Multi-year prevalence and macrolide resistance of Mycoplasma genitalium in clinical samples from a southern Italian hosp
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BRIEF REPORT
Multi-year prevalence and macrolide resistance of Mycoplasma genitalium in clinical samples from a southern Italian hospital Abbasciano Angela 1 & Del Prete Raffaele 1,2 & Romanelli Federica 1 & Mosca Adriana 1,2 & Santacroce Luigi 1,2 & Ronga Luigi 2 Received: 5 August 2020 / Accepted: 9 October 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract The use of azithromycin for the treatment of Mycoplasma genitalium infections has led to resistance to macrolides. From July 2014 to July 2020, 7150 samples were analysed for the detection of sexually transmitted infections at the Policlinico of Bari. A total of 67/7150 samples (0.93%) were positive for MG DNA and 47 samples were analysed for the evaluation of six azithromycin resistance-associated mutations. In 5/47 samples, the A2058G mutation was detected (10.63%). Although the cases of positive MG samples and mutations are low in our reality, diagnostic tests to detect azithromycin resistant-associated genes may provide a convenient way to monitor resistance rate. Keywords Mycoplasma genitalium . Epidemiology . Surveillance . Azithromycin resistance . Multiplex real-time PCR
Mycoplasma genitalium (MG) is a sexually transmitted microorganism causing clinical diseases mostly in men. Its role in nongonococcal urethritis (NGU) in men is well established and it has also been associated with pelvic inflammatory diseases, cervicitis, and preterm birth in women. MG has no peptidoglycan-containing cell wall, and thus it is naturally resistant to antibiotics such as beta-lactams; its treatment options are limited to tetracyclines, macrolides, streptogramins, or fluoroquinolones. However, due to their high therapeutic failure rate, tetracyclines are not an adequate treatment for MG infections [1]. Azithromycin regimen is usually used as first-line treatment of MG infections. Unfortunately, failure of azithromycin treatment has been reported in many cases of MG-positive NGU [2, 3]. Treatment failure may be caused by the selection of resistant mutants during treatment with a single 1-g dose of azithromycin and/or the presence of pre-existing resistant isolates [4, 5]. Several resistance-associated mutations are known to alter the ribosome binding of macrolides to the residues of * Ronga Luigi [email protected] 1
Dip DIM, Università degli Studi, Policlinico, P.zza G. Cesare, 4, 70124 Bari, Italy
2
UOC Microbiologia e Virologia, Azienda Ospedaliero-Universitaria Policlinico, P.zza G. Cesare, 4, 70124 Bari, Italy
23S rRNA (Escherichia coli numbering): A2058G, A2058T, A2058C, A2059G, and A2059C. The aim of the following work was to retrospectively evaluate the presence of azithromycin resistance-associated mutations in MG-positive clinical samples. From June 2014 to the end of July 2020, 7150 specimens collected from 5624 patients (4768 females and 856 males) were processed in the U.O.C. Microbiology and Virology, Azienda Ospedaliero-Universitaria, Policlinico of Bari for the detection of sexually transmitted infections (STI). Specimens includ
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