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Antimicrobial resistance in Mycoplasma genitalium sampled from the British general population
National Infection Service, Public Health England, London, United Kingdom.
Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. WHO Collaborating Centre for Gonorrhoea and Other STIs, National Reference Laboratory for STIs, Department of Laboratory Medicine, Microbiology.ORCID-id: 0000-0003-1710-2081
Centre for Population Research in Sexual Health and HIV, Institute for Global Health, UCL, London, United Kingdom.
National Infection Service, Public Health England, London, United Kingdom.
Visa övriga samt affilieringar
2020 (Engelska)Ingår i: Sexually Transmitted Infections, ISSN 1368-4973, E-ISSN 1472-3263, Vol. 96, nr 6, s. 464-468Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Background: Mycoplasma genitaliumis a common sexually transmitted infection. Treatment guidelines focus on those with symptoms and sexual contacts, generally with regimens including doxycycline and/or azithromycin as first-line and moxifloxacin as second-line treatment. We investigated the prevalence of antimicrobial resistance (AMR)-conferring mutations inM. genitaliumamong the sexually-active British general population.

Methods: The third national survey of sexual attitudes and lifestyles (Natsal-3) is a probability sample survey of 15 162 men and women aged 16-74 years in Britain conducted during 2010-12. Urine test results forM. genitaliumwere available for 4507 participants aged 16-44 years reporting>1 lifetime sexual partner. In this study, we sequenced regions of the 23S rRNA andparCgenes to detect known genotypic determinants for resistance to macrolides and fluoroquinolones respectively.

Results: 94% (66/70) of specimens were re-confirmed asM. genitaliumpositive, with successful sequencing in 85% (56/66) for 23S rRNA and 92% (61/66) forparCgenes. Mutations in 23S rRNA gene (position A2058/A2059) were detected in 16.1% (95%CI: 8.6% to 27.8%) and inparC(encodingParCD87N/D87Y) in 3.3% (0.9%-11.2%). Macrolide resistance was more likely in participants reporting STI diagnoses (past 5 years) (44.4% (18.9%-73.3%) vs 10.6% (4.6%-22.6%); p=0.029) or sexual health clinic attendance (past year) (43.8% (23.1%-66.8%) vs 5.0% (1.4%-16.5%); p=0.001). All 11 participants with AMR-conferring mutations had attended sexual health clinics (past 5 years), but none reported recent symptoms.

Conclusions: This study highlights challenges inM. genitaliummanagement and control. Macrolide resistance was present in one in six specimens from the general population in 2010-2012, but no participants with AMRM. genitaliumreported symptoms. Given anticipated increases in diagnostic testing, new strategies including novel antimicrobials, AMR-guided therapy, and surveillance of AMR and treatment failure are recommended.

Ort, förlag, år, upplaga, sidor
BMJ Publishing Group Ltd, 2020. Vol. 96, nr 6, s. 464-468
Nyckelord [en]
Mycoplasma genitalium, antibiotic resistance, molecular epidemiology, mycoplasma, public health
Nationell ämneskategori
Infektionsmedicin
Identifikatorer
URN: urn:nbn:se:oru:diva-78962DOI: 10.1136/sextrans-2019-054129ISI: 000566988500017PubMedID: 31924741Scopus ID: 2-s2.0-85087943534OAI: oai:DiVA.org:oru-78962DiVA, id: diva2:1385566
Forskningsfinansiär
Wellcome trust
Anmärkning

Funding Agencies:

Medical Research Council UK (MRC) G0701757

Economic & Social Research Council (ESRC)

Department of Health 

Tillgänglig från: 2020-01-14 Skapad: 2020-01-14 Senast uppdaterad: 2020-12-01Bibliografiskt granskad

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