Abstract
Increasing azithromycin treatment failure in sexually transmitted Mycoplasma genitalium infection, is linked to macrolide resistance and second-line treatment relies on the fluoroquinolone, moxifloxacin. We recently detected fluoroquinolone and macrolide resistance-associated mutations in 15% and 43%, respectively, of 143 initial M. genitalium PCR-positive specimens.For a subset of 33 Western Sydney Sexual Health Centre patients, clinical information and results of sequence analysis of M. genitalium macrolide and fluoroquinolone target genes - the 23S rRNA gene, and parC and gyrA, respectively - were used to examine whether mutations were associated with treatment failure. Macrolide resistance-associated mutations correlated with microbiological (p = 0.013) and clinical (p = 0.024) treatment failure, and fluoroquinolone resistance-associated mutations with microbiological moxifloxacin treatment failure (p = 0.005). We describe the first reported cases of clinical and microbiological moxifloxacin treatment failure. Failure of first- and second-line antibiotic treatment of M. genitalium infection is occurring and likely to increase with current treatment strategies.
Original language | English |
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Pages (from-to) | 822-828 |
Number of pages | 7 |
Journal | International Journal of STD and AIDS |
Volume | 24 |
Issue number | 10 |
DOIs | |
Publication status | Published - 2013 |
Keywords
- antibiotic
- Australia
- treatment failure
- bacterial disease
- location
- Mycoplasma genitalium
- non-gonococcal urethritis
- resistance
- Sexually transmitted infections
- STI
- treatment