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Journal of Antimicrobial Chemotherapy

Journal of Antimicrobial Chemotherapy

IF: 3.9
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Phenotypic antibiotic resistance of Mycoplasma genitalium and its variation between different macrolide resistance-associated mutations.

Published:3 February 2025 DOI: 10.1093/jac/dkae430 PMID: 39656801
T A Doelman,?N Adriaens,?B M Westerhuis,?S M Bruisten,?C E Vergunst,?F M Bouwman,?A P van Dam

Abstract

Objectives: Mycoplasma genitalium, a sexually transmitted bacterium, faces increasing antibiotic resistance, particularly to azithromycin. However, presence of macrolide resistance-associated mutations (MRAMs) does not evidently implicate azithromycin treatment failure. This study aimed to establish an in vitro co-culture system of M. genitalium isolates and perform phenotypic susceptibility testing for different antibiotics, focusing on azithromycin to evaluate genotypic and phenotypic resistance across MRAMs.

Methods: Urine specimens testing positive for M. genitalium via nucleic acid amplification were co-cultured with Vero cells. Phenotypic susceptibility testing was performed for eight antibiotics. Growth inhibition and MIC of M. genitalium by azithromycin were compared across different MRAMs.

Results: M. genitalium was cultured from 20/40 (50.0%) positive urine samples, with phenotypic susceptibility tested in a subset. MICs ranged as follows: azithromycin (0.008->32?mg/L), levofloxacin (1-4?mg/L), moxifloxacin (<0.25-1?mg/L), sitafloxacin (<0.032-0.25?mg/L), minocycline (<0.25-1?mg/L), doxycycline (<0.125-2?mg/L), spectinomycin (<2.5->25?mg/L) and lefamulin (<0.004-0.063?mg/L). Isolates with A2058T demonstrated 24-, 7-, 15- and 12-fold increases in growth inhibition compared with A2058G at azithromycin concentrations of 4, 8, 16 and 32?mg/L, respectively (P?32).

Conclusions: This study revealed that M. genitalium isolates vary in azithromycin-induced growth inhibition across MRAMs, potentially explaining differences in clinical treatment efficacy. Phenotypic susceptibility testing for other antibiotics demonstrated relatively low MICs. Future studies should incorporate clinical treatment efficacy and symptom severity to optimize treatment for M. genitalium.

Substances (6)

Materials
Procduct Name CAS Molecular Formula Supplier Price
Sitafloxacin 127254-12-0 C19H18ClF2N3O3 163 suppliers $48.00-$11880.00
Sitafloxacin 127254-12-0 C19H18ClF2N3O3 163 suppliers $48.00-$11880.00
Sitafloxacin 127254-12-0 C19H18ClF2N3O3 163 suppliers $48.00-$11880.00
Sitafloxacin 127254-12-0 C19H18ClF2N3O3 163 suppliers $48.00-$11880.00
Sitafloxacin 127254-12-0 - Inquiry
Sitafloxacin 127254-12-0 - Inquiry

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