Genetic Determinants of Macrolide and Fluoroquinolone Resistance in Mycoplasma genitalium and Their Prevalence in Moscow, Russia

Abstract

Macrolide (MLR) and fluoroquinolone (FQR) resistance in Mycoplasma genitalium (MG) has recently become a major problem worldwide. The available data on the prevalence of MLR and FQR in MG in Russia are limited. In this study, we aimed to evaluate the prevalence and pattern of mutations in 213 MG-positive urogenital swabs from patients in Moscow between March 2021 and March 2022. MLR- and FQR-associated mutations were searched in 23S rRNA as well as in the parC and gyrA genes using Sanger sequencing. The prevalence of MLR was 55/213 (26%), with A2059G and A2058G substitutions being the two most common variants (36/55, 65%, and 19/55, 35%, respectively). FQR detection showed 17% (37/213); two major variants were D84N (20/37, 54%) and S80I (12/37, 32.4%) and three minor variants were S80N (3/37, 8.1%), D84G (1/37, 2.7%), and D84Y (1/37, 2.7%). Fifteen of the fifty-five MLR cases (27%) simultaneously harbored FQR. This study revealed the high frequency of MLR and FQR. We conclude that the improvement of patient examination algorithms and therapeutic approaches should be combined with the routine monitoring of antibiotic resistance based on the sensitivity profiles presented. Such a complex approach will be essential for restraining the development of treatment resistance in MG.

Detection of resistance to macrolides and fluoroquinolones in Mycoplasma genitalium by targeted next-generation sequencing

“…As in other studies ( 22 , 23 ), the gyr A locus in M. genitalium is remarkably well conserved in our population also (e.g., only two samples have exhibited amino acid substitutions in gyr A, both with uncertain significance), and none of the 10 nonsynonymous mutations in gyr B identified in this study were previously published. Thus, in our setting, as described in other works, parC appears to be the major determinant for fluoroquinolone resistance, while the contribution of gyrase loci may be considered minor.…”

Detection of Macrolide and/or Fluoroquinolone Resistance Genes in Mycoplasma genitalium Strains Isolated from Men in the Northwest Region of Croatia in 2018–2023

“…From a genetic vantage point, macrolide resistance primarily arises from a single base mutation, typically occurring at position A2058 or A2059 within region V of the 23S rRNA gene (according to Escherichia coli numbering) [19,20]. On the other hand, resistance to fluoroquinolones is associated with mutations found in the quinolone resistance-determining region (QRDR) of the parC gene, often resulting in amino acid substitutions at positions S83 and D87 (according to M. genitalium numbering) [19,20]. Nonetheless, the existing data supporting correlations between mutations in parC and clinical resistance to moxifloxacin are limited.…”

“…Nonetheless, the existing data supporting correlations between mutations in parC and clinical resistance to moxifloxacin are limited. It has been suggested that mutations in the QRDR of the gyrA gene in isolates exhibiting a fluoroquinolone-resistant genotype in parC may enhance the likelihood of reduced susceptibility to fluoroquinolone antimicrobials [19,20]. Nonetheless, the confirmation of such claims without phenotypic data poses a significant challenge in understanding the intricacies of fluoroquinolone resistance in M. genitalium infections.…”