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. 2023 Aug 2;78(8):2070-2079.
doi: 10.1093/jac/dkad208.

Effectiveness of sitafloxacin monotherapy for quinolone-resistant rectal and urogenital Mycoplasma genitalium infections: a prospective cohort study

Naokatsu Ando  1 , Daisuke Mizushima  1 , Misao Takano  1 , Morika Mitobe  2 , Kai Kobayashi  2 , Hiroaki Kubota  2 , Hirofumi Miyake  2 , Jun Suzuki  2 , Kenji Sadamasu  2 , Takahiro Aoki  1 , Koji Watanabe  1 , Haruka Uemura  1 , Yasuaki Yanagawa  1 , Hiroyuki Gatanaga  1 , Shinichi Oka  1
Affiliations

Effectiveness of sitafloxacin monotherapy for quinolone-resistant rectal and urogenital Mycoplasma genitalium infections: a prospective cohort study

Naokatsu Ando et al. J Antimicrob Chemother. .

Abstract

Background: Mycoplasma genitalium has a tendency to develop macrolide and quinolone resistance.

Objectives: We investigated the microbiological cure rate of a 7 day course of sitafloxacin for the treatment of rectal and urogenital infections in MSM.

Patients and methods: This open-label, prospective cohort study was conducted at the National Center for Global Health and Medicine, Tokyo, Japan from January 2019 to August 2022. Patients with M. genitalium urogenital or rectal infections were included. The patients were treated with sitafloxacin 200 mg daily for 7 days. M. genitalium isolates were tested for parC, gyrA and 23S rRNA resistance-associated mutations.

Results: In total, 180 patients (median age, 35 years) were included in this study, of whom 77.0% (97/126) harboured parC mutations, including 71.4% (90/126) with G248T(S83I) in parC, and 22.5% (27/120) harboured gyrA mutations. The median time to test of cure was 21 days. The overall microbiological cure rate was 87.8%. The cure rate was 100% for microbes harbouring parC and gyrA WTs, 92.9% for microbes harbouring parC G248T(S83I) and gyrA WT, and 41.7% for microbes harbouring parC G248T(S83I) and gyrA with mutations. The cure rate did not differ significantly between urogenital and rectal infection (P = 0.359).

Conclusions: Sitafloxacin monotherapy was highly effective against infection caused by M. genitalium, except strains with combined parC and gyrA mutations. Sitafloxacin monotherapy can be used as a first-line treatment for M. genitalium infections in settings with a high prevalence of parC mutations and a low prevalence of gyrA mutations.

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Figures

Figure 1.
Figure 1.
Flow chart showing the selection of sitafloxacin monotherapy.
Figure 2.
Figure 2.
Cure rates for (a) patients infected with strains carrying G248T (S83I) in parC and a confirmed mutation in gyrA and (b) rectal and urogenital M. genitalium infection.
See this image and copyright information in PMC

References

    1. Horner PJ, Martin DH. Mycoplasma genitalium infection in men. J Infect Dis 2017; 216 Suppl 2: S396–405. 10.1093/infdis/jix145 - DOI - PMC - PubMed
    1. Taylor-Robinson D, Jensen JS. Mycoplasma genitalium: from chrysalis to multicolored butterfly. Clin Microbiol Rev 2011; 24: 498–514. 10.1128/CMR.00006-11 - DOI - PMC - PubMed
    1. Ong JJ, Aung E, Read TRH et al. Clinical characteristics of anorectal Mycoplasma genitalium infection and microbial cure in men who have sex with men. Sex Transm Dis 2018; 45: 522–6. 10.1097/OLQ.0000000000000793 - DOI - PubMed
    1. Read TRH, Murray GL, Danielewski JA et al. Symptoms, sites, and significance of Mycoplasma genitalium in men who have sex with men. Emerg Infect Dis 2019; 25: 719–27. 10.3201/eid2504.181258 - DOI - PMC - PubMed
    1. Machalek DA, Tao Y, Shilling H et al. Prevalence of mutations associated with resistance to macrolides and fluoroquinolones in Mycoplasma genitalium: a systematic review and meta-analysis. Lancet Infect Dis 2020; 20: 1302–14. 10.1016/S1473-3099(20)30154-7 - DOI - PubMed

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