Macrolide and fluoroquinolone resistance in Mycoplasma genitalium in two Swedish counties, 2011-2015

作者：Hadad Ronza; Golparian Daniel; Lagos Amaya C.; Ljungberg Johan; Nilsson Peter; Jensen Joergen S.; Fredlund Hans; Unemo Magnus^*

来源：Acta Pathologica, Microbiologica et Immunologica Scandinavica, 2018, 126(2): 123-127.

DOI：10.1111/apm.12792

• Mycoplasma genitalium
• treatment
• antimicrobial resistance
• azithromycin
• moxifloxacin
• 23S rRNA
• parC
• Sweden

Mycoplasma genitalium, causing non-gonococcal non-chlamydial urethritis and associated with cervicitis, has developed antimicrobial resistance (AMR) to both the macrolide azithromycin (first-line treatment) and the fluoroquinolone moxifloxacin (second-line treatment). Our aim was to estimate the prevalence of resistance, based on genetic AMR determinants, to these antimicrobials in the M. genitalium population in two Swedish counties, orebro and Halland, 2011-2015. In total, 672 M. genitalium positive urogenital samples were sequenced for 23S rRNA and parC gene mutations associated with macrolide and fluoroquinolone resistance, respectively. Of the samples, 18.6% and 3.2% in orebro and 15.2% and 2.7% in Halland contained mutations associated with macrolide and fluoroquinolone resistance, respectively. The predominating resistance-associated mutations in the 23S rRNA gene was A2059G (n = 39) in orebro and A2058G (n = 13) and A2059G (n = 13) in Halland. The most prevalent possible resistance-associated ParC amino acid alterations were S83I (n = 4) in orebro and S83N (n = 2) in Halland. Resistance-associated mutations to both macrolides and fluoroquinolones were found in 0.7% of samples. Our findings emphasize the need for routine AMR testing, at a minimum for macrolide resistance, of all M. genitalium-positive samples and regular national and international surveillance of AMR in M. genitalium, to ensure effective patient management and rational antimicrobial use.

• 出版日期2018-2