Mycoplasma genitalium Incidence, Organism Load, and Treatment Failure in a Cohort of Young Australian Women

Walker, Jennifer; Fairley, Christopher K.; Bradshaw, Catriona; Tabrizi, Sepehr N.; Twin, Jimmy; Chen, Marcus Y; Taylor, Nicole; Donovan, Basil; Kaldor, John; McNamee, Kathleen; Urban, Eve; Walker, Sandra; Currie, Marian J.; Birden, Hudson; Bowden, Francis J.; Gunn, Jane; Pirotta, Marie; Gurrin, Lyle C.; Harindra, V; Garland, Suzanne M.; Hocking, Jane S

doi:10.1093/cid/cis1210

Cited by 61 publications

(52 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Several recent studies have highlighted that azithromycin (AZM)-resistant M. genitalium strains are emerging worldwide (35)(36)(37)(38)(39)(40)(41)(42), two of which provide molecular evidence that resistance can be induced with 1 g of STAT dosing (38,42). Using conventional PCR and Sanger sequencing, analysis of the M. genitalium-positive subjects in this study showed that none of their infecting strains possessed mutations that confer macrolide resistance (data not shown).…”

Section: Resultsmentioning

confidence: 71%

Mycoplasma genitalium Infection Is Associated with Microscopic Signs of Cervical Inflammation in Liquid Cytology Specimens

Dehon¹,

McGowin²

2014

J Clin Microbiol

View full text Add to dashboard Cite

Cervicitis is a common clinical finding often attributed to sexually transmitted infections (STIs), but no etiologic agent is identified in the majority of cases. In this study, we comparatively assessed inflammation among the common infectious etiologies of cervicitis and assessed the potential value of liquid cytology specimens for predicting STIs. Among 473 Louisiana women at low risk for acquiring STIs, the prevalences of Mycoplasma genitalium, Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis in liquid-based cytology specimens were 1.5, 2.1, 0.6, and 4.4%, respectively. N. gonorrhoeae and human papillomavirus 18 (HPV18) infections were significantly more common among subjects infected with M. genitalium. Using direct microscopy, we observed significant increases in leukocyte infiltrates among subjects with monoinfections with M. genitalium or C. trachomatis compared to women with no detectable STIs. Inflammation was highest among subjects with M. genitalium. Using a threshold of >2 leukocytes per epithelial cell per high-powered field, the positive predictive values for M. genitalium, C. trachomatis, N. gonorrhoeae, and T. vaginalis were 100, 70, 67, and 20%, respectively. Several novel M. genitalium genotypes were identified, all of which were predicted to be susceptible to macrolide antibiotics, suggesting that different strains may circulate among low-risk women and that macrolide resistance is substantially lower than in high-risk populations. This study highlights the capacity of M. genitalium to elicit cervical inflammation and, considering the strong epidemiologic associations between M. genitalium and human immunodeficiency virus (HIV), provides a potential mechanism for acquisition and shedding of HIV via chronic leukocyte recruitment to the cervical mucosa.

show abstract

Section: Resultsmentioning

confidence: 71%

Mycoplasma genitalium Infection Is Associated with Microscopic Signs of Cervical Inflammation in Liquid Cytology Specimens

Dehon¹,

McGowin²

2014

J Clin Microbiol

View full text Add to dashboard Cite

show abstract

“…Of those with pretreatment macrolide resistance mutations 1 of 1 failed the 5-day regimen15 and 49 of 56,23 0 of 2,26 12 of 16,21 6 of 6,19 0 of 125 and 8 of 1017 failed azithromycin 1 g. Thus, 76 of 92 (82.6%, 95% CI 73.3% to 89.7%) individuals with a macrolide resistance mutation failed treatment with azithromycin.…”

Section: Resultsmentioning

confidence: 98%

“…One was a study of a random sample of men with NGU treated with azithromycin 1 g who were identified as MG positive 24 25. One was a female only study designed to test incidence, organism load and treatment failure after treatment with azithromycin 1 g 26. One was a prospective longitudinal cohort study comprising an observational study and a randomised treatment trial involving both men and women 17.…”

Section: Resultsmentioning

confidence: 99%

Which azithromycin regimen should be used for treating Mycoplasma genitalium? A meta-analysis

et al. 2017

View full text Add to dashboard Cite

General rightsThis document is made available in accordance with publisher policies. Please cite only the published version using the reference above. Full terms of use are available: http://www.bristol.ac.uk/pure/about/ebr-terms  Azithromycin 1g treatment is associated with 13.9% (7.7-20.1%) rate of failure and 12.0%(7.1-16.9%) risk of macrolide antimicrobial resistance. There is moderate but conflicting evidence that the 5 day regimen may be more effective and less likely to cause resistance. The difference in failure and resistance rates is 9.7% (95% CI: 4.3-15.0%, p=0.012) and 8.5%(95% CI: 3.2-13.8%, p=0.027) respectively. 3 AbstractBackground: There is increasing evidence that azithromycin 1g is driving the emergence of

show abstract

“…In M. pneumoniae, a close relative of M. genitalium, most resistant strains harbor the A2058 mutation (26). Macrolide resistance in M. genitalium is associated with therapeutic failure of 1 g azithromycin in about 85% of patients infected by a mutant strain (4), and selection of macrolide-resistant mutants during azithromycin treatment has been reported by several studies (9,12,15,27). In our study, we also observed the selection of macrolide resistance for 2 patients, patient 2 in 2011 and patient 17 in 2012.…”

Section: Discussionmentioning

confidence: 99%

Direct Detection of Macrolide Resistance in Mycoplasma genitalium Isolates from Clinical Specimens from France by Use of Real-Time PCR and Melting Curve Analysis

et al. 2014

View full text Add to dashboard Cite

Mycoplasma genitalium Incidence, Organism Load, and Treatment Failure in a Cohort of Young Australian Women

Abstract: Although MG incidence was relatively low, testing should be recommended for women considered to be at increased risk based on sexual history. Our results also suggest that organism load might be important in azithromycin treatment failure.

Cited by 61 publications

References 29 publications

Mycoplasma genitalium Infection Is Associated with Microscopic Signs of Cervical Inflammation in Liquid Cytology Specimens

Mycoplasma genitalium Infection Is Associated with Microscopic Signs of Cervical Inflammation in Liquid Cytology Specimens

Which azithromycin regimen should be used for treating Mycoplasma genitalium? A meta-analysis

Direct Detection of Macrolide Resistance in Mycoplasma genitalium Isolates from Clinical Specimens from France by Use of Real-Time PCR and Melting Curve Analysis

Contact Info

Product

Resources

About