俄罗斯和爱沙尼亚五个城市生殖支原体中大环内酯类和氟喹诺酮类耐药介导突变的流行情况。
Prevalence of macrolide and fluoroquinolone resistance-mediating mutations in Mycoplasma genitalium in five cities in Russia and Estonia.
作者信息
Shipitsyna Elena, Rumyantseva Tatiana, Golparian Daniel, Khayrullina Guzel, Lagos Amaya C, Edelstein Inna, Joers Kai, Jensen Jörgen S, Savicheva Alevtina, Rudneva Natalia, Sukhanova Larisa, Kozlov Roman, Guschin Alexander, Unemo Magnus
机构信息
Laboratory of Microbiology, D.O. Ott Research Institute of Obstetrics, Gynaecology and Reproductology, St. Petersburg, Russia.
WHO Collaborating Centre for Gonorrhoea and Other STIs, Department of Laboratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
出版信息
PLoS One. 2017 Apr 13;12(4):e0175763. doi: 10.1371/journal.pone.0175763. eCollection 2017.
BACKGROUND AND OBJECTIVE
Resistance in the sexually transmitted bacterium Mycoplasma genitalium to all recommended therapeutic antimicrobials have rapidly emerged. However, to date, internationally reported resistance surveillance data for M. genitalium strains circulating in Eastern Europe are entirely lacking. The aim of this study was to estimate the prevalence of macrolide and fluoroquinolone resistance-associated mutations in M. genitalium in four cities in Russia and one in Estonia, 2013-2016.
MATERIALS AND METHODS
Consecutive urogenital samples found positive for M. genitalium during diagnostic testing were retrospectively analyzed for resistance-associated mutations in the 23S rRNA and parC genes using pyrosequencing and conventional Sanger sequencing, respectively.
RESULTS
In total, 867 M. genitalium positive samples from 2013-2016 were analyzed. Macrolide resistance-associated mutations were detected in 4.6% of the samples from Russia (0.7-6.8% in different cities) and in 10% of the samples from Estonia. The mutations A2059G and A2058G were highly predominating in both Russia and Estonia, accounting together for 90.9% of the cases positive for nucleotide substitutions in the 23S rRNA gene. The rates of possible fluoroquinolone resistance-associated mutations were 6.2% in Russia (2.5-7.6% in different cities) and 5% in Estonia. The mutations S83I and S83N were the most frequent ones in Russia (24.4% each), whereas D87N highly predominated in Estonia (83.3% of all fluoroquinolone resistance-associated mutations). Approximately 1% of the samples in both countries harbored both macrolide and possible fluoroquinolone resistance-associated mutations, with A2058G and S83I being the most frequent combination (37.5%).
CONCLUSIONS
The prevalence of macrolide and fluoroquinolone resistance-associated mutations in M. genitalium was 4.6% and 6.2%, respectively, in Russia, and 10% and 5%, respectively, in Estonia. Despite the relatively low rates of macrolide and fluoroquinolone resistance in these countries, antimicrobial resistance surveillance and testing for resistance-associated mutations in M. genitalium positive cases would be valuable.
背景与目的
性传播细菌生殖支原体对所有推荐的治疗性抗菌药物的耐药性迅速出现。然而，迄今为止，完全缺乏关于在东欧传播的生殖支原体菌株的国际报告耐药监测数据。本研究的目的是估计2013 - 2016年俄罗斯四个城市和爱沙尼亚一个城市中生殖支原体中与大环内酯类和氟喹诺酮类耐药相关突变的流行率。
材料与方法
对诊断检测中发现的生殖支原体呈阳性的连续泌尿生殖系统样本进行回顾性分析，分别使用焦磷酸测序和传统桑格测序法检测23S rRNA和parC基因中的耐药相关突变。
结果
总共分析了2013 - 2016年的867份生殖支原体阳性样本。在俄罗斯的样本中，4.6%检测到与大环内酯类耐药相关的突变（不同城市为0.7 - 6.8%），在爱沙尼亚的样本中这一比例为10%。A2059G和A2058G突变在俄罗斯和爱沙尼亚都占主导地位，在23S rRNA基因中核苷酸替换阳性病例中合计占90.9%。俄罗斯可能与氟喹诺酮类耐药相关的突变率为6.2%（不同城市为2.5 - 7.6%），爱沙尼亚为5%。S83I和S83N突变在俄罗斯最为常见（各占24.4%），而D87N在爱沙尼亚占主导地位（在所有与氟喹诺酮类耐药相关的突变中占83.3%）。两国约1%的样本同时携带与大环内酯类和可能的氟喹诺酮类耐药相关的突变，其中A2058G和S83I是最常见的组合（37.5%）。
结论
俄罗斯生殖支原体中与大环内酯类和氟喹诺酮类耐药相关突变的流行率分别为4.6%和6.2%，爱沙尼亚分别为10%和5%。尽管这些国家大环内酯类和氟喹诺酮类耐药率相对较低，但对生殖支原体阳性病例进行抗菌药物耐药监测和耐药相关突变检测将很有价值。
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