Mondeja Brian A, Rodríguez Nadia M, Barroto Brenda, Blanco Orestes, Jensen Jørgen S
Pedro Kourí Tropical Medicine Institute, La Habana, Cuba.
Biology Faculty, University of Havana, La Habana, Cuba.
PLoS One. 2016 Sep 28;11(9):e0162924. doi: 10.1371/journal.pone.0162924. eCollection 2016.
Isolation of Mycoplasma genitalium from clinical specimens remains difficult and few strains are available for antimicrobial susceptibility testing. We describe the antimicrobial susceptibility of M. genitalium strains grown in Vero cell culture with first- and second- line antibiotics, using a modified cell-culture-based method. Macrolide- and -fluoroquinolone resistance determinants were detected by sequencing of the 23S and parC genes, respectively. Seven strains were examined, including three new, genetically distinct M. genitalium strains isolated from endocervical and urethral swab specimens from Cuban patients together with four reference strains isolated from specimens collected from men in Denmark, Sweden and Australia. Azithromycin was the most active drug against two of the Cuban M. genitalium strains with MICs values of 0.008 mg/liter, however, one strain was macrolide resistant with an MIC of >8 mg/liter, and the A2059G resistant genotype. Ciprofloxacin was the least active antimicrobial drug and moxifloxacin was the most active fluoroquinolone against the new clinical strains, although an MIC of 1 mg/l was found for two strains. However, no relevant parC mutations were detected. MICs for tetracyclines were 0.5-4 mg/liter. Although the number of Cuban strains was low, the results suggest that a single-dose azithromycin treatment could be ineffective, and that a second-line treatment with moxifloxacin, should become an option in Cuba. To our knowledge, this is the first report of isolation and antibiotic susceptibility testing of M. genitalium strains from the Latin-American region, and the first detection of macrolide resistance in such strains.
从临床标本中分离生殖支原体仍然困难，可供进行抗菌药敏试验的菌株很少。我们使用改良的基于细胞培养的方法，描述了在Vero细胞培养物中生长的生殖支原体菌株对一线和二线抗生素的药敏情况。分别通过对23S和parC基因进行测序来检测大环内酯类和氟喹诺酮类耐药决定簇。共检测了7株菌株，包括从古巴患者的宫颈和尿道拭子标本中分离出的3株新的、基因不同的生殖支原体菌株，以及从丹麦、瑞典和澳大利亚男性标本中分离出的4株参考菌株。阿奇霉素对其中两株古巴生殖支原体菌株活性最强，MIC值为0.008毫克/升，然而，有一株菌株对大环内酯耐药，MIC>8毫克/升，且具有A2059G耐药基因型。环丙沙星是活性最低的抗菌药物，莫西沙星是对新临床菌株活性最强的氟喹诺酮类药物，不过有两株菌株的MIC为1毫克/升。然而，未检测到相关的parC突变。四环素类的MIC为0.5 - 4毫克/升。尽管古巴菌株数量较少，但结果表明单剂量阿奇霉素治疗可能无效，在古巴莫西沙星二线治疗应成为一种选择。据我们所知，这是拉丁美洲地区生殖支原体菌株分离及抗生素药敏试验的首次报告，也是此类菌株中首次检测到大环内酯耐药。
