<i>Mycoplasma genitalium</i>: high prevalence of resistance to macrolides and frequent anorectal infection in men who have sex with men in western Sydney

Couldwell, Deborah L.; Jalocon, Dean; Power, Melissa; Jeoffreys, Neisha; Chen, Sharon C‐A; Lewis, David A.

doi:10.1136/sextrans-2017-053480

Cited by 70 publications

(77 citation statements)

References 21 publications

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“…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].…”

Section: Discussionsupporting

confidence: 90%

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

Spornraft‐Ragaller

Dumke

2020

Infection

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Background Rectal sexually transmitted infections (STI) are common in men having sex with men (MSM). Mycoplasma genitalium is increasingly being reported in this localization, but due to frequent lack of symptoms at this site, clinical significance is still unclear. Rectal prevalence of Mycoplasma hominis and Ureaplasma species is not well studied so far. We aimed to investigate the prevalence and antibiotic sensitivity of rectal Mollicutes in our HIV-cohort. Methods In 227 MSM presenting for annual STI-screening, 317 anorectal swabs were collected from January 2017 to December 2018. PCR was performed for detection of Chlamydia trachomatis, Neisseria gonorrhoeae, M. genitalium and also culture for M. hominis and Ureaplasma spec. Results Prevalence for M. genitalium, M. hominis, Ureaplasma spec., C. trachomatis and N. gonorrhoeae was 8.2%, 7.3%, 12.0%, 5.1% and 1.9%, respectively. Patients were asymptomatic with few exceptions. Seroprevalence of syphilis in 227 MSM was 41.9%. In 20 strains of M. genitalium, resistance-associated mutations to macrolides and quinolones were found in 60% and 30%, respectively; in five strains (25%) to both. M. hominis and Ureaplasma spec. frequently occurred combined, mostly in significant quantity consistent with infection. M. hominis and Ureaplasma spec. regularly showed sensitivity to tetracycline. Conclusion At screening, rectal colonization with Mollicutes was common in our patients, but rarely caused symptoms. Due to rising antibiotic resistance of M. genitalium against quinolones, therapeutic options are increasingly limited. Treatment should be guided by antibiotic resistance testing including quinolones. In persisting anorectal symptoms, M. hominis and Ureaplasma spec. should also be taken into account.

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Section: Discussionsupporting

confidence: 90%

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

Spornraft‐Ragaller

Dumke

2020

Infection

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“…A meta-analysis found much lower prevalence estimates for MSM of 3.2% in five community-based studies from Australia and Central America and 3.7% in four clinic-based studies from Europe and the US [35]. Other studies found MG prevalences between 2.0 and 13.4%, and differed in the number of tested sites, clinical status, and reported sexual behavior [36][37][38][39][40][41][42].…”

Section: Sti Prevalencesmentioning

confidence: 97%

“…HIV-participants were significantly younger than HIV+ MSM (median 35 IQR [30][31][32][33][34][35][36][37][38][39][40][41][42][43] vs. 44 [35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52], p < 0.01) and less likely to be born in Germany (67.2% vs. 80.8%, p < 0.01), but they were more likely to have acquired university-entrance diploma (74.6% vs. 54.4%, p < 0.01). The median number of male sex partners was significantly higher in HIV-MSM than in HIV+ (6 [3][4][5][6][7][8][9][10][11][12][13][14][15] vs. 4 [1][2][3][4]…”

Section: Demographic Characteristics and Sexual Behaviour Of The Studmentioning

confidence: 99%

STI in times of PrEP: high prevalence of chlamydia, gonorrhea, and mycoplasma at different anatomic sites in men who have sex with men in Germany

et al. 2020

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Background: Men who have sex with men (MSM) are disproportionally affected by sexually transmitted infections (STI). STI are often extragenital and asymptomatic. Both can delay diagnosis and treatment. Approval of HIV preexposure prophylaxis (PrEP) might have influenced sexual behaviour and STI-prevalence of HIV-MSM. We estimated STI-prevalence and risk factors amongst HIV-and HIV+ MSM in Germany to plan effective interventions. Methods: We conducted a nationwide, cross-sectional study between February and July 2018. Thirteen MSMfriendly STI-practices screened MSM for Chlamydia trachomatis (CT), Mycoplasma genitalium (MG), Neisseria gonorrhea (NG), and Trichomonas vaginalis (TV) using self-collected rectal and pharyngeal swabs, and urine samples. APTIMA™ STI-assays (Hologic™ Inc., San Diego, USA) were used for diagnostics, and samples were not pooled. We collected information on socio-demographics, HIV-status, clinical symptoms, sexual behaviour within the last 6 months, and PrEP use. We combined HIV status and PrEP use for defining risk groups, and used directed acyclic graphs and multivariable logistic regression to identify risk factors for STI. Results: Two thousand three hundred three MSM were included: 50.5% HIV+, median age 39 [18-79] years. Median number of male sex partners within the last 6 months was five. Sex without condom was reported by 73.6%, use of party drugs by 44.6%. 80.3% had a STI history, 32.2% of STI+ MSM reported STI-related symptoms. 27.6% of HIV-MSM used PrEP.

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“…In the UK, interest was galvanised in 2015 by data from the third National Survey of Health Attitudes and Lifestyles (NATSAL 3). But studies brought together of STI show us how identical issues are having to be addressed in Australia1 and two regions of the US 2 3. Everywhere there is the same challenge of defining universal standards for screening and management.…”

mentioning

confidence: 99%

“…Taylor et al 3 pursue the implications of MG for women’s reproductive health, analysing the association with histological endometritis, an a signal of pelvic inflammatory disease. Couldwell et al 1 address antibiotic resistance in an Australian MSM population, investigating mutations of the organism linked to macrolide resistance.…”

mentioning

confidence: 99%

Highlights from this issue

Cassell

2018

Sex Transm Infect

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Mycoplasma genitalium: high prevalence of resistance to macrolides and frequent anorectal infection in men who have sex with men in western Sydney

Cited by 70 publications

References 21 publications

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

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

STI in times of PrEP: high prevalence of chlamydia, gonorrhea, and mycoplasma at different anatomic sites in men who have sex with men in Germany

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