Macrolide and fluoroquinolone resistance-associated mutations in Mycoplasma genitalium in Johannesburg, South Africa, 2007–2014
Open Access
- 13 February 2019
- journal article
- research article
- Published by Springer Science and Business Media LLC in BMC Infectious Diseases
- Vol. 19 (1), 1-8
- https://doi.org/10.1186/s12879-019-3797-6
Abstract
Antimicrobial resistance in Mycoplasma genitalium is rising globally with resultant clinical treatment failure. We investigated the prevalence of mutations in the macrolide and fluoroquinolone resistance-determining regions of M. genitalium in Johannesburg, South Africa, and ascertained their association with HIV serostatus. Stored M. genitalium positive specimens, collected from STI and HIV patients enrolled in the Gauteng STI National Microbiological Surveillance programme (2007–2014) and a large HIV outpatient clinic-based study (2007) in Johannesburg, were tested for antimicrobial resistance. We determined the prevalence of 23S rRNA gene mutations conferring macrolide resistance and mutations in the quinolone resistance-determining regions (QRDR) of the gyrA and parC genes in 266 M. genitalium positive DNA extracts. No macrolide resistance-associated mutations were detected in any of the specimens analysed. QRDR mutations with known M. genitalium-associated fluoroquinolone resistance were not detected in gyrA, however, one specimen (0.4%) contained a D87Y amino acid alteration in parC, which has been linked to fluoroquinolone treatment failure. The most common parC amino acid change detected, of unknown clinical significance, was P62S (18.8%). We found no significant association between QRDR mutations in M. genitalium and HIV-infection. Ongoing antimicrobial resistance surveillance in M. genitalium is essential, as macrolide resistance may emerge given the recent incorporation of azithromycin into the 2015 South African national STI syndromic management guidelines.Keywords
Funding Information
- National Institute for Communicable Diseases (Internally funded)
This publication has 56 references indexed in Scilit:
- Draft Genome Sequences of Four Axenic Mycoplasma genitalium Strains Isolated from Denmark, Japan, and AustraliaJournal of Bacteriology, 2012
- Transmission and Selection of Macrolide Resistant Mycoplasma genitalium Infections Detected by Rapid High Resolution Melt AnalysisPLOS ONE, 2012
- The association between Mycoplasma genitalium and HIV-1 acquisition in African womenAIDS, 2012
- Mycoplasma genitalium: Should We Treat and How?Clinical Infectious Diseases, 2011
- Mycoplasma genitalium: from Chrysalis to Multicolored ButterflyClinical Microbiology Reviews, 2011
- Selection ofMycoplasma genitaliumstrains harbouring macrolide resistance-associated 23S rRNA mutations by treatment with a single 1 g dose of azithromycin: Table 1Sexually Transmitted Infections, 2011
- Azithromycin in the treatment of infection with Neisseria gonorrhoeaeSexually Transmitted Infections, 2010
- Mycoplasma genitalium PCR: Does Freezing of Specimens Affect Sensitivity?Journal of Clinical Microbiology, 2010
- Antibiotic treatment of symptomatic Mycoplasma genitalium infection in Scandinavia: a controlled clinical trialSexually Transmitted Infections, 2008
- Mycoplasma genitalium: prevalence and behavioural risk factors in the general populationSexually Transmitted Infections, 2006