Detection and Prevalence of Macrolide and Fluoroquinolone Resistance in Mycoplasma genitalium in Badalona, Spain

Belén Rivaya; Chloé Le Roy; Elena Jordana-Lluch; Gema Fernández-Rivas; Cristina Casañ; Victoria González; Jun Hao Wang-Wang; Cécile Bébéar; Lurdes Matas; Sabine Pereyre

doi:10.3390/antibiotics11040485

Detection and Prevalence of Macrolide and Fluoroquinolone Resistance in Mycoplasma genitalium in Badalona, Spain

Antibiotics (Basel). 2022 Apr 5;11(4):485. doi: 10.3390/antibiotics11040485.

Authors

Belén Rivaya^{1

2}, Chloé Le Roy³, Elena Jordana-Lluch^{1

2

4}, Gema Fernández-Rivas^{1

2}, Cristina Casañ^{1

2}, Victoria González^{1

2

4

5

6}, Jun Hao Wang-Wang^{1

2}, Cécile Bébéar^{3

7}, Lurdes Matas^{1

2

6}, Sabine Pereyre^{3

7}

Affiliations

¹ Microbiology Department, Laboratori Clinic Metropolitana Nord, Hospital Universitari Germans Trias i Pujol, Ctra. Del Canyet, S/N, 08916 Badalona, Spain.
² Department of Genetics and Microbiology, Universitat Autònoma de Barcelona, 08193 Cerdanyola del Vallès, Spain.
³ UMR 5234 Fundamental Microbiology and Pathogenicity, University of Bordeaux, CNRS, F-33000 Bordeaux, France.
⁴ Institute for Health Science Research Germans Trias i Pujol (IGTP), Ctra. Del Canyet, S/N, 08916 Badalona, Spain.
⁵ Center for Epidemiological Studies on HIV/AIDS and STI of Catalonia (CEEISCAT), Generalitat de Catalunya, Ctra, Del Canyet, S/N, 08916 Badalona, Spain.
⁶ CIBER in Epidemiology and Public Health (CIBERESP), Avda. Monforte de Lemos, 3-5, 28029 Madrid, Spain.
⁷ Bacteriology Department, National Reference Centre for Bacterial Sexually Transmitted Infections, CHU Bordeaux, F-33000 Bordeaux, France.

Abstract

Macrolide and fluoroquinolone resistance (MLr/FQr) in Mycoplasma genitalium (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 parC 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.

Keywords: Mycoplasma genitalium; Spain; fluoroquinolone; macrolide; resistance.