Mycoplasma genitalium in the Far North Queensland backpacker population: An observational study of prevalence and azithromycin resistance

BackgroundMycoplasma genitalium is a sexually transmitted infection (STI) pathogen. There have been no published studies concerning symptomatology, prevalence data, antibiotic resistance profiling or reports of co-infection with other STI in pregnant women.ObjectiveTo describe these characteristics among pregnant women attending prenatal clinics in a large tertiary care centre.DesignRemnant genital samples collected from pregnant women between August 2018 and November 2019 were tested for M. genitalium and Trichomonas vaginalis by the transcription-mediated amplification technique. Specimens with detectable M. genitalium RNA were sequenced for 23S rRNA mutations associated with azithromycin resistance and parC and gyrA mutations associated with resistance to moxifloxacin. Demographic, obstetric and STI co-infection data were recorded.ResultsOf the 719 samples, 41 (5.7 %) were positive for M. genitalium. M. genitalium infection was associated with black race, Hispanic ethnicity and young age (p=0.003, p=0.008 and p=0.004, respectively). M. genitalium infection was also associated with T. vaginalis co-infection and Streptococcus agalactiae (group B Streptococcus) colonisation (p≤0.001 and p=0.002, respectively). Of the 41 positive samples, 26 (63.4%) underwent successful sequencing. Eight (30.8%) had 23S rRNA mutations related to azithromycin resistance. One of 26 (3.8%) positive samples with sequencing results had the gyrA gene mutation and 1 of 18 sequenced samples (5.6%) had the parC gene mutation associated with moxifloxacin resistance.ConclusionsPrevalence rates of M. genitalium in pregnant women was 5.7%. M. genitalium infection disproportionately affects young black women co-infected with T. vaginalis. Pregnant women remain at risk for persistent infection with M. genitalium due to decreased azithromycin susceptibility.

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Mycoplasma genitalium in Primary Care: Prevalence and azithromycin resistance in Santiago de Compostela Health Care Area

Revista Española de Quimioterapia ◽

10.37201/req/052.2021 ◽

2021 ◽

Author(s):

Mercedes Treviño ◽

María Rodríguez-Velasco ◽

Tamara Manso ◽

María Cea

Keyword(s):

Primary Care ◽

Health Care ◽

General Population ◽

Sexually Transmitted Infections ◽

Mycoplasma Genitalium ◽

23S Rrna ◽

Rrna Gene ◽

Santiago De Compostela ◽

Sexually Transmitted ◽

Azithromycin Resistance

Objectives. Mycoplasma genitalium is associated with persistent/recurrent sexually transmitted infections. The aim of this work was to estimate the prevalence and azithromycin resistance of M. genitalium in general population that was attended at Primary Care of Santiago de Compostela Health Care Area. Material and methods. The study was carried out in 2019 in general population of Santiago de Compostela Health Care Area. Real-time multiplex PCR was used for screening of sexually transmitted infections associated pathogens and detection of mutations in the 23S rRNA gene. Results. A total of 502 women and 532 men were studied. The prevalence of M. genitalium was 2,4% in men and 2,9% in women. Overall azithromycin resistance was 20% all of them detected in men. The mutations found were A2059G, A2058G and A2058T. Conclusions. Although the proportion of M. genitalium infection is low, the high percentage of azithromycin resistance detected supports the relevance of these data in order to the right management of the patients with sexually transmitted diseases and, so as, to avoid the emergence of resistance in other pathogens of the urogenital tract.

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04 / Azithromycin resistance in Mycoplasma genitalium infection in Milan, Italy

10.26226/morressier.5af060631dd164001d5ef1d7 ◽

2018 ◽

Author(s):

Susanna Benardon

Keyword(s):

Mycoplasma Genitalium ◽

Azithromycin Resistance

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Impact of mass drug administration of azithromycin for trachoma elimination on prevalence and azithromycin resistance of genital Mycoplasma genitalium infection

Sexually Transmitted Infections ◽

10.1136/sextrans-2018-053938 ◽

2019 ◽

Vol 95 (7) ◽

pp. 522-528 ◽

Cited By ~ 3

Author(s):

Mark Andrew Harrison ◽

Emma Michele Harding-Esch ◽

Michael Marks ◽

Marcus James Pond ◽

Robert Butcher ◽

...

Keyword(s):

Drug Administration ◽

Mass Drug Administration ◽

Secondary Analysis ◽

Mycoplasma Genitalium ◽

Nucleic Acid Amplification ◽

23S Rrna ◽

Island Population ◽

Cross Sectional ◽

The Impact ◽

Azithromycin Resistance

BackgroundMass drug administration (MDA) of 20 mg/kg (maximum 1 g in adults) azithromycin for ocular Chlamydia trachomatis (CT) infection is a key component of the WHO trachoma elimination strategy. However, this dose may be suboptimal in Mycoplasma genitalium infection and may encourage emergence of antimicrobial resistance (AMR) to azithromycin.ObjectivesTo determine the effect of MDA for trachoma elimination on M. genitalium prevalence, strain type and azithromycin resistance.MethodsA secondary analysis of CT-negative vulvovaginal swabs from three outpatient antenatal clinics (Honiara, Solomon Islands) from patients recruited either pre-MDA, or 10 months post-MDA in two cross-sectional surveys was carried out. Swabs were tested for M. genitalium infection using Fast Track Diagnostics Urethritis Plus nucleic acid amplification assay. M. genitalium-positive samples were subsequently tested for azithromycin resistance by sequencing domain V of the 23S rRNA DNA region of M. genitalium and underwent phylogenetic analysis by dual locus sequence typing.ResultsM. genitalium prevalence was 11.9% (28/236) in women pre-MDA and 10.9% (28/256) 10 months post-MDA (p=0.7467). Self-reported receipt of azithromycin as part of MDA was 49.2% in women recruited post-MDA and 17.9% (5/28) in those who tested M. genitalium positive. Of samples sequenced (21/28 pre-MDA, 22/28 post-MDA), all showed a macrolide susceptible genotype. Strain typing showed that sequence types diverged into two lineages, with a suggestion of strain replacement post-MDA.ConclusionA single round of azithromycin MDA in an island population with high baseline M. genitalium prevalence did not appear to impact on either prevalence or azithromycin resistance, in contrast to reported decreased genital CT prevalence in the same population. This may be due to limitations such as sample size, including CT-negative samples only, and low MDA coverage. Further investigation of the impact of multiple rounds of MDA on M. genitalium azithromycin AMR in antibiotic experienced and naïve populations is warranted.

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Four-color multiplex real-time PCR assay prototype targeting azithromycin resistance mutations in Mycoplasma genitalium

BMC Infectious Diseases ◽

10.1186/s12879-019-4424-2 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 3

Author(s):

Olivier Thellin ◽

Benaïssa Elmoualij ◽

Willy Zorzi ◽

Jorgen S. Jensen ◽

Renaud Close ◽

...

Keyword(s):

Real Time ◽

Internal Control ◽

Plasmid Dna ◽

Limit Of Detection ◽

Analytical Data ◽

Mycoplasma Genitalium ◽

Clinical Samples ◽

Resistance Mutations ◽

Pcr Assay ◽

Azithromycin Resistance

Abstract Background The worldwide expansion of macrolide-resistant Mycoplasma genitalium (MG) in cases of genital infections has led to an increased recurrence rate of these infections after first-line azithromycin treatment. By detecting the presence of azithromycin-resistant MG, the patient’s antibiotic treatment can be targeted and the spread of resistance prevented. With this aim in mind, macrolide-resistance detection kits are helpful tools for the physician. Methods Azithromycin resistance mutations in MG are targeted using a four-color multiplex real-time RT-PCR assay. Tested targets include plasmid DNA (as positive controls) as well as macrolide-sensitive and macrolide-resistant genomic DNA from characterized cell lines and clinical samples. Results The analytical data presented here were generated from plasmid DNA and genomic RNA/DNA and include adaptation to an internal control, specificity between targets, specificity vs non-MG species, limit of detection (LoD) and interference studies (co-infection and endogenous substances). The clinical data were based on the application of the assay to clinical samples characterized by sequencing. Conclusions A new NAAT (nucleic acid amplification test) prototype has been developed in collaboration with the Diagenode s.a. company, this prototype targets MG and azithromycin-resistance mutations in that pathogen.

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Evaluation of treatment with two weeks of doxycycline on macrolide-resistant strains of Mycoplasma genitalium: a retrospective observational study

BMC Infectious Diseases ◽

10.1186/s12879-021-06910-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

M. Gossé ◽

S. A. Nordbø ◽

B. Pukstad

Keyword(s):

Observational Study ◽

Symptom Relief ◽

Mycoplasma Genitalium ◽

Retrospective Observational Study ◽

Cure Rate ◽

Asymptomatic Patients ◽

Antibiotic Drug ◽

Resistant Strains ◽

Microbiological Cure ◽

Experienced Symptom

Abstract Background Increasing macrolide resistance makes treatment of Mycoplasma genitalium infections challenging. The second-line treatment is moxifloxacin, an antibiotic drug best avoided due to the potential of severe side effects and interactions. This study evaluates the effects of treatment with doxycycline 100 mg twice daily for 2 weeks as an alternative to moxifloxacin. Methods This retrospective observational study examined the medical records of patients testing positive for macrolide resistant Mycoplasma genitalium from January 1st, 2016 to September 1st, 2019 in Trondheim, Norway. Information regarding symptoms as well as clinical and microbiological cure was collected. Results 263 infections from 259 patients (161 females/98 males) were examined. 155 (58.9%) had a negative test of cure following treatment. 34.7% of symptomatic patients not achieving microbiological cure experienced symptom relief or clearance. There was no statistical difference between bacterial loads in symptomatic versus asymptomatic patients. The mean difference was 1.6 × 105 copies/ml (95% CI − 1.4 × 105–4.8 × 105, p = 0.30) for women and 1.4 × 106 copies/ml (95% CI -4.0 × 105–3.2 × 106, p = 0.12) for men. Conclusions The cure rate of doxycycline in this study is higher than previously reported. This adds support to doxycycline’s role in treatment before initiating treatment with less favorable drugs such as moxifloxacin.

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Mycoplasma genitalium and its resistance to azithromycin in incarcerated men from Far North Queensland

Sexual Health ◽

10.1071/sh14147 ◽

2014 ◽

Vol 11 (6) ◽

pp. 587 ◽

Cited By ~ 3

Author(s):

Gemma Maree Daley ◽

Darren B. Russell ◽

Sepehr N. Tabrizi ◽

Jimmy Twin ◽

William J. H. McBride

Keyword(s):

Mycoplasma Genitalium ◽

Macrolide Resistance ◽

Urine Samples ◽

23S Rrna ◽

Rrna Gene ◽

Far North ◽

Incarcerated Men ◽

23S Rrna Gene

This study examined the prevalence of Mycoplasma genitalium in incarcerated men from Far North Queensland as well as the prevalence of macrolide resistance in identified isolates. Overall, eight out of 140 [5.71% (95% CI 1.82–9.60)] urine samples tested positive and two out of eight (25%) samples carried a mutation in the 23S rRNA gene associated with macrolide resistance.

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Molecular epidemiological analysis of Mycoplasma genitalium shows low prevalence of azithromycin resistance and a well-established epidemic in South Africa

Sexually Transmitted Infections ◽

10.1136/sextrans-2019-054371 ◽

2020 ◽

pp. sextrans-2019-054371 ◽

Cited By ~ 1

Author(s):

Jolein G E Laumen ◽

Lieke B van Alphen ◽

Liteboho D Maduna ◽

Charlotte M Hoffman ◽

Jeffrey D Klausner ◽

...

Keyword(s):

South Africa ◽

Mycoplasma Genitalium ◽

Sub Saharan Africa ◽

Healthcare Sector ◽

23S Rrna ◽

Melting Curve Analysis ◽

Snp Analysis ◽

Syndromic Management ◽

Sequence Types ◽

Azithromycin Resistance

ObjectivesMacrolide resistance in Mycoplasma genitalium is emerging globally. There is paucity of data from sub-Saharan Africa where syndromic management is used to treat sexually transmitted infections (STIs). We conducted a molecular epidemiological study to determine the prevalence of azithromycin resistance and epidemic diversity of M. genitalium infections in South Africa.MethodsWe analysed 90 M. genitalium-positive specimens that had been collected consecutively from men and women (50% symptomatic) from geographically diverse communities across the northern part of South Africa between 2015 and 2019. Melting curve analysis followed by targeted sequencing of the 23S rRNA gene was performed to detect azithromycin resistance. Molecular typing was done through single nucleotide polymorphism (SNP) analysis of the MG191 gene and short tandem repeats (STR) assessment of the MG309 gene. An overview of all published M. genitalium sequence types was generated and novel sequence types identified in this study were allocated numbers accordingly.ResultsAzithromycin resistance was detected in 1/90 M. genitalium-positive specimens (1.1%; 95% CI 0% to 3.3%) as conferred by A2071G mutation; this strain also harboured a C234T mutation in the parC gene with wild type gyrA gene. SNP typing and STR assessment was successful in 38/90 specimens (42%) and showed a genetically diverse epidemic, without geographic clustering, with eight novel sequence types identified.ConclusionThis is the first study that determines resistance in M. genitalium infection since introduction of azithromycin in the syndromic management regimen for STIs in South Africa in 2015. Despite a well-established epidemic, azithromycin-resistant M. genitalium infection is still uncommon in the public healthcare sector. However, it has the potential to undermine the effectiveness of syndromic management. Introduction of molecular diagnostics and continuous surveillance are warranted for early detection emergence of resistance.

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Identification of Maize Rayado Fino Virus by Immunoelectron Microscopy

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100119879 ◽

1985 ◽

Vol 43 ◽

pp. 636-637

Author(s):

O. E. Bradfute

Keyword(s):

Electron Microscopy ◽

Zea Mays ◽

Costa Rica ◽

Severe Disease ◽

Rabbit Serum ◽

Normal Rabbit Serum ◽

Virus Particles ◽

Far North ◽

Maize Rayado Fino Virus ◽

Antibody Coating

Maize rayado fino virus (MRFV) causes a severe disease of corn (Zea mays) in many locations throughout the neotropics and as far north as southern U.S. MRFV particles detected by direct electron microscopy of negatively stained sap from infected leaves are not necessarily distinguishable from many other small isometric viruses infecting plants (Fig. 1).Immunosorbent trapping of virus particles on antibody-coated grids and the antibody coating or decoration of trapped virus particles, was used to confirm the identification of MRFV. Antiserum to MRFV was supplied by R. Gamez (Centro de Investigacion en Biologia Celular y Molecular, Universidad de Costa Rica, Ciudad Universitaria, Costa Rica).Virus particles, appearing as a continuous lawn, were trapped on grids coated with MRFV antiserum (Fig. 2-4). In contrast, virus particles were infrequently found on grids not exposed to antiserum or grids coated with normal rabbit serum (similar to Fig. 1). In Fig. 3, the appearance of the virus particles (isometric morphology, 30 nm diameter, stain penetration of some particles, and morphological subunits in other particles) is characteristic of negatively stained MRFV particles. Decoration or coating of these particles with MRFV antiserum confirms their identification as MRFV (Fig. 4).

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