Detection of Macrolide and/or Fluoroquinolone Resistance Genes in Mycoplasma genitalium Strains Isolated from Men in the Northwest Region of Croatia in 2018–2023

Scientific paper - Original scientific paper

• Author: Sunčanica Ljubin-Sternak
• Author: Tomislav Meštrović
• Author: Tatjana Marijan
• Author: Maja Anušić
• Author: Sandra Šuto
• Author: Jasmina Vraneš
• Author's institution: University of Zagreb; School of Medicine; (Department of Medical Microbiology and Parasitology)
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Medical Microbiology

Abstract (english)

Mycoplasma genitalium (M. genitalium) poses a significant public health challenge due to its association with non-gonococcal urethritis (particularly in men) and antimicrobial resistance. However, despite the prevalence of M. genitalium infections and the rise in resistance rates, routine testing and surveillance remain limited. This is the first study from Croatia that aimed to assess the prevalence and trends of resistance in M. genitalium strains isolated from male individuals by detecting macrolide and fluoroquinolone resistance genes. The study also aimed to explore the factors associated with resistance and changes in resistance patterns over time. Urine samples collected from male individuals in the Zagreb County and northwest region of Croatia between 2018 and 2023 were tested for M. genitalium with the use of molecular methods. Positive samples were subjected to DNA extraction and multiplex tandem polymerase chain reaction (MT-PCR) targeting genetic mutations associated with macrolide (23S rRNA gene) and fluoroquinolone (parC gene) resistance. Of the 8073 urine samples tested from 6480 male individuals (and following the exclusion of repeated specimens), we found that the prevalence of M. genitalium infection was 2.2%. Macrolide resistance was observed in 60.4% of strains, while fluoroquinolone resistance was found in 19.2%. Co-resistance to both antibiotics was present in 18.2% of cases. A statistically significant increase in fluoroquinolone resistance was noted over the study period (p = 0.010), but this was not evident for azithromycin resistance (p = 0.165). There were no statistically significant differences in resistance patterns between age groups, whereas re-testing of patients revealed dynamic changes in resistance profiles over time. The high burden of macrolide resistance and increasing fluoroquinolone resistance underscore the urgent need for comprehensive resistance testing and surveillance programs. The implementation of resistance-guided treatment strategies, along with enhanced access to molecular diagnostics, is pivotal for effectively managing M. genitalium infections.

• Keywords (english): Adolescent; Adult; Anti-Bacterial Agents / pharmacology; Anti-Bacterial Agents / therapeutic use; Croatia / epidemiology; Drug Resistance, Bacterial / genetics; Fluoroquinolones / pharmacology; Fluoroquinolones / therapeutic use; Humans; Macrolides / pharmacology; Macrolides / therapeutic use; Male; Microbial Sensitivity Tests; Middle Aged; Mycoplasma Infections / drug therapy; Mycoplasma Infections / epidemiology; Mycoplasma Infections / microbiology; Mycoplasma Infections / urine; Mycoplasma genitalium / drug effects; Mycoplasma genitalium / genetics; Mycoplasma genitalium / isolation & purification; RNA, Ribosomal, 23S / genetics; Urethritis / drug therapy; Urethritis / epidemiology; Urethritis / microbiology; Young Adult
• Language: english
• Publication type: Scientific paper - Original scientific paper
• Publication status: Published
• Peer review: Peer review
• Publication version: Published version
• Journal title: Genes
• Numbering: vol. 15, no. 4, 470
• e-ISSN: 2073-4425
• DOI: https://doi.org/10.3390/genes15040470
• URN:NBN: urn:nbn:hr:105:738270
• Publication: 2024-04-08
• Document URL: https://www.mdpi.com/2073-4425/15/4/470
• Type of resource: Text
• Access conditions: Open access
• Created on: 2025-02-28 10:33:15