasma genitalium in Human Immunodeficiency Virus-Infected Men Who Have Sex With Men in Alabama

Abstract

We tested for Mycoplasma genitalium in 157 HIV-infected men. Urogenital and rectal prevalence were 10.8% and 6.4%. Macrolide resistance mutations were detected in 70.6% and 80% of urogenital and rectal samples, and fluoroquinolone resistance mutations in 26.7% and 40%, respectively.

Macrolide and fluoroquinolone associated mutations in Mycoplasma genitalium in a retrospective study of male and female patients seeking care at an STI Clinic in Guangzhou, China, 2016-2018.

“…With the exception of a study from Greenland, the mutation frequency (66.4%) [62] observed was higher than frequencies reported by Russia and Estonia (0.7 10%) [63], South Africa (10%) [64], southern Sweden (13%) [65], France (17%) [66], Japan (42.2%) [42], southern USA (48%) [67], Norway (56%) [68], and Denmark (57%) [68]. However, our rate of 66.4% is lower than rates reported from England (82.4%) [69], the US (Alabama: 74.1% HIV positive MSM) [26], and Australia (79.4%) [70].…”

“…NC_000908.2) was used as a reference strain. Amino acid changes in the QRDRs of the gyrA and parC genes in this study were compared with previous studies [6,24,26,33,38,41].…”

“…M. genitalium is also a suspected cause of reactive arthritis and proctitis [13]. Characteristics contributing to increased risk of M. genitalium infections include living in low-and-middle-income localities [14][15][16][17], being symptomatic [18], experiencing fertility problems for both men [19,20] and women [21], abnormal pregnancy status [22], and being members of vulnerable populations, including men-who-have-sex-with men (MSM) [23,24], female sex workers (FSW) [25], and people living with HIV [26]. These considerations have spurred clinicians and public health agencies to call for global coordination of M. genitalium guidelines and treatment to help mitigate AMR-related problems [1][2][3][4][5][6].…”

Prevalence and antibiotic resistance of rectal Mollicutes in HIV-infected men who have sex with men at the University Hospital of Dresden, Germany

“…In our study, 60% and 30% of 20 strains showed mutations associated with macrolide and quinolone resistance, and 25% with both. Prevalence of macrolide resistance of M. genitalium may now exceed 50% [3,24] and is reported to be even higher in HIV-positive patients [25] or HIV-PrEP users [26,27], which corresponds to our results. The study from Germany calculated a rate of 80% macrolide-resistant strains [22].…”

Macrolide and fluoroquinolone associated mutations in Mycoplasma genitalium in a retrospective study of male and female patients seeking care at an STI Clinic in Guangzhou, China, 2016-2018.

“…Moreover, there is a growing consensus from research in China and internationally, of other characteristics contributing to increased risk of M. genitalium infections. Characteristics linked to increased infection include experiencing problems with fertility for both men [9,30] and women [31], abnormal pregnancy status [32], and from being members of vulnerable populations, including menwho-have-sex-with men (MSM) [33], female sex workers (FSW) [34], and people living with HIV [35].…”