Univ. Bordeaux, Unité Sous Contrat Mycoplasmal and Chlamydial Infections in Humans, Bordeaux, France.
J Antimicrob Chemother. 2012 Nov;67(11):2598-601. doi: 10.1093/jac/dks263. Epub 2012 Jul 6.
Mycoplasma genitalium is a sexually transmitted organism associated with non-gonococcal urethritis in men and several inflammatory reproductive tract syndromes in women. Resistance to macrolides has been recently associated with point mutations in the 23S rRNA gene. The aim of this study was to detect these mutations using a large French collection of M. genitalium-positive specimens. We evaluated whether these mutations were related to azithromycin treatment failure and whether macrolide-resistant M. genitalium may be spreading.
A retrospective study conducted in France between 2003 and 2010 included 156 urogenital clinical specimens from 136 patients that were positive for M. genitalium. Mutations in domain V of M. genitalium 23S rRNA were detected using amplification and sequencing. The mutated strains were genotyped by studying single nucleotide polymorphisms in the mgpB gene.
We have detected macrolide resistance-associated mutations in M. genitalium since 2006 at a rate of 13.2%, ranging from 10% to 15.4% of patients per year. Nine mutations at position 2059 as well as two A2058G substitutions, one A2062T substitution and one C2038T substitution (Escherichia coli numbering) were identified in M. genitalium. These patients had treatment failure with azithromycin in 75% (6/8) of cases. For one patient, genotyping showed selection for the mutation during treatment with azithromycin.
For the first time, we describe macrolide resistance for M. genitalium in France and demonstrate that its detection has increased since 2006. Epidemiological surveillance of M. genitalium is necessary to adapt treatments to M. genitalium infections.
生殖支原体是一种性传播病原体，与男性非淋球菌性尿道炎以及女性几种炎症性生殖道综合征有关。最近发现，23S rRNA 基因的点突变与大环内酯类耐药有关。本研究的目的是使用大量法国生殖支原体阳性标本检测这些突变。我们评估了这些突变是否与阿奇霉素治疗失败有关，以及是否存在传播性的耐大环内酯类生殖支原体。
这是一项 2003 年至 2010 年在法国进行的回顾性研究，共纳入了 136 名泌尿生殖标本阳性的患者的 156 份泌尿生殖标本。使用扩增和测序检测生殖支原体 23S rRNA 结构域 V 的突变。通过研究 mgpB 基因中的单核苷酸多态性来对突变株进行基因分型。
自 2006 年以来，我们检测到生殖支原体的大环内酯类耐药相关突变，每年患者的耐药率为 10%-15.4%，高达 13.2%。在生殖支原体中发现了 2059 位的 9 种突变以及 2 种 A2058G 取代、1 种 A2062T 取代和 1 种 C2038T 取代（大肠杆菌编号）。在 75%（6/8）的病例中，这些患者的阿奇霉素治疗失败。对于 1 名患者，基因分型显示在阿奇霉素治疗期间选择了突变。
这是首次在法国描述生殖支原体的大环内酯类耐药，并表明自 2006 年以来其检出率有所增加。有必要对生殖支原体进行流行病学监测，以调整针对生殖支原体感染的治疗方案。
