Molecular Characterization and Detection of Macrolide and Fluoroquinolone Resistance Determinants in Mycoplasma genitalium in South Africa, 2015 to 2018

Abstract

A low prevalence of macrolide resistance–associated mutations in Mycoplasma genitalium strains obtained from genital discharge specimens was observed in South Africa over a 4-year surveillance period.

Southern African HIV Clinicians Society 2022 guideline for the management of sexually transmitted infections: Moving towards best practice

“…Nevertheless, AMR in N. gonorrhoeae and M. genitalium is on the rise globally and evaluation for AMR should be included in any diagnostic work-up. 24,45,46 It is essential to take a thorough sexual and clinical history, and to conduct a physical examination of all patients presenting with persistent or recurrent MUDS or VDS. If reinfection, new infection, or poor treatment adherence is likely, then retreatment with the same empirical STI regimen is indicated.…”

“…Nevertheless, AMR in N. gonorrhoeae and M. genitalium is on the rise globally and evaluation for AMR should be included in any diagnostic work-up. 24 , 45 , 46 …”

“…Macrolide resistance has emerged globally; however, limited data for the African region (including South Africa and Kenya) suggest that local macrolide resistance levels are still low. 24 , 46 , 56 , 59 , 62 In the absence of resistance testing and given the widespread use of moxifloxacin (an alternative treatment) in management of tuberculosis, a course of azithromycin is still recommended as first-line treatment of M. genitalium ( Table 6 ). Resistance-guided therapy is preferred in settings where macrolide resistance testing is available.…”

mgpB genotyping and genetic diversity for antimicrobial resistance of Mycoplasma genitalium

“…genitalium . Whole genome-based SNP phylogeny SLSB mgp B genotyping studies used the number of repeats in gene MG_309 typing in epidemiological assessments [4, 7, 9–14, 19]. In addition to the whole genome-based study, SLSB mgp B genotyping is the most common and widely used method to study the epidemiology of infections [4, 7, 9–14].…”

“…Reliable and effective genotyping methods are key to detailed epidemiological and evolutionary studies of M. genitalium. Whole genome-based SNP phylogeny SLSB mgpB genotyping studies used the number of repeats in gene MG_309 typing in epidemiological assessments [4,7,[9][10][11][12][13][14]19]. In addition to the whole genome-based study, SLSB mgpB genotyping is the most common and widely used method to study the epidemiology of infections [4,7,[9][10][11][12][13][14].…”