Multidrug-resistant Mycoplasma genitalium infections in Europe

J F Braam, L van Dommelen, C J M Henquet, J H B van de Bovenkamp, J G Kusters

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

In Japan and Australia, multidrug-resistant Mycoplasma genitalium infections are reported with increasing frequency. Although macrolide-resistant M. genitalium strains are common in Europe and North America, fluoroquinolone-resistant strains are still exceptional. However, an increase of multidrug-resistant M. genitalium in Europe and America is to be expected. The aim of this paper is to increase awareness on the rising number of multidrug-resistant M. genitalium strains. Here, one of the first cases of infection with a genetically proven multidrug-resistant M. genitalium strain in Europe is described. The patient was a native Dutch 47-year-old male patient with urethritis. Mycoplasma genitalium was detected, but treatment failed with azithromycin, doxycycline and moxifloxacin. A urogenital sample was used to determine the sequence of the 23S rRNA, gyrA, gyrB and parC genes. The sample contained an A2059G single nucleotide polymorphism (SNP) in the 23S rRNA gene and an SNP in the parC gene, resulting in an amino acid change of Ser83 → Ile, explaining both azithromycin and moxifloxacin treatment failure. The SNPs associated with resistance were probably generated de novo, as a link with high-prevalence areas was not established. It is, thus, predictable that there is going to be an increase of multidrug-resistant M. genitalium strains in Europe. As treatment options for multidrug-resistant M. genitalium are limited, the treatment of M. genitalium infections needs to be carefully considered in order to limit the rapid increase of resistance to macrolides and fluoroquinolones.

Original languageEnglish
Pages (from-to)1565-1567
Number of pages3
JournalEuropean Journal of Clinical Microbiology and Infectious Diseases
Volume36
Issue number9
DOIs
Publication statusPublished - Sep 2017

Fingerprint

Mycoplasma genitalium
Mycoplasma Infections
Single Nucleotide Polymorphism
Azithromycin
Fluoroquinolones
Macrolides
Urethritis
Doxycycline
North America
Treatment Failure
rRNA Genes
Genes
Japan
Therapeutics

Keywords

  • Anti-Bacterial Agents/pharmacology
  • Drug Resistance, Multiple, Bacterial
  • Europe/epidemiology
  • Genes, Bacterial
  • Humans
  • Male
  • Middle Aged
  • Mycoplasma Infections/drug therapy
  • Mycoplasma genitalium/drug effects
  • Polymorphism, Single Nucleotide
  • Population Surveillance

Cite this

Braam, J F ; van Dommelen, L ; Henquet, C J M ; van de Bovenkamp, J H B ; Kusters, J G. / Multidrug-resistant Mycoplasma genitalium infections in Europe. In: European Journal of Clinical Microbiology and Infectious Diseases. 2017 ; Vol. 36, No. 9. pp. 1565-1567.
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Multidrug-resistant Mycoplasma genitalium infections in Europe. / Braam, J F; van Dommelen, L; Henquet, C J M; van de Bovenkamp, J H B; Kusters, J G.

In: European Journal of Clinical Microbiology and Infectious Diseases, Vol. 36, No. 9, 09.2017, p. 1565-1567.

Research output: Contribution to JournalArticleAcademicpeer-review

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T1 - Multidrug-resistant Mycoplasma genitalium infections in Europe

AU - Braam, J F

AU - van Dommelen, L

AU - Henquet, C J M

AU - van de Bovenkamp, J H B

AU - Kusters, J G

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AB - In Japan and Australia, multidrug-resistant Mycoplasma genitalium infections are reported with increasing frequency. Although macrolide-resistant M. genitalium strains are common in Europe and North America, fluoroquinolone-resistant strains are still exceptional. However, an increase of multidrug-resistant M. genitalium in Europe and America is to be expected. The aim of this paper is to increase awareness on the rising number of multidrug-resistant M. genitalium strains. Here, one of the first cases of infection with a genetically proven multidrug-resistant M. genitalium strain in Europe is described. The patient was a native Dutch 47-year-old male patient with urethritis. Mycoplasma genitalium was detected, but treatment failed with azithromycin, doxycycline and moxifloxacin. A urogenital sample was used to determine the sequence of the 23S rRNA, gyrA, gyrB and parC genes. The sample contained an A2059G single nucleotide polymorphism (SNP) in the 23S rRNA gene and an SNP in the parC gene, resulting in an amino acid change of Ser83 → Ile, explaining both azithromycin and moxifloxacin treatment failure. The SNPs associated with resistance were probably generated de novo, as a link with high-prevalence areas was not established. It is, thus, predictable that there is going to be an increase of multidrug-resistant M. genitalium strains in Europe. As treatment options for multidrug-resistant M. genitalium are limited, the treatment of M. genitalium infections needs to be carefully considered in order to limit the rapid increase of resistance to macrolides and fluoroquinolones.

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KW - Drug Resistance, Multiple, Bacterial

KW - Europe/epidemiology

KW - Genes, Bacterial

KW - Humans

KW - Male

KW - Middle Aged

KW - Mycoplasma Infections/drug therapy

KW - Mycoplasma genitalium/drug effects

KW - Polymorphism, Single Nucleotide

KW - Population Surveillance

U2 - 10.1007/s10096-017-2969-9

DO - 10.1007/s10096-017-2969-9

M3 - Article

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JO - European Journal of Clinical Microbiology and Infectious Diseases

JF - European Journal of Clinical Microbiology and Infectious Diseases

SN - 0934-9723

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