Evolving patterns of macrolide and fluoroquinolone resistance in Mycoplasma genitalium: an updated global systematic review and meta-analysisResearch Unit for Reproductive Microbiology, Statens Serum Institut, Copenhagen, Denmark.
Melbourne Sexual Health Centre, Alfred Health, Carlton Vic, Australia; Central Clinical School, Monash University, Melbourne Vic, Australia; Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Parkville Vic, Australia.
Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
The University of Queensland Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane Qld, Australia; Pathology Queensland Central Laboratory, Brisbane Qld, Australia.
The University of Queensland Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane Qld, Australia.
Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Parkville Vic, Australia.
Centre for Women’s Infectious Diseases, The Royal Women’s Hospital, Parkville Vic, Australia; Molecular Microbiology Research Group, Murdoch Children’s Research Institute, Parkville Vic, Australia.
Department of Obstetrics, Gynaecology and Newborn Health, University of Melbourne, Parkville Vic, Australia; Centre for Women’s Infectious Diseases, The Royal Women’s Hospital, Parkville Vic, Australia; Molecular Microbiology Research Group, Murdoch Children’s Research Institute, Parkville Vic, Australia.
Melbourne Sexual Health Centre, Alfred Health, Carlton Vic, Australia; Central Clinical School, Monash University, Melbourne Vic, Australia.
Melbourne Sexual Health Centre, Alfred Health, Carlton Vic, Australia; Central Clinical School, Monash University, Melbourne Vic, Australia; China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, China; Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, China; Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China.
Melbourne Sexual Health Centre, Alfred Health, Carlton Vic, Australia; Central Clinical School, Monash University, Melbourne Vic, Australia; Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Parkville Vic, Australia.
Centre for Women’s Infectious Diseases, The Royal Women’s Hospital, Parkville Vic, Australia; The Kirby Institute, University of New South Wales, Sydney NSW, Australia.
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2024 (Engelska)Ingår i: Sexual Health, ISSN 1448-5028, E-ISSN 1449-8987, Vol. 21, nr 4, s. 70-70, artikel-id 124Artikel i tidskrift, Meeting abstract (Övrigt vetenskapligt) Published
Abstract [en]
Background: Previous analysis found global macrolide, fluoroquinolone, and dual-class resistance in M. genitalium increased over time, reaching 51.4%, 9.3%, and 4.0%, respectively in 2016–2017; prevalence was highest in the Western-Pacific region. Contemporary estimates of antimicrobial resistance in M. genitalium are needed to inform treatment guidelines.
Methods: PubMed, Embase, and MEDLINE were searched between 1 January 2019 and 18 April 2023 for studies reporting macrolide and fluoroquinolone resistance-associated mutations in M. genitalium. Data were extracted by year of collection and geographic region. The frequency of each ParC amino acid changes (S83I/R/C/N and D87N/Y) were also extracted. Pooled prevalence estimates (95% confidence intervals [CI]) were calculated using random-effects models.
Results: Overall, 166 studies (107 from the updated search period) were included. In 2018–21, the global prevalence of macrolide, fluoroquinolone, and dual-class resistance was 33.3% (95% CI 27.2–39.7), 13.3% (10.0–17.0), and 6.5% (4.0–9.4), respectively. Over time, macrolide resistance plateaued in the Western Pacific and the Americas but rose in the European region. Fluoroquinolone resistance was highest in the Western Pacific and increased in the European non-Nordic region. ParC S83I was the most common variant associated with fluoroquinolone resistance, increasing from 0.0% (0.0–0.30) before 2012 to 7.3% (4.7–10.3) in 2018–21; Ptrend = 0.055).
Conclusion: Macrolide resistance levels appear to be stabilising in some regions, which could be due to the reduction in use of single-dose azithromycin as first-line therapy and increase in the use of resistance-guided therapy for M. genitalium. The continuing rise in prevalence of fluoroquinolone and dual-class resistance mutations highlights the urgent need for new treatment strategies including diagnostic assays that detect fluoroquinolone resistance markers. The steady increase in the ParC S83I change supports emerging evidence of its role in fluoroquinolone treatment failure, making this mutation a target for next-generation resistance-guided therapy assays.
Ort, förlag, år, upplaga, sidor
CSIRO Publishing, 2024. Vol. 21, nr 4, s. 70-70, artikel-id 124
Nationell ämneskategori
Infektionsmedicin
Identifikatorer
URN: urn:nbn:se:oru:diva-119162ISI: 001388851800125OAI: oai:DiVA.org:oru-119162DiVA, id: diva2:1936568
Konferens
25th IUSTI World Congress incorporating the Australasian Sexual and Reproductive Health Conference, Sydney, Australia, September 17-20, 2024
Anmärkning
This work was supported by the Australian Research Council.
2025-02-112025-02-112025-02-11Bibliografiskt granskad