Wujian Ke1,2, Dongling Li1,2, Lai Sze Tso3,4,5, Ran Wei6, Yinyuan Lan7, Zhengyu Chen1,2, Xiaohui Zhang1,2, Liuyuan Wang1,2, Chunmei Liang1,2, Yuying Liao1,2, Huiru Chen1,2, Yahui Liu8, Heping Zheng9,10, Ligang Yang11,12,13. 1. Department of Sexually Transmitted Diseases, Dermatology Hospital, Southern Medical University, Guangzhou, 510095, China. 2. Department of Sexually Transmitted Diseases, Guangdong Provincial Dermatology Hospital, Guangzhou, 510095, China. 3. Department of Culture Studies and Oriental Languages, University of Oslo, 0315, Oslo, Norway. 4. Anthropology, Massachusetts Institute of Technology, Cambridge, MA, 02142, USA. 5. Center for Health and Human Development Studies, Sun Yat-Sen University, Guangzhou, 510275, China. 6. Department of Dermatovenerology, Tianjin Medical University General Hospital, Tianjin, 300052, China. 7. Clinical Laboratory, Dermatology Hospital, Southern Medical University, Guangzhou, 510095, China. 8. Department of Dermatology, Qingyuan Chronic Disease Prevention Hospital, Qingyuan, 511500, China. 9. Clinical Laboratory, Dermatology Hospital, Southern Medical University, Guangzhou, 510095, China. zhhpf@hotmail.com. 10. Dermatology Hospital, Southern Medical University, Guangzhou, 510091, Guangdong, China. zhhpf@hotmail.com. 11. Department of Sexually Transmitted Diseases, Dermatology Hospital, Southern Medical University, Guangzhou, 510095, China. yanglg3@hotmail.com. 12. Department of Sexually Transmitted Diseases, Guangdong Provincial Dermatology Hospital, Guangzhou, 510095, China. yanglg3@hotmail.com. 13. Dermatology Hospital, Southern Medical University, Guangzhou, 510091, Guangdong, China. yanglg3@hotmail.com.
Abstract
BACKGROUND: Antimicrobial resistance in M. genitalium is a growing clinical problem. We investigated the mutations associated with macrolide and fluoroquinolone resistance, two commonly used medical regimens for treatment in China. Our aim is to analyze the prevalence and diversity of mutations among M. genitalium-positive clinical specimens in Guangzhou, south China. METHODS: A total of 154 stored M. genitalium positive specimens from men and women attending a STI clinic were tested for macrolide and fluoroquinolone mutations. M. genitalium was detected via TaqMan MGB real-time PCR. Mutations associated with macrolide resistance were detected using primers targeting region V of the 23S rRNA gene. Fluoroquinolone resistant mutations were screened via primers targeting topoisomerase IV (parC) and DNA gyrase (gyrA). RESULTS: 98.7% (152/154), 95.5% (147/154) and 90.3% (139/154) of M. genitalium positive samples produced sufficient amplicon for detecting resistance mutations in 23S rRNA, gyrA and parC genes, respectively. 66.4% (101/152), 0.7% (1/147) and 77.7% (108/139) samples manifested mutations in 23S rRNA, gyrA and parC genes, respectively. A2072G (59/101, 58.4%) and S83I (79/108, 73.1%) were highly predominating in 23S rRNA and parC genes, respectively. Two samples had amino acid substitutions in gyrA (M95I and A96T, respectively). Two samples had two amino acid substitutions in parC (S83I + D87Y). 48.6% (67/138) of samples harbored both macrolide and fluoroquinolone resistance-associated mutations. The most common combination of mutations was A2072G (23S rRNA) and S83I (parC) (40/67, 59.7%). One sample had three amino acid changes in 23S rRNA, gyrA and parC genes (A2072G + A96T + S83I). CONCLUSIONS: The high antimicrobial resistance rate of M. genitalium in Guangzhou is a very worrying problem and suggests that antimicrobial resistance testing and the development of new antibiotic regimens are crucially needed.
BACKGROUND: Antimicrobial resistance in M. genitalium is a growing clinical problem. We investigated the mutations associated with macrolide and fluoroquinolone resistance, two commonly used medical regimens for treatment in China. Our aim is to analyze the prevalence and diversity of mutations among M. genitalium-positive clinical specimens in Guangzhou, south China. METHODS: A total of 154 stored M. genitalium positive specimens from men and women attending a STI clinic were tested for macrolide and fluoroquinolone mutations. M. genitalium was detected via TaqMan MGB real-time PCR. Mutations associated with macrolide resistance were detected using primers targeting region V of the 23S rRNA gene. Fluoroquinolone resistant mutations were screened via primers targeting topoisomerase IV (parC) and DNA gyrase (gyrA). RESULTS: 98.7% (152/154), 95.5% (147/154) and 90.3% (139/154) of M. genitalium positive samples produced sufficient amplicon for detecting resistance mutations in 23S rRNA, gyrA and parC genes, respectively. 66.4% (101/152), 0.7% (1/147) and 77.7% (108/139) samples manifested mutations in 23S rRNA, gyrA and parC genes, respectively. A2072G (59/101, 58.4%) and S83I (79/108, 73.1%) were highly predominating in 23S rRNA and parC genes, respectively. Two samples had amino acid substitutions in gyrA (M95I and A96T, respectively). Two samples had two amino acid substitutions in parC (S83I + D87Y). 48.6% (67/138) of samples harbored both macrolide and fluoroquinolone resistance-associated mutations. The most common combination of mutations was A2072G (23S rRNA) and S83I (parC) (40/67, 59.7%). One sample had three amino acid changes in 23S rRNA, gyrA and parC genes (A2072G + A96T + S83I). CONCLUSIONS: The high antimicrobial resistance rate of M. genitalium in Guangzhou is a very worrying problem and suggests that antimicrobial resistance testing and the development of new antibiotic regimens are crucially needed.
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