大环内酯类和氟喹诺酮类相关突变在 2016-2018 年中国广州性传播感染诊所就诊的男性和女性患者的生殖支原体中的回顾性研究。
Macrolide and fluoroquinolone associated mutations in Mycoplasma genitalium in a retrospective study of male and female patients seeking care at a STI Clinic in Guangzhou, China, 2016-2018.
机构信息
Department of Sexually Transmitted Diseases, Dermatology Hospital, Southern Medical University, Guangzhou, 510095, China.
Department of Sexually Transmitted Diseases, Guangdong Provincial Dermatology Hospital, Guangzhou, 510095, China.
出版信息
BMC Infect Dis. 2020 Dec 11;20(1):950. doi: 10.1186/s12879-020-05659-3.
BACKGROUND
Antimicrobial resistance in M. genitalium is a growing clinical problem. We investigated the mutations associated with macrolide and fluoroquinolone resistance, two commonly used medical regimens for treatment in China. Our aim is to analyze the prevalence and diversity of mutations among M. genitalium-positive clinical specimens in Guangzhou, south China.
METHODS
A total of 154 stored M. genitalium positive specimens from men and women attending a STI clinic were tested for macrolide and fluoroquinolone mutations. M. genitalium was detected via TaqMan MGB real-time PCR. Mutations associated with macrolide resistance were detected using primers targeting region V of the 23S rRNA gene. Fluoroquinolone resistant mutations were screened via primers targeting topoisomerase IV (parC) and DNA gyrase (gyrA).
RESULTS
98.7% (152/154), 95.5% (147/154) and 90.3% (139/154) of M. genitalium positive samples produced sufficient amplicon for detecting resistance mutations in 23S rRNA, gyrA and parC genes, respectively. 66.4% (101/152), 0.7% (1/147) and 77.7% (108/139) samples manifested mutations in 23S rRNA, gyrA and parC genes, respectively. A2072G (59/101, 58.4%) and S83I (79/108, 73.1%) were highly predominating in 23S rRNA and parC genes, respectively. Two samples had amino acid substitutions in gyrA (M95I and A96T, respectively). Two samples had two amino acid substitutions in parC (S83I + D87Y). 48.6% (67/138) of samples harbored both macrolide and fluoroquinolone resistance-associated mutations. The most common combination of mutations was A2072G (23S rRNA) and S83I (parC) (40/67, 59.7%). One sample had three amino acid changes in 23S rRNA, gyrA and parC genes (A2072G + A96T + S83I).
CONCLUSIONS
The high antimicrobial resistance rate of M. genitalium in Guangzhou is a very worrying problem and suggests that antimicrobial resistance testing and the development of new antibiotic regimens are crucially needed.
背景
生殖器支原体的耐药性是一个日益严重的临床问题。我们研究了与大环内酯类和氟喹诺酮类耐药相关的突变，这两种药物在中国常用于治疗。我们的目的是分析中国南方广州的生殖器支原体阳性临床标本中突变的流行和多样性。
方法
对 154 份来自性传播感染门诊就诊的男性和女性的储存的生殖器支原体阳性标本进行了大环内酯类和氟喹诺酮类耐药突变检测。采用 TaqMan MGB 实时 PCR 检测生殖器支原体。用靶向 23S rRNA 基因 V 区的引物检测与大环内酯类耐药相关的突变。通过靶向拓扑异构酶 IV(parC)和 DNA 回旋酶(gyrA)的引物筛选氟喹诺酮耐药突变。
结果
98.7%（152/154）、95.5%（147/154）和 90.3%（139/154）的生殖器支原体阳性样本分别足以检测 23S rRNA、gyrA 和 parC 基因中的耐药突变。23S rRNA、gyrA 和 parC 基因中分别有 66.4%（101/152）、0.7%（1/147）和 77.7%（108/139）的样本显示出突变。A2072G（59/101，58.4%）和 S83I（79/108，73.1%）在 23S rRNA 和 parC 基因中占主导地位。两个样本的 gyrA 中氨基酸取代（M95I 和 A96T，分别）。两个样本的 parC 中有两个氨基酸取代（S83I+D87Y）。48.6%（67/138）的样本携带大环内酯类和氟喹诺酮类耐药相关突变。最常见的突变组合是 A2072G（23S rRNA）和 S83I（parC）（40/67，59.7%）。一个样本的 23S rRNA、gyrA 和 parC 基因有三个氨基酸变化（A2072G+A96T+S83I）。
结论
广州生殖器支原体的高抗菌药物耐药率是一个非常令人担忧的问题，这表明迫切需要进行抗菌药物耐药性检测和新抗生素方案的开发。
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