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. 2022 Nov 9;9(11):ofac615.
doi: 10.1093/ofid/ofac615. eCollection 2022 Nov.

Mycoplasma genitalium and Antimicrobial Resistance Among a Cohort of West African Men Who Have Sex With Men Using Preexposure Prophylaxis (CohMSM-PrEP ANRS 12369-Expertise France Study)

Irith De Baetselier  1 , Bea Vuylsteke  2 , Vicky Cuylaerts  1 , Benjamin Cuer  3 , Issifou Yaya  3 , Ephrem Mensah  4 , Elias Dah  5 , Camille Anoma  6 , Amadou Koné  7 , Souba Diandé  8 , Anoumou Dagnra  9 , Hortense Fayé-Ketté  10 , Alain Yeo  10 , Hilde Smet  1 , Dorien Van den Bossche  1 , Bintou Dembélé Keita  11 , Bruno Spire  12 , Christian Laurent  3 , Tania Crucitti  13 ; CohMSM-PrEP Study Group
Collaborators, Affiliations

Mycoplasma genitalium and Antimicrobial Resistance Among a Cohort of West African Men Who Have Sex With Men Using Preexposure Prophylaxis (CohMSM-PrEP ANRS 12369-Expertise France Study)

Irith De Baetselier et al. Open Forum Infect Dis. .

Abstract

Background: Antimicrobial resistance to macrolides and fluoroquinolones in Mycoplasma genitalium (MG) among men who have sex with men (MSM) is worryingly high in high-resource countries. Data in Africa are lacking. We aimed to assess the burden of MG including the presence of resistance-associated mutations (RAMs) in MG among MSM using human immunodeficiency virus preexposure prophylaxis in Burkina Faso, Côte d'Ivoire, Mali, and Togo.

Methods: MSM were included in a prospective cohort study (2017-2021). Molecular detection of MG in urine, anorectal, and pharyngeal samples was performed at baseline and after 6 and 12 months. Detection of RAMs to macrolides and fluoroquinolones was performed by sequencing the 23S ribosomal RNA, parC, and gyrA genes. A sample was found to be possibly resistant to fluoroquinolones if alterations were found in ParC position 83/87.

Results: Of 598 participants, 173 (28.9%) were positive at least once for MG and global point-prevalence was 19.4%. Interestingly, 238 of 250 (95.2%) infections were asymptomatic and 72 of 138 MG infections with follow-up data (52.2%) cleared during the study. Only 1 macrolide RAM was found (0.6%). Prevalence of fluoroquinolones RAMs was 11.3% overall, ranging from 2.4% in Burkina Faso to 17.5% in Mali.

Conclusions: Although MG was highly prevalent in these MSM, macrolide resistance was almost nonexistent. Nevertheless, >10% of the samples were possibly resistant to fluoroquinolones. Heterogeneity in the prevalence of fluoroquinolone RAMs between countries may be explained by different antimicrobial consumption in humans and animals.

Keywords: Africa; Mycoplasma genitalium; antimicrobial resistance; men who have sex with men; sexually transmitted infections.

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Conflict of interest statement

Potential conflicts of interest. The authors: No reported conflicts of interest.

Figures

Figure 1.
Figure 1.
Mycoplasma genitalium (MG) point-prevalence at baseline, month 6, and month 12.
Figure 2.
Figure 2.
Proportion of ParC mutations in Mycoplasma genitalium (only first or new episodes) detected in the CohMSM-PrEP study, stratified per country. Other mutations included P62S, G81C, I89V, S93F, A119S, A119E.
See this image and copyright information in PMC

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