Detection of macrolide resistance in Mycoplasma genitalium in France

Abstract

For the first time, we describe macrolide resistance for M. genitalium in France and demonstrate that its detection has increased since 2006. Epidemiological surveillance of M. genitalium is necessary to adapt treatments to M. genitalium infections.

Direct Detection of Macrolide Resistance in Mycoplasma genitalium Isolates from Clinical Specimens from France by Use of Real-Time PCR and Melting Curve Analysis

“…A troubling fact is that macrolide resistance in M. genitalium seems to be spreading throughout the world. Studies reported the detection of macrolide resistance in Japan (16), Australia (9,10,13,22), Northern Europe (9), France (8), and, recently, Greenland (14). In our study, 19/ 134 patients (14.2%) had a substitution in the 23S rRNA gene, with prevalence rates of 14.5% in 2011 and 13.8% in 2012.…”

“…However, resistance to macrolides seems to be increasing worldwide (4,8,10,14,22). Susceptibility testing is rarely achieved because of the difficulty of culturing clinical isolates of M. genitalium (23).…”

“…Tetracyclines are not adequate for the treatment of M. genitalium infections because of the high rate of therapeutic failure (1,4). Azithromycin regimens have been commonly used for the treatment of M. genitalium infections (7), but the failure of azithromycin treatment has been reported in many cases of M. genitalium-positive NGU (8,9). This can be due to the selection of resistant mutants during treatment with a single 1-g dose of azithromycin and/or the presence of preexisting resistant isolates (10,11).…”

“…Macrolide-resistant M. genitalium isolates have been detected in patients from Australia, Sweden, Norway, and the United States, and mutations in domain V of the 23S rRNA gene have been detected in specimens from Greenland, Japan, France, and an increasing number of other countries (8,9,(12)(13)(14). The resistance mutations consist mainly of adenine-to-guanine mutations in the 23S rRNA gene at position 2058 or 2059 (Escherichia coli numbering) (9,12,15,16).…”

Mycoplasma genitalium Infection Is Associated with Microscopic Signs of Cervical Inflammation in Liquid Cytology Specimens

“…Several recent studies have highlighted that azithromycin (AZM)-resistant M. genitalium strains are emerging worldwide (35)(36)(37)(38)(39)(40)(41)(42), two of which provide molecular evidence that resistance can be induced with 1 g of STAT dosing (38,42). Using conventional PCR and Sanger sequencing, analysis of the M. genitalium-positive subjects in this study showed that none of their infecting strains possessed mutations that confer macrolide resistance (data not shown).…”