Epidemiology and prevalence of mutations associated with resistance to macrolides and fluoroquinolones in Mycoplasma genitalium in a tertiary hospital from Madrid, Spain

Abstract

Objectives. Mycoplasma genitalium causes persistent sexually transmitted infections. The aims of this study were to estimate the prevalence of resistances to macrolides and fluoroquinolones in M. genitalium and the sexually transmitted coinfections in patients at Hospital Universitario La Paz (Madrid, Spain). Material and methods. Patients attended between January and October 2021 were studied. Screening for sexually transmitted pathogens and detection of 23S rRNA and parC genes mutations were performed by real-time PCR (Allplex,SeegeneTM). Results. A total of 1,518 females and 1,136 males were studied. The prevalence of M. genitalium was 2.1%. The macrolides resistance rate was 51.8%. The mutations found were A2059G, A2058T and A2058G. The rate of resistance to fluoroquinolones was 17.8% being the G248T mutation (S83I) the most frequent. Seven males had some sexual transmitted coinfection. Conclusions. Although the percentage of M. genitalium infections is low, the high rate of resistance to macrolides makes it necessary to revise the protocols for diagnosis and empirical treatment of sexually transmitted infections. The use of fluoroquinolones is appropriate after screening of macrolide resistance profile.

Prevalence of mutations associated with macrolide and fluoroquinolone resistance in Neisseria gonorrhoeae with Allplex™ NG&DR Assay (Seegene®) in a tertiary hospital from Madrid, Spain

“…Treatment with fluoroquinolones (ciprofloxacin) may be an option in allergic or intolerant patients to third-generation cephalosporins, provided that a gyrA mutation is not detected following the sexually transmitted infections guidelines [ 3 , 4 ]. The resistance rates to macrolides and fluoroquinolones are well known for Mycoplasma genitalium infections due to the large supply of commercially available assays [ 5 - 7 ]. However, new commercial kits are emerging for the detection of mutations associated with therapeutic failure of these second-line treatments using nucleic acid amplification tests (NAAT) for NG infection.…”