Microbiology Department, Instituto de Investigación Ibs.Granada, Hospital Universitario San Cecilio, Granada, Spain.
Dermatology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain.
Sex Transm Infect. 2021 Feb;97(1):8-10. doi: 10.1136/sextrans-2019-054386. Epub 2020 Jul 13.
In recent years, resistance in (MG) to first-line (azithromycin) and second-line (moxifloxacin) treatment has been increasingly reported worldwide, however, no data regarding the south of Spain are available.
To determine resistance rates, MG-positive samples collected from June 2018 to June 2019 were analysed by sequencing the 23S rRNA and parC genes.
A total of 77 patients (24 men having sex with men (MSM), 30 heterosexual men and 23 women) were included. Resistance-associated mutations against macrolide and fluoroquinolones were found in 36.4% (95% CI 25.7% to 48.1%) and 9.1% (95% CI 3.7% to 17.8%) of the patients, respectively. Being MSM and having had another STI in the last year were significantly associated with macrolide-resistant MG infection, while no associations were found with resistance to fluoroquinolones.
Testing for resistance to first-line and second-line drugs against MG should be recommended for the general population and mandatory for the MSM population. We suggest that empiric azithromycin use for STI management should be avoided.
近年来，全球范围内越来越多地报道了 （MG）对一线（阿奇霉素）和二线（莫西沙星）治疗的耐药性，但西班牙南部尚无相关数据。
通过对 23S rRNA 和 parC 基因进行测序，分析了 2018 年 6 月至 2019 年 6 月期间收集的 MG 阳性样本，以确定耐药率。
共纳入 77 例患者（24 例男男性行为者（MSM）、30 例异性恋男性和 23 例女性）。分别有 36.4%（95%可信区间 25.7%至 48.1%）和 9.1%（95%可信区间 3.7%至 17.8%）的患者存在对抗大环内酯类和氟喹诺酮类药物的耐药相关突变。MSM 以及在过去一年中患有其他性传播感染（STI）与大环内酯类耐药 MG 感染显著相关，而与氟喹诺酮类耐药性无关。
应建议对普通人群和 MSM 人群进行针对 MG 的一线和二线药物耐药性检测。我们建议避免将经验性阿奇霉素用于 STI 管理。
