Mycoplasma genitalium Macrolide and Fluoroquinolone Resistance: Prevalence and Risk Factors Among a 2013–2014 Cohort of Patients in Barcelona, Spain

Barberá, María-Jesús; Fernández-Huerta, Miguel; Jensen, Jørgen-Skov; Caballero, Estrella; Andreu, Antònia

doi:10.1097/olq.0000000000000631

Cited by 60 publications

(28 citation statements)

References 27 publications

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“…Macrolide resistance mutations were routinely detected in 265 (51.5% [95% CI 47.0–55.9]) of 515 heterosexual men and women compared with 349 (81.5% [95% CI 77.5–85.1]) of 428 MSM (p<0.0001). This difference between MSM and heterosexuals was also seen in a recent study in Spain, which reported macrolide resistance in 71% of MSM compared with 13% of heterosexuals (p<0.001); prior azithromycin exposure was a significant risk factor for resistance ( 20 ). Other recent studies in MSM report macrolide resistance in 74%–80% of M. genitalium infections ( 17 , 21 ).…”

Section: Discussionsupporting

confidence: 66%

Symptoms, Sites, and Significance ofMycoplasma genitaliumin Men Who Have Sex with Men

Read¹,

Murray²,

Danielewski³

et al. 2019

Emerg. Infect. Dis.

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During 2016–2017, we tested asymptomatic men who have sex with men (MSM) in Melbourne, Australia, for Mycoplasma genitalium and macrolide resistance mutations in urine and anorectal swab specimens by using PCR. We compared M. genitalium detection rates for those asymptomatic men to those for MSM with proctitis and nongonococcal urethritis (NGU) over the same period. Of 1,001 asymptomatic MSM, 95 had M. genitalium; 84.2% were macrolide resistant, and 17% were co-infected with Neisseria gonorrhoeae or Chlamydia trachomatis. Rectal positivity for M. genitalium was 7.0% and urine positivity was 2.7%. M. genitalium was not more commonly detected in the rectums of MSM (n = 355, 5.6%) with symptoms of proctitis over the same period but was more commonly detected in MSM (n = 1,019, 8.1%) with NGU. M. genitalium is common and predominantly macrolide-resistant in asymptomatic MSM. M. genitalium is not associated with proctitis in this population.

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Section: Discussionsupporting

confidence: 66%

Symptoms, Sites, and Significance ofMycoplasma genitaliumin Men Who Have Sex with Men

Read¹,

Murray²,

Danielewski³

et al. 2019

Emerg. Infect. Dis.

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“…We also detected other mutations in parC and parE that were nonsense or caused amino acid changes, but the impact of these mutations on MG treatment outcomes is unknown. All MG infections with strains carrying QRMs in our study also had MRMs, thus the frequency of potentially multi-drug resistant strains among MG infections was 11.1%, higher than rates reported in Canada (21) and European countries (20, 22) (<5%), similar to the frequency in Australia (8.6%) (33), and lower than the frequency in Japan (30.8%) (34). In the US, there are limited other drugs available for treating the potentially multi-drug resistant MG infections.…”

Section: Discussionsupporting

confidence: 47%

“…Limited microbiological evidence has approved that S83I and G81C mutations in ParC are closely related to MG quinolone resistance, while the level of minimum inhibitory concentration (MIC) may be modified by mutations in GyrA (18, 19). The frequency of MG strains with QRMs detected in MG infections has been reported to be as low as 5–8% in Europe (20–22) and as high as 47.1% in Japan (23). We published the only US study evaluating for MG QRMs, finding a prevalence of 29.6% in HIV-infected men who have sex with men (MSM) with MG infection (11).…”

Section: Introductionmentioning

confidence: 99%

Mycoplasma genitalium Infections With Macrolide and Fluoroquinolone Resistance-Associated Mutations in Heterosexual African American Couples in Alabama

Xiao

Waites²,

Pol

et al. 2019

Sexual Trans Dis

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“…A further limitation of this study was the fact that we were unable to accurately correlate sexuality with our antibiotic resistance data. Studies elsewhere have shown an association between high rates of macrolide-resistant M. genitalium and MSM (29,34), with high rates of dual resistance to both macrolides and quinolones being seen among MSM populations (29). It is, however, likely that many of the samples obtained from males within our study came from MSM, and this is supported by the fact that we observed higher levels of macrolide resistance and dual-class resistance in rectal swab samples from males (a sample type which represents MSM) than in genitourinary samples from females (more likely to represent heterosexual individuals), and this difference was statistically significant.…”

Section: Resultsmentioning

confidence: 99%

Levels of Mycoplasma genitalium Antimicrobial Resistance Differ by Both Region and Gender in the State of Queensland, Australia: Implications for Treatment Guidelines

Sweeney

Trembizki

Bletchly³

et al. 2019

J Clin Microbiol

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Mycoplasma genitaliumis frequently associated with urogenital and rectal infections, with the number of cases of macrolide-resistant and quinolone-resistantM. genitaliuminfection continuing to increase. In this study, we examined the levels of resistance to these two common antibiotic treatments in geographically distinct locations in Queensland, Australia. Samples were screened for macrolide resistance-associated mutations using a commercially available kit (ResistancePlus MG; SpeeDx), and quinolone resistance-associated mutations were identified by PCR and DNA sequencing. Comparisons between antibiotic resistance mutations and location/gender were performed. The levels ofM. genitaliummacrolide resistance were high across both locations (62%). Quinolone resistance mutations were found in ∼10% of all samples, with a number of samples harboring mutations conferring resistance to both macrolides and quinolones. Quinolone resistance was higher in southeast Queensland than in north Queensland, and this was consistent in both males and females (P = 0.007). TheM. genitaliumisolates in rectal swab samples from males harbored high levels of macrolide (75.9%) and quinolone (19%) resistance, with 15.5% harboring resistance to both classes of antibiotics. Overall, the lowest observed level of resistance was to quinolones in females from north Queensland (1.6%). These data highlight the high levels of antibiotic resistance inM. genitaliumisolates within Queensland and the challenges faced by sexually transmitted infection clinicians in managing these infections. The data do, however, show that the levels of antibiotic resistance may differ between populations within the same state, which has implications for clinical management and treatment guidelines. These findings also support the need for ongoing antibiotic resistance surveillance and tailored treatment.

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Mycoplasma genitalium Macrolide and Fluoroquinolone Resistance: Prevalence and Risk Factors Among a 2013–2014 Cohort of Patients in Barcelona, Spain

Cited by 60 publications

References 27 publications

Symptoms, Sites, and Significance ofMycoplasma genitaliumin Men Who Have Sex with Men

Symptoms, Sites, and Significance ofMycoplasma genitaliumin Men Who Have Sex with Men

Mycoplasma genitalium Infections With Macrolide and Fluoroquinolone Resistance-Associated Mutations in Heterosexual African American Couples in Alabama

Levels of Mycoplasma genitalium Antimicrobial Resistance Differ by Both Region and Gender in the State of Queensland, Australia: Implications for Treatment Guidelines

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