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. 2019 Jul;25(7):1297-1303.
doi: 10.3201/eid2507.181556.

Macrolide-Resistant Mycoplasma genitalium in Southeastern Region of the Netherlands, 2014-2017

Liesbeth Martens, Sharon Kuster, Wilco de Vos, Maikel Kersten, Hanneke Berkhout, Ferry Hagen

Macrolide-Resistant Mycoplasma genitalium in Southeastern Region of the Netherlands, 2014-2017

Liesbeth Martens et al. Emerg Infect Dis. 2019 Jul.

Abstract

Mycoplasma genitalium infections of the urogenital tract are usually treated with azithromycin; however, for the past several years, rates of azithromycin treatment failure have increased. To document the occurrence and frequency of macrolide resistance-mediating mutations (MRMMs) in M. genitalium infections, we collected 894 M. genitalium-positive samples during April 2014-December 2017 and retrospectively tested them for MRMMs. We designated 67 samples collected within 6 weeks after a positive result as test-of-cure samples; of these, 60 were MRMM positive. Among the remaining 827 samples, the rate of MRMM positivity rose from 22.7% in 2014 and 22.3% in 2015 to 44.4% in 2016 but decreased to 39.7% in 2017. Because of these high rates of MRMMs in M. genitalium infections, we recommend that clinicians perform tests of cure after treatment and that researchers further explore the clinical consequences of this infection.

Keywords: Mycoplasma genitalium; antimicrobial resistance; bacteria; macrolide resistance; molecular diagnostics; sexually transmitted disease; the Netherlands.

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Figures

Figure 1
Figure 1
Characteristics of all samples received during study of macrolide-resistant Mycoplasma genitalium in southeastern region of the Netherlands, 2014–2017. qPCR, quantitative PCR.
Figure 2
Figure 2
Proportion of Mycoplasma genitalium–positive samples containing MRMMs in study of macrolide-resistant M. genitalium in southeastern region of the Netherlands, 2014–2017. Percentages of M. genitalium–positive samples that are either wild-type or positive for MRMMs are based on quantitative PCR. MRMM, macrolide resistance–mediating mutation; Q, quarter.
Figure 3
Figure 3
Characteristics of test-of-cure samples in study of macrolide-resistant Mycoplasma genitalium in southeastern region of the Netherlands, 2014–2017. Positive results indicate presence of M. genitalium; negative results indicate no M. genitalium. Q, quarter.
Figure 4
Figure 4
Identification and test results for test-of-cure samples in study of macrolide-resistant Mycoplasma genitalium in southeastern region of the Netherlands, 2014–2017. Positive results indicate presence of M. genitalium; negative results indicate no M. genitalium. MRMM, macrolide resistance–mediating mutation.
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