Sexually Transmitted Infections Section, Centre for HIV and Sexually Transmitted Infections, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa.
Western Sydney Sexual Health Centre, Western Sydney Local Health District, Parramatta, Australia.
BMC Infect Dis. 2019 Feb 13;19(1):148. doi: 10.1186/s12879-019-3797-6.
Antimicrobial resistance in Mycoplasma genitalium is rising globally with resultant clinical treatment failure. We investigated the prevalence of mutations in the macrolide and fluoroquinolone resistance-determining regions of M. genitalium in Johannesburg, South Africa, and ascertained their association with HIV serostatus.
Stored M. genitalium positive specimens, collected from STI and HIV patients enrolled in the Gauteng STI National Microbiological Surveillance programme (2007-2014) and a large HIV outpatient clinic-based study (2007) in Johannesburg, were tested for antimicrobial resistance.
We determined the prevalence of 23S rRNA gene mutations conferring macrolide resistance and mutations in the quinolone resistance-determining regions (QRDR) of the gyrA and parC genes in 266 M. genitalium positive DNA extracts. No macrolide resistance-associated mutations were detected in any of the specimens analysed. QRDR mutations with known M. genitalium-associated fluoroquinolone resistance were not detected in gyrA, however, one specimen (0.4%) contained a D87Y amino acid alteration in parC, which has been linked to fluoroquinolone treatment failure. The most common parC amino acid change detected, of unknown clinical significance, was P62S (18.8%). We found no significant association between QRDR mutations in M. genitalium and HIV-infection.
Ongoing antimicrobial resistance surveillance in M. genitalium is essential, as macrolide resistance may emerge given the recent incorporation of azithromycin into the 2015 South African national STI syndromic management guidelines.
全球范围内，生殖支原体的抗生素耐药性正在上升，导致临床治疗失败。我们调查了南非约翰内斯堡生殖支原体大环内酯类和氟喹诺酮类耐药决定区突变的流行情况，并确定了它们与 HIV 血清阳性状态的关系。
我们对从参加豪登省性传播感染国家微生物监测计划（2007-2014 年）和约翰内斯堡一个大型艾滋病门诊为基础的研究（2007 年）的性传播感染和艾滋病毒患者中收集的储存的生殖支原体阳性标本进行了抗生素耐药性检测。
我们确定了 266 份生殖支原体阳性 DNA 提取物中 23S rRNA 基因突变导致大环内酯类耐药的情况以及喹诺酮耐药决定区（QRDR）中 gyrA 和 parC 基因的突变。在所分析的标本中均未发现与大环内酯类相关的耐药相关突变。在 gyrA 中未发现与已知生殖支原体相关的氟喹诺酮耐药相关的 QRDR 突变，但有一个标本（0.4%）含有 parC 中的 D87Y 氨基酸改变，这与氟喹诺酮治疗失败有关。检测到的最常见的 parC 氨基酸改变，其临床意义未知，为 P62S（18.8%）。我们没有发现生殖支原体 QRDR 突变与 HIV 感染之间存在显著关联。
鉴于阿奇霉素最近被纳入 2015 年南非国家性传播感染综合管理指南，对生殖支原体的抗生素耐药性进行持续监测至关重要。
