Hadad Ronza, Golparian Daniel, Lagos Amaya C, Ljungberg Johan, Nilsson Peter, Jensen Jörgen S, Fredlund Hans, Unemo Magnus
Department of Laboratory Medicine, Clinical Microbiology, Faculty of Medicine and Health, WHO Collaborating Centre for Gonorrhoea and other Sexually Transmitted Infections, National Reference Laboratory for Sexually Transmitted Infections, Örebro University, Örebro, Sweden.
Department of Infectious Diseases, Hospital of Halmstad, Halmstad, Sweden.
APMIS. 2018 Feb;126(2):123-127. doi: 10.1111/apm.12792. Epub 2017 Dec 13.
Mycoplasma genitalium, causing non-gonococcal non-chlamydial urethritis and associated with cervicitis, has developed antimicrobial resistance (AMR) to both the macrolide azithromycin (first-line treatment) and the fluoroquinolone moxifloxacin (second-line treatment). Our aim was to estimate the prevalence of resistance, based on genetic AMR determinants, to these antimicrobials in the M. genitalium population in two Swedish counties, Örebro and Halland, 2011-2015. In total, 672 M. genitalium positive urogenital samples were sequenced for 23S rRNA and parC gene mutations associated with macrolide and fluoroquinolone resistance, respectively. Of the samples, 18.6% and 3.2% in Örebro and 15.2% and 2.7% in Halland contained mutations associated with macrolide and fluoroquinolone resistance, respectively. The predominating resistance-associated mutations in the 23S rRNA gene was A2059G (n = 39) in Örebro and A2058G (n = 13) and A2059G (n = 13) in Halland. The most prevalent possible resistance-associated ParC amino acid alterations were S83I (n = 4) in Örebro and S83N (n = 2) in Halland. Resistance-associated mutations to both macrolides and fluoroquinolones were found in 0.7% of samples. Our findings emphasize the need for routine AMR testing, at a minimum for macrolide resistance, of all M. genitalium-positive samples and regular national and international surveillance of AMR in M. genitalium, to ensure effective patient management and rational antimicrobial use.
生殖支原体可引发非淋菌性非衣原体性尿道炎，并与宫颈炎相关，它已对大环内酯类阿奇霉素（一线治疗药物）和氟喹诺酮类莫西沙星（二线治疗药物）产生了抗菌耐药性。我们的目的是基于抗菌耐药性的基因决定因素，估算2011 - 2015年瑞典厄勒布鲁和哈兰两个郡生殖支原体群体中对这些抗菌药物的耐药率。总共对672份生殖支原体阳性泌尿生殖系统样本进行了测序，分别检测与大环内酯类和氟喹诺酮类耐药相关的23S rRNA和parC基因突变。在这些样本中，厄勒布鲁郡分别有18.6%和3.2%的样本含有与大环内酯类和氟喹诺酮类耐药相关的突变，哈兰郡则分别为15.2%和2.7%。23S rRNA基因中主要的耐药相关突变在厄勒布鲁郡是A2059G（n = 39），在哈兰郡是A2058G（n = 13）和A2059G（n = 13）。最常见的可能与耐药相关的ParC氨基酸改变在厄勒布鲁郡是S83I（n = 4），在哈兰郡是S83N（n = 2）。在0.7%的样本中发现了对大环内酯类和氟喹诺酮类均耐药的相关突变。我们的研究结果强调，对于所有生殖支原体阳性样本，至少应常规检测大环内酯类耐药情况，并定期进行全国和国际范围内生殖支原体抗菌耐药性监测，以确保有效的患者管理和合理使用抗菌药物。
