Student research committee, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Medical Microbiology, School of Medicine, Iranshahr University of Medical Sciences, Iranshahr, Iran.
Ann Clin Microbiol Antimicrob. 2023 Aug 10;22(1):70. doi: 10.1186/s12941-023-00627-6.
The emergence of multidrug-resistant (MDR) strains of genital pathogens, notably Mycoplasma genitalium and Ureaplasma spp., constitutes a significant global threat today. The present study aimed to evaluate the prevalence and trend of changes in MDR mycoplasma and ureaplasma strains.
An exhaustive search was performed across the ISI Web of Science, PubMed, Scopus, ScienceDirect, and Google Scholar databases to accumulate relevant studies without restrictions until April 2023. We used event rate and corresponding 95% confidence intervals to determine the frequency of resistance-related mutations and examine the trend of antibiotic resistance changes.
The data from 27 studies, including 24,662 patients across 14 countries, were evaluated. Out of the total studies, 20 focused on M. genitalium infections, and five on Ureaplasma spp. The frequency of resistance-associated mutations to macrolides, tetracyclines, and fluoroquinolones in clinical strains of M. genitalium was 43.5%, 13.1%, and 18.6%, respectively. The prevalence of M. genitalium strains with double resistance and MDR was 11.0% and 17.4%, respectively. The incidence of both double-drug-resistant and MDR strains was higher in the World Health Organization (WHO) Western Pacific Region than in European and American populations. For Ureaplasma strains, resistance-associated mutations to macrolides, tetracyclines, and fluoroquinolones were 40.8%, 25.7%, and 90.3%, respectively. The rate of antibiotic resistance was higher in the African population compared to the European and WHO Western Pacific Regions. The rate of MDR Ureaplasma infections was 13.2%, with a higher incidence in the African population compared to the WHO Western Pacific and European regions.
The proliferation and spread of MDR Mycoplasma and Ureaplasma strains present a significant public health challenge. The situation is indeed alarming, and the rising trend of MDR M. genitalium and MDR Ureaplasma infections suggests that therapies involving macrolides and fluoroquinolones may become less effective.
目前，性传播病原体（尤其是生殖道支原体和脲原体）的耐药（MDR）菌株的出现是一个重大的全球威胁。本研究旨在评估 MDR 支原体和脲原体耐药菌株的流行率和变化趋势。
我们在 ISI Web of Science、PubMed、Scopus、ScienceDirect 和 Google Scholar 数据库中进行了全面检索，无限制地收集截至 2023 年 4 月的相关研究。我们使用事件发生率和相应的 95%置信区间来确定耐药相关突变的频率，并检查抗生素耐药性变化的趋势。
共评估了 27 项研究的数据，这些研究涉及来自 14 个国家的 24662 名患者。其中 20 项研究聚焦于生殖道支原体感染，5 项研究聚焦于脲原体。临床分离的生殖道支原体对大环内酯类、四环素类和氟喹诺酮类的耐药相关突变频率分别为 43.5%、13.1%和 18.6%。双重耐药和 MDR 生殖道支原体的流行率分别为 11.0%和 17.4%。世界卫生组织（WHO）西太平洋区域的双重耐药和 MDR 菌株的发生率均高于欧美人群。对于脲原体菌株，对大环内酯类、四环素类和氟喹诺酮类的耐药相关突变频率分别为 40.8%、25.7%和 90.3%。非洲人群的抗生素耐药率高于欧洲和 WHO 西太平洋地区。MDR 脲原体感染的发生率为 13.2%，非洲人群的发生率高于 WHO 西太平洋和欧洲地区。
MDR 支原体和脲原体菌株的增殖和传播对公共卫生构成了重大挑战。情况确实令人担忧，而且 MDR 生殖道支原体和 MDR 脲原体感染的上升趋势表明，涉及大环内酯类和氟喹诺酮类的治疗可能效果降低。
