Moore Josephine, Krueger Trinity, Zapp Amanda, Lavey Stephen C, Munson Kimber L, Stafford Irene A, Newcomb Michael E, Mustanski Brian, Munson Erik
Department of Medical Laboratory Science, Marquette University, Milwaukee, Wisconsin, USA.
Loyola University Parkinson School of Health Sciences and Public Health, Maywood, Illinois, USA.
Microbiol Spectr. 2025 Jul;13(7):e0073825. doi: 10.1128/spectrum.00738-25. Epub 2025 May 22.
Recent work has optimized parameters of a real-time reverse transcriptase PCR-based laboratory-developed test on the Panther Fusion system which detects Mycoplasma genitalium-specific macrolide resistance-associated mutations LDT (MRM-LDT) from primary swab and urine specimens. In this study, MRM-LDT was applied to a large multi-demographic study set to further characterize resistance in the United States. A total of 2,145 primary clinical specimens testing positive for 16S rRNA by transcription-mediated amplification (TMA) were initially titered by the same assay using serial 10-fold dilutions to determine relative target nucleic acid burden. Specimens were then processed for MRM-LDT. Findings were stratified by men who have sex with men (MSM; = 3 settings), community care ( = 2), and university student ( = 3) populations. The mean log target nucleic acid titer of a TMA-positive specimen was 3.46 (median 3; range 0-10). A 43.2% MRM-LDT detection rate was found in specimens derived from community care settings. Analogous assessments of university student and MSM demographics revealed 60.8% and 62.0% detection, respectively ( ≤ 0.0004 versus community care). Within the university student demographic, differences existed in target nucleic acid titer for two settings ( = 0.01); similar differences were encountered between a local MSM cohort and two that were nationally based ( ≤ 0.01). Within the university cohort, MRM-LDT detection rate was increased in symptomatic patients ( = 0.005). macrolide resistance rates among multiple demographics, as determined by MRM-LDT, are high in the United States and are consistent with target nucleic acid burden within the primary specimen. However, caveats experienced within subgroupings of these demographics support reflex MRM-LDT on -positive specimens.
Data generated from a high-throughput, automated system and presented in this report expand upon knowledge of -specific macrolide resistance in the United States and may further inform providers on population- or demographic-based considerations for macrolide resistance mutation determination in .
近期的工作优化了基于实时逆转录聚合酶链反应的实验室研发检测方法在Panther Fusion系统上的参数，该检测方法可从原始拭子和尿液标本中检测生殖支原体特异性大环内酯类耐药相关突变的实验室研发检测方法（MRM-LDT）。在本研究中，MRM-LDT应用于一个大型多人群研究集，以进一步表征美国的耐药情况。共有2145份通过转录介导扩增（TMA）检测16S rRNA呈阳性的原始临床标本，最初使用连续10倍稀释的相同检测方法进行滴定，以确定相对靶核酸负荷。然后对标本进行MRM-LDT处理。研究结果按男男性行为者（MSM；=3组）、社区护理（=2组）和大学生（=3组）人群进行分层。TMA阳性标本的平均对数靶核酸滴度为3.46（中位数3；范围0-10）。在来自社区护理机构的标本中，MRM-LDT检测率为43.2%。对大学生和MSM人群的类似评估显示，检测率分别为60.8%和62.0%（与社区护理相比，P≤0.0004）。在大学生人群中，两种情况的靶核酸滴度存在差异（P=0.01）；在本地MSM队列与两个全国性队列之间也遇到了类似差异（P≤0.01）。在大学队列中，有症状患者的MRM-LDT检测率有所提高（P=0.005）。根据MRM-LDT确定，美国多种人群中的大环内酯类耐药率很高，并且与原始标本中的靶核酸负荷一致。然而，在这些人群亚组中遇到的注意事项支持对TMA阳性标本进行MRM-LDT检测。
本报告中来自高通量自动化系统的数据扩展了美国生殖支原体特异性大环内酯类耐药的知识，并可能进一步为医疗服务提供者在基于人群或人口统计学考虑确定生殖支原体大环内酯类耐药突变方面提供参考。
