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Biswal D, Gupta S, Sethi S, Singh S, Khanna N, Dhawan B. Macrolide and fluoroquinolone resistance associated mutations in Mycoplasma genitalium in men who have sex with men attending STI clinic: A pilot study from India. Indian J Dermatol Venereol Leprol 2024; 0:1-4. [PMID: 38899414 DOI: 10.25259/ijdvl_933_2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 12/18/2023] [Indexed: 06/21/2024]
Abstract
Background Increasing rates of macrolide and fluroquinolone resistance in Mycoplasma genitalium (MG) are being reported worldwide with resultant treatment failure. Aims and objectives We aimed to determine the level of antibiotic resistance of MG in men who have sex with men (MSM) attending a sexually transmitted infections (STIs) clinic in New Delhi, India. Methods Real-time polymerase chain reaction (PCR) assays targeting MgPa and pdhD genes were performed to detect MG rectal, urogenital or oropharyngeal infections in 180 MSM between January 2022 and June 2023. Macrolide resistance-associated mutations (MRM) and quinolone resistance-associated mutations (QRM) were detected by specific amplification of domain V of 23SrRNA gene and appropriate regions of parC and gyrA genes respectively followed by sequencing. PCR-based screening for Chlamydia trachomatis (CT) infection was also performed. Results A total of 13 (7.2%) MSM were positive for MG infection. The most common site of infection was anorectum (8/13; 61.5%) followed by the urethra (5/13; 38.5%). None of the patients had infection at both the sites, and no oropharyngeal MG infection was detected. CT infection was detected in 37 (20.6%) MSM. Of the 13 MG-infected MSM, 6 (46.2%) were co-infected with CT. MRM and QRM were found in five (46.2%) and two (15.4%) strains, respectively. Both Quinolone resistance mutation (QRM)-harbouring strains also harboured MRM. All the five MG isolates carried the MRM A2071G. Both the QRM isolates co-harboured the parC and gyrA single-nucleotide polymorphisms. There was no correlation between the presence of antibiotic resistance and co-infection with CT (P = 0.52). Limitation Because all patients in the study were MSM, the high rate of resistance to macrolides and fluoroquinolones could not be extrapolated for non-MSM patients. Conclusion This is a report of an initial survey of antibiotic resistance to MG in a country where its diagnosis and treatment are not routinely available. We found a high prevalence of MG-carrying MRM, QRM and dual-class resistance in MSM in the absence of antibiotic exposure. This study mandates the need for both screening and detection of antimicrobial resistance against MG.
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Affiliation(s)
- Debasish Biswal
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Somesh Gupta
- Dermatology, Venereology and Leprology, All India Institute of Medical Sciences, New Delhi, India
| | - Sunil Sethi
- Department of Medical Microbiology, Post Graduate Institute of Medical Education and Research, Chandigarh, Punjab, India
| | - Saurabh Singh
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Neena Khanna
- Dermatology, Venereology and Leprology, All India Institute of Medical Sciences, New Delhi, India
| | - Benu Dhawan
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
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Piñeiro L, Idigoras P, Arrastia M, Manzanal A, Ansa I, Cilla G. Increases in the Macrolide Resistance of Mycoplasma genitalium and the Emergence of the A2058T Mutation in the 23S rRNA Gene: Clonal Spread? Antibiotics (Basel) 2022; 11:antibiotics11111492. [PMID: 36358147 PMCID: PMC9686820 DOI: 10.3390/antibiotics11111492] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 10/21/2022] [Accepted: 10/25/2022] [Indexed: 11/16/2022] Open
Abstract
The management of Mycoplasma genitalium sexually transmitted infection (STI) is hindered by increasing resistance to the recommended antibiotics, macrolides and quinolones, worldwide. In Gipuzkoa (Basque Country, Spain), macrolide and quinolone resistance rates in 2014−2018 were reported as <20% and <10%, respectively. The aims of this study were to compare these rates with those in 2019−2021 and analyse the genetic and epidemiological features of the strains and cases associated with striking changes in the resistance trends. Resistance to macrolides (n = 1019) and quinolones (n = 958) was studied, analysing mutations in 23S rRNA and parC/gyrA genes, respectively. The rate of macrolide resistance increased from 17.3% in 2014−2018 to 32.1% in 2019−2021, as much in the more prevalent A2058/2059G mutations (16.6−27.8%) as in the emergent A2058T mutations (0.5−4.1%) but with differences in the odds ratios and the relative risk increase between A2058T and A2058/2059G mutations. MG191 adhesin and MG309 lipoprotein of the 27 emergent strains detected with A2058T mutations were amplified, sequenced, and typed using phylogenetic and variable number tandem repeat analysis, respectively. Genetic clonal spread was ruled out, but most of the A2058T cases were men who had sex with men (24/27) with a history of STI and antibiotic treatments (19/27). No changes were observed in quinolone resistance trends, but the rate of resistance to both antibiotics rose from 2.9% to 8.3%, especially in cases with A2058T mutations. The genetic characterisation of strains and epidemiological surveillance of cases are needed to detect populations at increased risk of treatment failure in this infection.
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Affiliation(s)
- Luis Piñeiro
- Microbiology Department, Donostia University Hospital, 20014 Donostia, Spain
- Biodonostia Health Research Institute, 20014 Donostia, Spain
- Correspondence:
| | - Pedro Idigoras
- Microbiology Department, Donostia University Hospital, 20014 Donostia, Spain
| | - Maitane Arrastia
- Microbiology Department, Donostia University Hospital, 20014 Donostia, Spain
| | - Ayla Manzanal
- Microbiology Department, Donostia University Hospital, 20014 Donostia, Spain
| | - Iñigo Ansa
- Microbiology Department, Donostia University Hospital, 20014 Donostia, Spain
| | - Gustavo Cilla
- Microbiology Department, Donostia University Hospital, 20014 Donostia, Spain
- Biodonostia Health Research Institute, 20014 Donostia, Spain
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Detection and Prevalence of Macrolide and Fluoroquinolone Resistance in Mycoplasma genitalium in Badalona, Spain. Antibiotics (Basel) 2022; 11:antibiotics11040485. [PMID: 35453236 PMCID: PMC9025937 DOI: 10.3390/antibiotics11040485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 03/25/2022] [Accepted: 04/01/2022] [Indexed: 12/04/2022] Open
Abstract
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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Muñoz Santa A, Aramburu Arnuelos J, Bernet Sánchez A, Bellés Bellés A. Mycoplasma genitalium: Analysis of mutations associated with macrolide resistance in Lleida, Spain. ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA (ENGLISH ED.) 2022; 40:209-210. [PMID: 35473993 DOI: 10.1016/j.eimce.2021.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 02/04/2021] [Indexed: 06/14/2023]
Affiliation(s)
- Alba Muñoz Santa
- Sección Microbiología Hospital Universitari Arnau de Vilanova, Lleida, Spain.
| | | | | | - Alba Bellés Bellés
- Sección Microbiología Hospital Universitari Arnau de Vilanova, Lleida, Spain
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Otero-Guerra L, Gil-Alonso L, López-de Munain J, Del Romero-Guerrero J, Serra-Pladevall J, Vazquez F. Survey of diagnostic resources for STI in Spain. ACTA ACUST UNITED AC 2021; 39:390-394. [PMID: 34362706 DOI: 10.1016/j.eimce.2021.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 06/23/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Scarce information is available on the resources to deal with the Sexually Transmitted Infections (STIs), both in the clinic and in the laboratory. The objective is to describe and know the reality of the clinics and laboratories that treat these infections in Spain. METHODS Cross-sectional observational study with data collection through a survey aimed at the members of the GEITS Group. RESULTS Responses were obtained from 24 centers (response rate 38.1%) belonging to 10 Autonomous Communities. Regarding STI consultations, 38% require that the patient present a health card to provide assistance, and 31.8% only provide it by referral from another doctor. The 52.4% perform diagnostic methods in the care center. Regarding laboratories, 18.2% do not offer immediate response diagnostic tests, although 100% have PCR against Neisseria gonorrhoeae and Chlamydia trachomatis, 47.8% against Mycoplasma genitalium and 65% detect lymphogranuloma venereum genotypes. All laboratories continue to perform culture and gonococcal sensitivity techniques, and 20% perform molecular methods for detection of MG antimicrobial resistance. CONCLUSION There is great variability in the provision of human and material resources both in the clinics and in the laboratories that attend STIs. In a significant number of centers there are limitations for patient access. Although laboratories have molecular biology technologies, not all of them offer immediate response tests. All laboratories detect N. gonorrhoeae infection by PCR and also by culture, which allows sensitivity testing in all centers.
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Affiliation(s)
- Luis Otero-Guerra
- Servicio de Microbiología, Hospital Universitario de Cabueñes, Gijón, Asturias; Grupo de Microbiología Translacional, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA); Grupo de Estudio de Infecciones de Transmisión Sexual, GEITS, SEIMC, Spain.
| | - Leire Gil-Alonso
- Unidad de Enfermedades Infecciosas, Hospital Universitario Donostia, San Sebastián; Grupo de Estudio de Infecciones de Transmisión Sexual, GEITS, SEIMC, Spain
| | - Josefina López-de Munain
- Servicio de Enfermedades Infecciosas, Hospital Universitario Basurto (OSI Bilbao-Basurto, Osakidetza), Bilbao; Grupo de Estudio de Infecciones de Transmisión Sexual, GEITS, SEIMC, Spain
| | - Jorge Del Romero-Guerrero
- Centro Sanitario Sandoval, IdISSC, Hospital Clínico San Carlos, Madrid; Universidad Complutense de Madrid, Madrid; Grupo de Estudio de Infecciones de Transmisión Sexual, GEITS, SEIMC, Spain
| | - Judit Serra-Pladevall
- Servicio de Microbiología, Hospital Universitario Vall d'Hebron, Barcelona; Universidad Autónoma de Barcelona, Barcelona; Grupo de Estudio de Infecciones de Transmisión Sexual, GEITS, SEIMC, Spain
| | - Fernando Vazquez
- Servicio de Microbiología, Hospital Universitario Central de Asturias, Oviedo, Asturias; Área de Microbiología, Facultad de Medicina, Universidad de Oviedo; Grupo de Microbiología Translacional, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA); Instituto Universitario Fernández Vega (IUFV) y Fundación de Investigación Oftalmológica (FIO), Oviedo; Grupo de Estudio de Infecciones de Transmisión Sexual, GEITS, SEIMC, Spain
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Shedko ED, Goloveshkina EN, Akimkin VG. Molecular epidemiology and antimicrobials resistance mechanism of Mycoplasma genitlaium. VESTNIK DERMATOLOGII I VENEROLOGII 2021. [DOI: 10.25208/vdv1192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Currently, infections caused by Mycoplasma genitalium are ones the most common sexually transmitted infections. Their prevalence is varied from 1.3% to 15.9%. Infections caused by M.genitalium may lead to urethritis in men and a wide spectrum of diseases in women. Antibiotic resistance now is one of the most emerging problems both in the scientific and in the healthcare fields. The usage of antimicrobials inhibiting cell wall synthesis for the treatment of M.genitalium is ineffective, and resistance to macrolides and fluoroquinolones is increasing rapidly. M.genitalium infections diagnostics is complicated due to specific conditions and duration of culture methods. The usage of nucleic acid amplification techniques is the most relevant for laboratory diagnostics, and is used in existing assays. This review compiles current data on the prevalence, molecular mechanisms of pathogenesis and antibiotic resistance, as well as diagnostics methods of M.genitalium.
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Fernández-Huerta M, Serra-Pladevall J, Pumarola T, Pich OQ, Espasa M. Comment on: Lower mgpB diversity in macrolide-resistant Mycoplasma genitalium infecting men visiting two sexually transmitted infection clinics in Montpellier, France. J Antimicrob Chemother 2021; 76:1649-1650. [PMID: 33657213 DOI: 10.1093/jac/dkab041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 01/27/2021] [Indexed: 11/15/2022] Open
Affiliation(s)
- Miguel Fernández-Huerta
- Microbiology Department, Vall d´Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain.,Microbiology Department, Bellvitge University Hospital, University of Barcelona, Barcelona, Spain
| | - Judit Serra-Pladevall
- Microbiology Department, Vall d´Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Tomàs Pumarola
- Microbiology Department, Vall d´Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Oscar Q Pich
- Microbiology Department, Corporació Sanitària Parc Taulí, Universitat Autònoma de Barcelona, Barcelona, Spain.,Institute of Biotechnology and Biomedicine & Department of Biochemistry and Molecular Biology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Mateu Espasa
- Microbiology Department, Corporació Sanitària Parc Taulí, Universitat Autònoma de Barcelona, Barcelona, Spain
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From Resistance-Guided to Risk-Guided Antimicrobial Therapy in Mycoplasma genitalium. Sex Transm Dis 2021; 47:409-411. [PMID: 32209955 DOI: 10.1097/olq.0000000000001177] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Muñoz Santa A, Aramburu Arnuelos J, Bernet Sánchez A, Bellés Bellés A. Mycoplasma genitalium: Analysis of mutations associated with macrolide resistance in Lleida, Spain. Enferm Infecc Microbiol Clin 2021; 40:S0213-005X(21)00041-0. [PMID: 33771406 DOI: 10.1016/j.eimc.2021.02.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 02/02/2021] [Accepted: 02/04/2021] [Indexed: 11/20/2022]
Affiliation(s)
- Alba Muñoz Santa
- Sección Microbiología Hospital Universitari Arnau de Vilanova, Lleida, Spain.
| | | | | | - Alba Bellés Bellés
- Sección Microbiología Hospital Universitari Arnau de Vilanova, Lleida, Spain
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Clinical evaluation of commercial PCR assays for antimicrobal resistance in Mycoplasma genitalium and estimation of resistance-mediated mutation prevalence in Moscow and Moscow region. Eur J Clin Microbiol Infect Dis 2021; 40:1413-1418. [PMID: 33515097 DOI: 10.1007/s10096-021-04170-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 01/19/2021] [Indexed: 10/22/2022]
Abstract
Mycoplasma genitalium is a widespread sexually transmitted infection (STI) with growing rate of antimicrobials resistance. In our study, 137 vaginal and 131 urethral M. genitalium-positive swabs were sequentially collected through the work of Reference Center for STI during 2019. For prevalence evaluation of macrolide-resistance mutations three commercially available kits were used: AmpliSens® M. genitalium-ML/FQ-Resist-FL (Central Research Institute of Epidemiology, Russia), ResistancePlus® MG (SpeeDx, Australia), and S-DiaMGRes™ (Diagenode, Belgium). Macrolide resistance mutations were detected in 16% (43 of 268) of samples. Diagnostic characteristics were evaluated against Sanger sequencing. For AmpliSens® M. genitalium-ML/FQ-Resist-FL specificity was shown to be 100% (CI 95%, 98.4-100), and sensitivity was 90.7% (CI 95%, 77.9-97.4). ResistancePlus® MG specificity was 100% (CI 95%, 98.3-100), and sensitivity was 92.1% (CI 95%, 78.6-98.3). S-DiaMGRes™ specificity was shown to be 88.6% (CI 95%, 83.9-92.4), and sensitivity was 100% (CI 95%, 84.4-100). Mutations of parC gene region were detected in 14.5% (38 of 268) using AmpliSens® M. genitalium-ML/FQ-Resist-FL with further validation by Sanger sequencing. Of studied samples, 6.3% (17 of 268) contained both antimicrobials of class resistance mutations. Prevalence of macrolide-resistant M. genitalium in Moscow was 21.7% (23 of 106) and of fluoroquinolone-resistant M. genitaliuim was 20.8% (22 of 106). In Moscow region, macrolide-resistant M. genitalium were 12.3% (20 of 162) and 9.9% (16 of 162) of fluoroquinolone-resistant M. genitalium. All three kits can be used both for epidemiological monitoring of M. genitalium presence and mutation prevalence estimation. In Moscow, macrolide- and fluoroquinolone-resistant mutant prevalence increased in 3.9 and 2.7 times in 3 years.
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Otero-Guerra L, Gil-Alonso L, López-de Munain J, Del Romero-Guerrero J, Serra-Pladevall J, Vazquez F. Survey of diagnostic resources for STI in Spain. Enferm Infecc Microbiol Clin 2020; 39:S0213-005X(20)30255-X. [PMID: 32826099 DOI: 10.1016/j.eimc.2020.06.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 06/20/2020] [Accepted: 06/23/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Scarce information is available on the resources to deal with the Sexually Transmitted Infections (STIs), both in the clinic and in the laboratory. The objective is to describe and know the reality of the clinics and laboratories that treat these infections in Spain. METHODS Cross-sectional observational study with data collection through a survey aimed at the members of the GEITS Group. RESULTS Responses were obtained from 24 centers (response rate 38.1%) belonging to 10Autonomous Communities. Regarding STI consultations, 38% require that the patient present a health card to provide assistance, and 31.8% only provide it by referral from another doctor. The 52.4% perform diagnostic methods in the care center. Regarding laboratories, 18.2% do not offer immediate response diagnostic tests, although 100% have PCR against Neisseria gonorrhoeae and Chlamydia trachomatis, 47.8% against Mycoplasma genitalium and 65% detect lymphogranuloma venereum genotypes. All laboratories continue to perform culture and gonococcal sensitivity techniques, and 20% perform molecular methods for detection of MG antimicrobial resistance. CONCLUSION There is great variability in the provision of human and material resources both in the clinics and in the laboratories that attend STIs. In a significant number of centers there are limitations for patient access. Although laboratories have molecular biology technologies, not all of them offer immediate response tests. All laboratories detect N.gonorrhoeae infection by PCR and also by culture, which allows sensitivity testing in all centers.
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Affiliation(s)
- Luis Otero-Guerra
- Servicio de Microbiología, Hospital Universitario de Cabueñes, Gijón, Asturias; Grupo de Microbiología Translacional, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA); Grupo de Estudio de Infecciones de Transmisión Sexual, GEITS, SEIMC, España.
| | - Leire Gil-Alonso
- Unidad de Enfermedades Infecciosas, Hospital Universitario Donostia, San Sebastián; Grupo de Estudio de Infecciones de Transmisión Sexual, GEITS, SEIMC, España
| | - Josefina López-de Munain
- Servicio de Enfermedades Infecciosas, Hospital Universitario Basurto (OSI Bilbao-Basurto, Osakidetza), Bilbao; Grupo de Estudio de Infecciones de Transmisión Sexual, GEITS, SEIMC, España
| | - Jorge Del Romero-Guerrero
- Centro Sanitario Sandoval, IdISSC, Hospital Clínico San Carlos, Madrid; Universidad Complutense de Madrid, Madrid; Grupo de Estudio de Infecciones de Transmisión Sexual, GEITS, SEIMC, España
| | - Judit Serra-Pladevall
- Servicio de Microbiología, Hospital Universitario Vall d'Hebron, Barcelona; Universidad Autónoma de Barcelona, Barcelona; Grupo de Estudio de Infecciones de Transmisión Sexual, GEITS, SEIMC, España
| | - Fernando Vazquez
- Servicio de Microbiología, Hospital Universitario Central de Asturias, Oviedo, Asturias; Área de Microbiología, Facultad de Medicina, Universidad de Oviedo; Grupo de Microbiología Translacional, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA); Instituto Universitario Fernández Vega (IUFV) y Fundación de Investigación Oftalmológica (FIO), Oviedo; Grupo de Estudio de Infecciones de Transmisión Sexual, GEITS, SEIMC, España
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Fernández-Huerta M, Salmerón P, Silgado A, Espasa M, Pumarola T, Tulsiani-Drud S, Barberá MJ, Hoyos-Mallecot Y, Serra-Pladevall J. Clinical evaluation of the ResistancePlus MG FleXible test on the GeneXpert Infinity-48s instrument: a near-patient assay for simultaneous detection of Mycoplasma genitalium and macrolide resistance. Diagn Microbiol Infect Dis 2020; 97:115062. [PMID: 32451118 DOI: 10.1016/j.diagmicrobio.2020.115062] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 04/11/2020] [Accepted: 04/11/2020] [Indexed: 11/28/2022]
Abstract
Antibiotic resistance in Mycoplasma genitalium (MG) is rising globally, especially to macrolides. In response to this challenge, assays reporting both the detection of MG and macrolide resistance-mediating mutations (MRMM) allow therapy to be tailored to the individual. The study evaluated the performance of the ResistancePlus® MG FleXible assay for the detection of MG and MRMM. Overall, the test performed well for the detection of MG compared to the AllplexTM STI Essential assay, used as a reference, with a kappa value of 0.926 (95% CI, 0.863-0.990). The kit also performed well for the detection of MRMM when compared with Sanger sequencing of the 23S rRNA gene, with a kappa value of 0.901 (95% CI, 0.807-0.996). The rate of MRMM in MG among the study population was 41.8%. In conclusion, the ResistancePlus® MG FleXible is a rapid, simple, and accurate cartridge-based assay for simultaneous detection of MG and MRMM in clinical settings.
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Affiliation(s)
- Miguel Fernández-Huerta
- Microbiology Department, Vall d´Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Paula Salmerón
- Microbiology Department, Vall d´Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Aroa Silgado
- Microbiology Department, Vall d´Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Mateu Espasa
- Microbiology Department, Parc Taulí University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Tomàs Pumarola
- Microbiology Department, Vall d´Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | - María-Jesús Barberá
- Sexually Transmitted Infections Unit Vall d´Hebron-Drassanes, Infectious Diseases Department, Vall d´Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Yannick Hoyos-Mallecot
- Microbiology Department, Vall d´Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Judit Serra-Pladevall
- Microbiology Department, Vall d´Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain.
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Single-Locus-Sequence-Based Typing of the mgpB Gene Reveals Transmission Dynamics in Mycoplasma genitalium. J Clin Microbiol 2020; 58:JCM.01886-19. [PMID: 31941694 DOI: 10.1128/jcm.01886-19] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 01/11/2020] [Indexed: 11/20/2022] Open
Abstract
Sexually transmitted infections (STIs) by Mycoplasma genitalium are a major problem worldwide, especially given their marked and rapid propensity for developing antimicrobial resistance. Since very few treatment options exist, clinicians face an important challenge in the management of the infection. In this scenario, little is known regarding the transmission dynamics of M. genitalium and the epidemiology of antimicrobial resistance. This mgpB-based molecular typing study, conducted among 54 asymptomatically infected individuals prospectively recruited from an STI screening service, reveals two distinct epidemiological clusters that significantly correlate with sexual conduct in heterosexuals and men who have sex with men (MSM), respectively. This well-defined structuration suggests the presence of two independent sexual networks with little connectivity between them. On the other hand, the study demonstrates the multiclonal feature of the emergence of antibiotic resistance in M. genitalium to both macrolides and fluoroquinolones. The high prevalence of macrolide resistance in M. genitalium among MSM, influenced by dense network connectivity and strong antibiotic selective pressure, may correspond to allodemics affecting other STIs such as gonorrhea, syphilis and enteric pathogens. Collaterally, the structural and functional impact of mutations in the mgpB gene, encoding the major adhesin P140 (MgpB), may require further investigation.
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