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. 2024 Feb;29(7):2300318.
doi: 10.2807/1560-7917.ES.2024.29.7.2300318.

Estimation of antimicrobial resistance of Mycoplasma genitalium, Belgium, 2022

Irith De Baetselier  1 , Hilde Smet  1 , Kaat Kehoe  2 , Imelda Loosen  3 , Marijke Reynders  4 , Iqbal Mansoor  5 , Lorenzo Filippin  5 , Mathieu Cauchie  6 , Ellen Van Even  7 , Nadia Makki  2 , Gilberte Schiettekatte  8 , Wouter Vandewal  9 , Bart Glibert  10 , Veerle Matheeussen  11 , Yolien Van der Beken  12 , Reinoud Cartuyvels  13 , Sophia Steyaert  14 , Ann Lemmens  15 , Maria-Grazia Garrino  16 , Henry Paridaens  17 , Elena Lazarova  18 , Bénédicte Lissoir  19 , Marine Deffontaine  20 , Amélie Heinrichs  21 , Veroniek Saegeman  22 , Elizaveta Padalko  23 , Amaryl Lecompte  24 , Wim Vanden Berghe  24 , Chris Kenyon  25 , Dorien Van den Bossche  1
Affiliations

Estimation of antimicrobial resistance of Mycoplasma genitalium, Belgium, 2022

Irith De Baetselier et al. Euro Surveill. 2024 Feb.

Abstract

BackgroundAntimicrobial resistance (AMR) of Mycoplasma genitalium (MG) is a growing concern worldwide and surveillance is needed. In Belgium, samples are sent to the National Reference Centre of Sexually Transmitted Infections (NRC-STI) on a voluntary basis and representative or robust national AMR data are lacking.AimWe aimed to estimate the occurrence of resistant MG in Belgium.MethodsBetween July and November 2022, frozen remnants of MG-positive samples from 21 Belgian laboratories were analysed at the NRC-STI. Macrolide and fluoroquinolone resistance-associated mutations (RAMs) were assessed using Sanger sequencing of the 23SrRNA and parC gene. Differences in resistance patterns were correlated with surveillance methodology, socio-demographic and behavioural variables via Fisher's exact test and logistic regression analysis.ResultsOf the 244 MG-positive samples received, 232 could be sequenced for macrolide and fluoroquinolone RAMs. Over half of the sequenced samples (55.2%) were resistant to macrolides. All sequenced samples from men who have sex with men (MSM) (24/24) were macrolide-resistant. Fluoroquinolone RAMs were found in 25.9% of the samples and occurrence did not differ between socio-demographic and sexual behaviour characteristics.ConclusionAlthough limited in sample size, our data suggest no additional benefit of testing MG retrieved from MSM for macrolide resistance in Belgium, when making treatment decisions. The lower occurrence of macrolide resistance in other population groups, combined with emergence of fluoroquinolone RAMs support macrolide-resistance testing in these groups. Continued surveillance of resistance in MG in different population groups will be crucial to confirm our findings and to guide national testing and treatment strategies.

Keywords: Belgium; Europe; Mycoplasma genitalium; antimicrobial resistance; fluoroquinolone resistance; macrolide resistance.

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Conflict of interest statement

Conflict of interest: None declared.

Figures

Figure 1
Figure 1
Percentage of resistance-associated mutations of Mycoplasma genitalium in samples from symptomatic and asymptomatic cases, Belgium, 2022 (n = 244)
See this image and copyright information in PMC

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