Mycoplasma genitalium: Analysis of mutations associated with macrolide resistance in Lleida, Spain

Santa, Alba Muñoz; Arnuelos, Jesús Aramburu; Sánchez, Albert Bernet; Bellés, Alba Bellés

doi:10.1016/j.eimc.2021.02.004

Cited by 5 publications

(8 citation statements)

References 8 publications

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“…However, their cohort included 25% of MSM versus 9.1% in our cohort. Focusing on Catalonia, our prevalence of resistance is similar to the one reported by Muñoz-Santa et al (23%) [34] and between the rates published by Lucena-Nemirosky et al (12.6%) in a routine diagnostic service [18] and Fernández-Huerta et al (36.1%) in a STI Unit [15].…”

Section: Discussionsupporting

confidence: 89%

Detection and Prevalence of Macrolide and Fluoroquinolone Resistance in Mycoplasma genitalium in Badalona, Spain

et al. 2022

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Macrolide and fluoroquinolone resistance (MLr/FQr) in Mycoplasma genitalium (MG) infections is concerning worldwide. Current guidelines recommend performing MLr detection in MG-positive cases to adjust antimicrobial therapy. We aimed to evaluate the usefulness of PCR followed by pyrosequencing for MLr detection in comparison with a one-step commercial assay and to assess the prevalence of MLr and FQr in Badalona, Spain. A total of 415 MG-positive samples by Allplex STI-7 (Seegene) were analyzed for MLr detection by pyrosequencing. From those, 179 samples were further analyzed for MG and MLr by ResistancePlus® MG kit (SpeeDx) and 100 of them also for fluoroquinolone resistance (FQr) by sequencing the parC gene. Regarding MG detection, Allplex and Resistance Plus® showed an overall agreement of 87%, but this value rose to 95.4% if we compare them for MLr detection. Prevalence of MLr was 23.1% in Badalona, but this rate increased to 73.7% in the HIV-positive patients cohort. FQr detection showed 3% of resistant strains. Pyrosequencing is a convenient and cheap technique for MLr detection, but one-step tools should be considered in high-throughput laboratories. Despite the fact that MLr remained moderate and FQr was low in our study, simultaneous MG and MLr detection would improve patient’s management applying resistance-guided treatment strategies.

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Section: Discussionsupporting

confidence: 89%

Detection and Prevalence of Macrolide and Fluoroquinolone Resistance in Mycoplasma genitalium in Badalona, Spain

et al. 2022

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“…In this study we described the mutations in MG that confer resistance to azithromycin or moxifloxacin. It is a continuation of a previous one performed between 2019-2021 in which Muñoz-Santa et al evaluated the prevalence of MG and mutations related to azithromycin resistance in our area [5]. The main mutation detected in Azi-R-MG in the present study has been A2059G (55/95, 57.9%), which was the most frequent in the fore-mentioned report (55.6%).…”

Section: Discussionsupporting

confidence: 83%

“…Azithromycin inhibits protein synthesis and its resistance is associated with mutations in the region V of the 23S rRNA gene, being the point mutations at positions 2058 and 2059 the most frequent ones [7]. Azithromycin-resistant MG (Azi-R-MG) has been reported worldwide in the last years [2,5,[8][9][10][11]. On the other hand, mutations in the parC and/or gyrA are responsible for moxifloxacinresistant MG (Moxi-R-MG) [12].…”

Section: Resultsmentioning

confidence: 99%

“…However, MG is still a clinical challenge. MG is intrinsically resistant to β-lactams due to the lack of cell wall, and therefore the choice of an appropriate treatment is limited to macrolides, tetracyclines, and quinolones [ 5 ]. According to the Clinical Guidelines, azithromycin is the first line of treatment and its cure rate is approximately 85% in macrolide susceptible infections, while doxycycline has a cure rate between 30-40%.…”

Section: Introductionmentioning

confidence: 99%

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Azithromycin and moxifloxacin resistance determinants in Mycoplasma genitalium in Lleida, Spain

Fraile García,

Aramburu Arnuelos,

López González

et al. 2024

Rev Esp Quimioter

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Introduction. Mycoplasma genitalium (MG) is a microorganism related to sexually transmitted infections. Antibiotic resistance of MG leads to an increase in treatment failure rates and the persistence of the infection. The aim of this study was to describe the most frequent mutations associated with azithromycin and moxifloxacin resistance in our geographical area. Material and methods. A prospective study from May 2019 to May 2023 was performed. MG-positive samples were collected. Real-time PCRs (AllplexTM MG & AziR Assay and AllplexTM MG & MoxiR Assay, Seegene) were performed in MG positive samples to detect mutations in 23S rRNA V domain and parC gene. Results. A 37.1% of samples presented resistance determinants to azithromycin and the most common mutation detected was A2059G (57.9%). Resistance to moxifloxacin was studied in 72 azithromycin-resistant samples and 36.1% showed mutations, being G248T the most prevalent (73.1%). Conclusions. The resistance to different lines of treat ment suggests the need for a targeted therapy and the performing of a test of cure afterwards.

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“…d Asociada a la mutación G248T(S83I) en parC. [9,10]. En las muestras que presentaron mutaciones, en cuatro pacientes se observó tratamiento previo con 1,5 gramos de azitromicina; esta pauta se ha relacionado con un aumento de las resistencias a macrólidos [3].…”

Section: Tabla 1 Mutaciones Detectadas En Macrólidos (Dominio V 23s) ...unclassified

High macrolides and fluoroquinolones resistance rate in Mycoplasma genitalium in southern Tenerife

León¹,

Artola²,

Pino-Calm³

2023

Rev Esp Quimioter

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Introduction. Mycoplasma genitalium (MG) is a recognized sexually transmitted pathogen. Increasing resistance to main lines of treatment (macrolides and quinolones) justifies a genetic study of mutations to improve cure rates. Material and methods. A total of 8,508 samples from April 2018 to July 2022 were processed using AllplexTM STI Essential Assay. In MG positive cases 23S rRNA V domain, gyrA and parC genes were studied. Mutations detected were checked to assess their clinical significance and medical records were reviewed to obtain demographic and treatment information. Results. Resistance study was performed on 92 samples (65 men and 27 women). In relation to the genotypic study, 28 patients presented mutations to macrolides (30.43%). Most common was A2059G (18.48%). For quinolones, 5 patients (5.43%) had clinically relevant mutations in parC gene. Of note was a patient with G295 mutation in gyrA associated with G248T in parC. Thirty subjects underwent a test of cure (TOC). Azithromycin was the most common empirical regimen and moxifloxacin the main alternative. Conclusions. High rate of resistance in our environment evidences the need for targeted therapy by genotypic study of macrolide resistance, supported by the detection of mutations in parC and gyrA to predict quinolones susceptibility and the use of TOC to evaluate treatment response

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Mycoplasma genitalium: Analysis of mutations associated with macrolide resistance in Lleida, Spain

Cited by 5 publications

References 8 publications

Detection and Prevalence of Macrolide and Fluoroquinolone Resistance in Mycoplasma genitalium in Badalona, Spain

Detection and Prevalence of Macrolide and Fluoroquinolone Resistance in Mycoplasma genitalium in Badalona, Spain

Azithromycin and moxifloxacin resistance determinants in Mycoplasma genitalium in Lleida, Spain

High macrolides and fluoroquinolones resistance rate in Mycoplasma genitalium in southern Tenerife

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