Emerging multidrug resistance contributes to treatment failure in Mycoplasma genitalium infected patients in China

Diagn Microbiol Infect Dis. 2023 Feb;105(2):115854. doi: 10.1016/j.diagmicrobio.2022.115854. Epub 2022 Nov 7.

Abstract

The increased treatment failure in patients with sexually transmitted Mycoplasma genitalium infection is associated with antimicrobial resistance. We performed a retrospective survey of antimicrobial clinical outcomes in M. genitalium-infected patients. In addition, we detected macrolide, fluoroquinolone and tetracycline resistance-associated markers to determine their role in treatment failure. The overall incidence of treatment failure was 28.29%, regardless of the drug used. In the present study, the prevalence of macrolide resistance-associated mutations in the 23S rRNA gene was 64%; that of fluroquinolone resistance-associated S83/D87 substitutions in the parC gene was 67.5%; and that of the tetracycline resistance-associated C1192T mutation in the 16S rRNA gene was 22.5%. Furthermore, evidence of dual antimicrobial resistance was found in 46.4% of pretreatment samples, and triple antimicrobial resistance was identified in 9.9%. These findings regarding the emergence of multidrug-resistant strains of M. genitalium in China are concerning and emphasize the importance of guiding M. genitalium treatment with antimicrobial resistance assays.

Keywords: China; Mycoplasma genitalium; antibiotic resistance; fluroquinolone; macrolide; tetracycline.

MeSH terms

  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use
  • Drug Resistance, Bacterial / genetics
  • Drug Resistance, Multiple
  • Humans
  • Macrolides / pharmacology
  • Macrolides / therapeutic use
  • Mutation
  • Mycoplasma Infections* / drug therapy
  • Mycoplasma Infections* / epidemiology
  • Mycoplasma genitalium* / genetics
  • Prevalence
  • RNA, Ribosomal, 16S
  • RNA, Ribosomal, 23S / genetics
  • Retrospective Studies
  • Treatment Failure

Substances

  • Anti-Bacterial Agents
  • Macrolides
  • RNA, Ribosomal, 16S
  • RNA, Ribosomal, 23S