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Increasing Macrolide and Fluoroquinolone Resistance in Mycoplasma genitalium
Emerging Infectious Diseases
|April 19, 2017
Abstract:
Escalating resistance to azithromycin and moxifloxacin is being reported for Mycoplasma genitalium in the Asia-Pacific region. Analyzing 140 infections, we found pretreatment fluoroquinolone-resistance mutations in parC (13.6%) and gyrA (5%). ParC S83 changes were associated with moxifloxacin failure. Combined macrolide/fluoroquinolone-resistance mutations were in 8.6% of specimens, for which recommended therapies would be ineffective.
Insights
Drug resistance in Mycoplasma genitalium is rising in the Asia-Pacific. Pretreatment mutations in key genes predict treatment failure, impacting effective therapies for this common infection.
Area of Science:
- Microbiology
- Infectious Diseases
- Antimicrobial Resistance
Background:
- Mycoplasma genitalium infections are increasingly difficult to treat due to rising azithromycin and moxifloxacin resistance.
- The Asia-Pacific region shows a concerning trend of escalating antimicrobial resistance for this pathogen.
Purpose of the Study:
- To investigate the prevalence of pretreatment resistance mutations to fluoroquinolones in Mycoplasma genitalium.
- To determine the association between specific mutations and treatment outcomes.
Main Methods:
- Analysis of 140 Mycoplasma genitalium infections.
- Genotyping for fluoroquinolone-resistance mutations in parC and gyrA genes.
- Correlation of mutation status with treatment success/failure.
Main Results:
- Prevalence of fluoroquinolone-resistance mutations: 13.6% in parC and 5% in gyrA.
- ParC S83 mutations were significantly associated with moxifloxacin treatment failure.
- Combined macrolide and fluoroquinolone resistance mutations detected in 8.6% of specimens.
Conclusions:
- Pretreatment resistance mutations are common in Mycoplasma genitalium in the Asia-Pacific.
- Current recommended therapies may be ineffective for a significant proportion of patients due to resistance.
- Genotypic resistance testing could guide more effective treatment strategies.