Macrolide and fluoroquinolone associated mutations in Mycoplasma genitalium in a retrospective study of male and female
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RESEARCH ARTICLE
Open Access
Macrolide and fluoroquinolone associated mutations in Mycoplasma genitalium in a retrospective study of male and female patients seeking care at a STI Clinic in Guangzhou, China, 2016-2018 Wujian Ke1,2†, Dongling Li1,2†, Lai Sze Tso3,4,5†, Ran Wei6†, Yinyuan Lan7, Zhengyu Chen1,2, Xiaohui Zhang1,2, Liuyuan Wang1,2, Chunmei Liang1,2, Yuying Liao1,2, Huiru Chen1,2, Yahui Liu8, Heping Zheng7,9* and Ligang Yang1,2,9*
Abstract Background: Antimicrobial resistance in M. genitalium is a growing clinical problem. We investigated the mutations associated with macrolide and fluoroquinolone resistance, two commonly used medical regimens for treatment in China. Our aim is to analyze the prevalence and diversity of mutations among M. genitalium-positive clinical specimens in Guangzhou, south China. Methods: A total of 154 stored M. genitalium positive specimens from men and women attending a STI clinic were tested for macrolide and fluoroquinolone mutations. M. genitalium was detected via TaqMan MGB real-time PCR. Mutations associated with macrolide resistance were detected using primers targeting region V of the 23S rRNA gene. Fluoroquinolone resistant mutations were screened via primers targeting topoisomerase IV (parC) and DNA gyrase (gyrA). Results: 98.7% (152/154), 95.5% (147/154) and 90.3% (139/154) of M. genitalium positive samples produced sufficient amplicon for detecting resistance mutations in 23S rRNA, gyrA and parC genes, respectively. 66.4% (101/152), 0.7% (1/147) and 77.7% (108/139) samples manifested mutations in 23S rRNA, gyrA and parC genes, respectively. A2072G (59/101, 58.4%) and S83I (79/108, 73.1%) were highly predominating in 23S rRNA and parC genes, respectively. Two samples had amino acid substitutions in gyrA (M95I and A96T, respectively). Two samples had two amino acid substitutions in parC (S83I + D87Y). 48.6% (67/138) of samples harbored both macrolide and fluoroquinolone resistance-associated mutations. The most common combination of mutations was A2072G (23S rRNA) and S83I (parC) (40/67, 59.7%). One sample had three amino acid changes in 23S rRNA, gyrA and parC genes (A2072G + A96T + S83I). (Continued on next page)
* Correspondence: [email protected]; [email protected] † Wujian Ke, Dongling Li, Lai Sze Tso and Ran Wei contributed equally to this work. 7 Clinical Laboratory, Dermatology Hospital, Southern Medical University, Guangzhou 510095, China 1 Department of Sexually Transmitted Diseases, Dermatology Hospital, Southern Medical University, Guangzhou 510095, China Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this art
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