UK Health Security Agency, 61 Colindale Avenue, London, NW9 5EQ, UK.
Statens Serum Institut, Copenhagen, Denmark.
J Antimicrob Chemother. 2022 Oct 28;77(11):2901-2907. doi: 10.1093/jac/dkac281.
The sexually transmitted bacterial pathogen Mycoplasma genitalium has proved a complex organism to work with in the laboratory setting. Exhibiting an extremely fastidious nature, successful in vitro propagation of M. genitalium has remained elusive for many researchers. Antimicrobial resistance to both first- and second-line recommended therapies (macrolides and fluoroquinolones, respectively) is commonly reported. However, phenotypic susceptibility testing is not routinely performed, due to the difficulties of in vitro growth. Instead, molecular detection of known resistance determinants is used to infer susceptibility/resistance. However, associations between determinant detection and clinical treatment failure are not always clear. Furthermore, molecular assays have limited use for detection of emerging resistance mechanisms. The present review collates and discusses the development of successful culture systems for initial isolation of this organism and current methodologies employed for phenotypic susceptibility testing to aid researchers in this field. As with Neisseria gonorrhoeae, future treatment options are extremely limited for M. genitalium and, if this sexually transmitted infection is to remain treatable, phenotypic susceptibility testing will play an invaluable role in evaluation of potential therapeutics. As such, retainment of these techniques is imperative.
性传播细菌病原体支原体生殖器已被证明是一种在实验室环境中难以处理的复杂生物体。由于其极其挑剔的性质，许多研究人员仍然难以成功地在体外繁殖支原体生殖器。对抗生素的耐药性已被广泛报道，包括一线和二线推荐疗法（大环内酯类和氟喹诺酮类）。然而，由于体外生长的困难，通常不进行表型药敏试验。相反，使用已知耐药决定因素的分子检测来推断敏感性/耐药性。然而，耐药决定因素的检测与临床治疗失败之间的关联并不总是明确的。此外，分子检测对于检测新出现的耐药机制的用途有限。本综述收集并讨论了成功培养该生物体的初始分离的培养系统的发展和目前用于表型药敏试验的方法，以帮助该领域的研究人员。与淋病奈瑟菌一样，对于支原体生殖器，未来的治疗选择非常有限，如果要保持这种性传播感染的可治疗性，表型药敏试验将在评估潜在治疗方法方面发挥非常宝贵的作用。因此，保留这些技术至关重要。
