Rivaya Belén, Le Roy Chloé, Jordana-Lluch Elena, Fernández-Rivas Gema, Casañ Cristina, González Victoria, Wang-Wang Jun Hao, Bébéar Cécile, Matas Lurdes, Pereyre Sabine
Microbiology Department, Laboratori Clinic Metropolitana Nord, Hospital Universitari Germans Trias i Pujol, Ctra. Del Canyet, S/N, 08916 Badalona, Spain.
Department of Genetics and Microbiology, Universitat Autònoma de Barcelona, 08193 Cerdanyola del Vallès, Spain.
Antibiotics (Basel). 2022 Apr 5;11(4):485. doi: 10.3390/antibiotics11040485.
Macrolide and fluoroquinolone resistance (MLr/FQr) in (MG) infections is concerning worldwide. Current guidelines recommend performing MLr detection in MG-positive cases to adjust antimicrobial therapy. We aimed to evaluate the usefulness of PCR followed by pyrosequencing for MLr detection in comparison with a one-step commercial assay and to assess the prevalence of MLr and FQr in Badalona, Spain. A total of 415 MG-positive samples by Allplex STI-7 (Seegene) were analyzed for MLr detection by pyrosequencing. From those, 179 samples were further analyzed for MG and MLr by ResistancePlus MG kit (SpeeDx) and 100 of them also for fluoroquinolone resistance (FQr) by sequencing the gene. Regarding MG detection, Allplex and Resistance Plus showed an overall agreement of 87%, but this value rose to 95.4% if we compare them for MLr detection. Prevalence of MLr was 23.1% in Badalona, but this rate increased to 73.7% in the HIV-positive patients cohort. FQr detection showed 3% of resistant strains. Pyrosequencing is a convenient and cheap technique for MLr detection, but one-step tools should be considered in high-throughput laboratories. Despite the fact that MLr remained moderate and FQr was low in our study, simultaneous MG and MLr detection would improve patient's management applying resistance-guided treatment strategies.
支原体（MG）感染中的大环内酯类和氟喹诺酮类耐药性（MLr/FQr）在全球范围内都令人担忧。当前指南建议在MG阳性病例中进行MLr检测以调整抗菌治疗。我们旨在评估聚合酶链反应（PCR）后焦磷酸测序法在MLr检测中的实用性，并与一步法商业检测进行比较，同时评估西班牙巴达洛纳市MLr和FQr的流行情况。通过Allplex STI-7（Seegene）检测出的415份MG阳性样本采用焦磷酸测序法进行MLr检测分析。其中，179份样本进一步采用ResistancePlus MG试剂盒（SpeeDx）进行MG和MLr分析，其中100份样本还通过对 基因测序进行氟喹诺酮耐药性（FQr）分析。关于MG检测，Allplex和Resistance Plus的总体一致性为87%，但如果比较它们的MLr检测结果，这一数值升至95.4%。巴达洛纳市MLr的流行率为23.1%，但在HIV阳性患者队列中这一比率增至73.7%。FQr检测显示耐药菌株占3%。焦磷酸测序法是一种用于MLr检测的便捷且廉价的技术，但在高通量实验室中应考虑使用一步法工具。尽管在我们的研究中MLr仍然处于中等水平且FQr较低，但同时进行MG和MLr检测将通过耐药性指导治疗策略改善患者管理。
