High Prevalence of Antibiotic-Resistant Mycoplasma genitalium in Nongonococcal Urethritis: The Need for Routine Testing and the Inadequacy of Current Treatment Options

Mycoplasma genitalium infections were as frequent a cause of nongonococcal urethritis as Chlamydia trachomatis, had high rates of macrolide-associated genotypic resistance, and were nonclonal, suggesting an established community infection. Detection of genotypic resistance to fluoroquinolones is cause for concern.

[1]  P. Muir,et al.  2015 UK National Guideline on the management of non-gonococcal urethritis , 2016, International journal of STD & AIDS.

[2]  K. Workowski,et al.  Sexually transmitted diseases treatment guidelines, 2015. , 2015, MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports.

[3]  M. Golden,et al.  O02.3 Treatment Outcomes For Persistent Mycoplasma Genitalium-Associated NGU: Evidence of Moxifloxacin Treatment Failures , 2013, Sexually Transmitted Infections.

[4]  G. Gilbert,et al.  Fluoroquinolone and Macrolide Resistance-Associated Mutations in Mycoplasma genitalium , 2013, Journal of Clinical Microbiology.

[5]  J. Jensen,et al.  Treatment of Mycoplasma genitalium. Observations from a Swedish STD Clinic , 2013, PloS one.

[6]  Navneet R. Hakhu,et al.  Standard treatment regimens for nongonococcal urethritis have similar but declining cure rates: a randomized controlled trial. , 2013, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[7]  M. Yasuda,et al.  Contribution of Topoisomerase IV Mutation to Quinolone Resistance in Mycoplasma genitalium , 2013, Antimicrobial Agents and Chemotherapy.

[8]  S. Goldenberg,et al.  Performance of the GeneXpert CT/NG Assay Compared to That of the Aptima AC2 Assay for Detection of Rectal Chlamydia trachomatis and Neisseria gonorrhoeae by Use of Residual Aptima Samples , 2012, Journal of Clinical Microbiology.

[9]  T. Chirwa,et al.  Urethritis/Cervicitis Pathogen Prevalence and Associated Risk Factors Among Asymptomatic HIV-Infected Patients in South Africa , 2012, Sexually transmitted diseases.

[10]  C. Bébéar,et al.  The first performance report for the Bio-Rad Dx CT/NG/MG assay for simultaneous detection of Chlamydia trachomatis, Neisseria gonorrhoeae and Mycoplasma genitalium in urogenital samples. , 2012, Journal of microbiological methods.

[11]  S. Garland,et al.  Transmission and Selection of Macrolide Resistant Mycoplasma genitalium Infections Detected by Rapid High Resolution Melt Analysis , 2012, PloS one.

[12]  C. Bébéar,et al.  Method comparison for molecular typing of French and Tunisian Mycoplasma genitalium-positive specimens. , 2012, Journal of medical microbiology.

[13]  M. Golden,et al.  Mycoplasma genitalium: should we treat and how? , 2011, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[14]  K. Workowski,et al.  Centers for Disease Control and Prevention Sexually Transmitted Disease Treatment Guidelines. , 2011, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[15]  M. Yasuda,et al.  Selection of Mycoplasma genitalium strains harbouring macrolide resistance-associated 23S rRNA mutations by treatment with a single 1 g dose of azithromycin , 2011, Sexually Transmitted Infections.

[16]  T. Anderson,et al.  Induced Macrolide Resistance in Mycoplasma genitalium Isolates from Patients with Recurrent Nongonococcal Urethritis , 2011, Journal of Clinical Microbiology.

[17]  L. Lopez,et al.  Re-evaluating the treatment of nongonococcal urethritis: emphasizing emerging pathogens--a randomized clinical trial. , 2011, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[18]  Stuart Berman,et al.  Sexually transmitted diseases treatment guidelines, 2010. , 2010, MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports.

[19]  M. Yasuda,et al.  gyrB and parE mutations in urinary Mycoplasma genitalium DNA from men with non-gonococcal urethritis. , 2010, International journal of antimicrobial agents.

[20]  P. Butcher,et al.  Point-of-care antibiotic susceptibility testing for gonorrhoea: improving therapeutic options and sparing the use of cephalosporins , 2010, Sexually Transmitted Infections.

[21]  J. Baseman,et al.  Analysis Identifying Common and Distinct Sequences among Texas Clinical Strains of Mycoplasma genitalium , 2009, Journal of Clinical Microbiology.

[22]  S. Tabrizi,et al.  Azithromycin treatment failure in Mycoplasma genitalium-positive patients with nongonococcal urethritis is associated with induced macrolide resistance. , 2008, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[23]  Liang Ma,et al.  Short tandem repeat sequences in the Mycoplasma genitalium genome and their use in a multilocus genotyping system , 2008, BMC Microbiology.

[24]  David H. Martin,et al.  Nongonococcal urethritis: New views through the prism of modern molecular microbiology , 2008, Current infectious disease reports.

[25]  J. Jensen,et al.  Antibiotic treatment of symptomatic Mycoplasma genitalium infection in Scandinavia: a controlled clinical trial , 2007, Sexually Transmitted Infections.

[26]  Y. Htun,et al.  Comparison of a TaqMan-based real-time polymerase chain reaction with conventional tests for the detection of Trichomonas vaginalis , 2006, Sexually Transmitted Infections.

[27]  Alexandros Stamatakis,et al.  RAxML-VI-HPC: maximum likelihood-based phylogenetic analyses with thousands of taxa and mixed models , 2006, Bioinform..

[28]  S. Garland,et al.  Azithromycin Failure in Mycoplasma genitalium Urethritis , 2006, Emerging infectious diseases.

[29]  Liang Ma,et al.  Sequence-Based Typing of Mycoplasma genitalium Reveals Sexual Transmission , 2006, Journal of Clinical Microbiology.

[30]  J. Jensen,et al.  Use of TaqMan 5′ Nuclease Real-Time PCR for Quantitative Detection of Mycoplasma genitalium DNA in Males with and without Urethritis Who Were Attendees at a Sexually Transmitted Disease Clinic , 2004, Journal of Clinical Microbiology.

[31]  J. Jensen.  Mycoplasma genitalium: the aetiological agent of urethritis and other sexually transmitted diseases , 2004, Journal of the European Academy of Dermatology and Venereology : JEADV.

[32]  R. Hamasuna.  Identification of treatment strategies for Mycoplasma genitalium-related urethritis in male patients by culturing and antimicrobial susceptibility testing , 2013, Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy.

[33]  Clinical Effectiveness Group British Association for Sexual Health and Hiv , 2011 .

[34]  U. Bauer,et al.  [Centers for Disease Control and Prevention (CDC)]. , 2000, Annales de dermatologie et de venereologie.