Mycoplasma genitalium in Symptomatic Male Urethritis: Macrolide Use Is Associated With Increased Resistance.

Autor:	Li Y; Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing.; Affiliated Qingdao Municipal Hospital of Qingdao University, China., Su X; Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing., Le W; Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing., Li S; Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing., Yang Z; Biostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health., Chaisson C; Biostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health., Madico G; National Emerging Infectious Diseases Laboratories, Boston University., Gong X; Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing., Reed GW; Department of Medicine, Division of Infectious Diseases and Immunology, University of Massachusetts Medical School, Worcester.; Corrona Research Foundation, Albany, New York., Wang B; Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing.; Department of Dermatology, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China., Rice PA; Department of Medicine, Division of Infectious Diseases and Immunology, University of Massachusetts Medical School, Worcester.
Jazyk:	angličtina
Zdroj:	Clinical infectious diseases : an official publication of the Infectious Diseases Society of America [Clin Infect Dis] 2020 Feb 14; Vol. 70 (5), pp. 805-810.
DOI:	10.1093/cid/ciz294
Abstrakt:	Background: Mycoplasma genitalium (MG) causes symptomatic urethritis in men, and can infect alone or together with other sexually transmitted infection (STI) agents. Methods: The prevalence of MG and other STIs was determined in 1816 men with symptomatic urethritis. Resistance of MG to macrolides and fluoroquinolones was determined by sequencing; the impact of recent antimicrobial usage on the distribution of MG single or mixed infections was determined. Results: Overall, prevalence of MG infection was 19.7% (358/1816). Fifty-four percent (166/307) of MG infections occurred alone in the absence of other STI agents. Men with single MG infection self-administered or were prescribed antibiotics more often in the 30 days prior to enrollment than subjects with urethritis caused by MG coinfection (P < .0001). Higher rates (96.7%) of infection with macrolide resistance in MG were identified in men who had taken macrolides prior to enrollment (P < .03). Overall, 88.9% (303/341) of 23S ribosomal RNA (rRNA) genes contained mutations responsible for macrolide resistance; 89.5% (308/344) of parC and 12.4% (42/339) of gyrA genes had mutations responsible for fluoroquinolone resistance. Approximately 88% (270/308) of MG had combined mutations in 23S rRNA and parC genes; 10.4% (32/308) had mutations in all 3 genes. Conclusions: MG was the single pathogen identified in 11% of men with symptomatic urethritis. Overall, nearly 90% of MG infections were resistant to macrolides and fluoroquinolones. Men who took macrolides in the 30 days prior to enrollment had higher rates (97%) of macrolide-resistant MG. Resistance was associated with numerous mutations in 23SrRNA, parC, and gyrA genes. (© The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
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