Dumke Roger, Glaunsinger Tobias
Institute of Medical Microbiology and Virology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
Praxis Prenzlauer Berg, Berlin, Germany.
J Glob Antimicrob Resist. 2025 Mar;41:29-34. doi: 10.1016/j.jgar.2024.12.020. Epub 2024 Dec 24.
The cell wall-less species Mycoplasma genitalium is a sexually transmitted pathogen with a strong tendency to acquire resistance. Current knowledge on trends of resistance rates and differences between the at-risk population of men who have sex with men (MSM) and heterosexual patients, as well as on circulating genotypes in both groups, is limited.
Between August 2017 and December 2023, M. genitalium strains in 373 samples from patients (MSM: n = 269, non-MSM: n = 104) consulting at a specialized sexually transmitted infection practice in Berlin, Germany, were characterized by molecular methods to detect the presence of mutations associated with macrolide (23S rRNA) and quinolone resistance (parC), and to determine the MgpB strain type.
Overall, 37.5% of MSM and 30.8% of heterosexual patients carrying M. genitalium were asymptomatic. Among MSM, the rate of macrolide resistance remained relatively constant during the investigation period (mean: 85.9% of strains), whereas quinolone resistance (mean: 19.7%% of strains) increased from 6.8% (2017) to approximately 38% (2021-2023). In contrast, mean resistance rates of 42.2% for macrolides and 12.5% for quinolones were measured in strains from heterosexual patients. The most common MgpB strain types were types 4 (MSM: 38.4%) and 7 (non-MSM: 16.7%).
The results of this study confirm a constantly high rate of macrolide-resistant M. genitalium strains and a trend of increased quinolone resistance among MSM in an urban environment. Despite lower rates, the percentage of resistant strains in heterosexual patients has also reached an alarming extent. The determination of MgpB strain types provides insights into the distribution of genotypes of an important agent of sexually transmitted infections in both population groups.
无细胞壁的生殖支原体是一种性传播病原体，极易产生耐药性。目前关于耐药率趋势、男男性行为者（MSM）高危人群与异性恋患者之间的差异以及两组中流行基因型的了解有限。
2017年8月至2023年12月期间，对在德国柏林一家专门的性传播感染诊所就诊的373例患者（MSM：n = 269，非MSM：n = 104）样本中的生殖支原体菌株进行分子方法鉴定，以检测与大环内酯（23S rRNA）和喹诺酮耐药性（parC）相关的突变，并确定MgpB菌株类型。
总体而言，携带生殖支原体的MSM中有37.5%无症状，异性恋患者中有30.8%无症状。在MSM中，大环内酯耐药率在调查期间保持相对稳定（平均：85.9%的菌株），而喹诺酮耐药率（平均：19.7%的菌株）从2017年的6.8%增加到2021 - 2023年的约38%。相比之下，异性恋患者菌株的大环内酯平均耐药率为42.2%，喹诺酮为12.5%。最常见的MgpB菌株类型是4型（MSM：38.4%）和7型（非MSM：16.7%）。
本研究结果证实了城市环境中MSM中大环内酯耐药生殖支原体菌株的持续高比率以及喹诺酮耐药性增加的趋势。尽管比率较低，但异性恋患者中耐药菌株的百分比也已达到令人担忧的程度。MgpB菌株类型的确定为这两个人群组中性传播感染重要病原体的基因型分布提供了见解。
