Mycoplasma genitalium (MG) infection is a sexually transmitted infection that causes up to 25% of nongonococcal urethritis (NGU). MG strains carrying genetic markers of antimicrobial resistance that may affect treatment outcomes are increasingly recognized as a public health concern. We present two cases of persistent MG NGU with strains carrying both macrolide and quinolone resistance-associated mutations that were eradicated successfully by an extended course of minocycline.
Taylor-RobinsonDJensenJS.Mycoplasma genitalium: from chrysalis to multicolored butterfly. Clin Microbiol Rev2011;
24: 498–514.
2.
ManhartLEJensenJSBradshawCSet al.
Efficacy of antimicrobial therapy for Mycoplasma genitalium infections. Clin Infect Dis2015;
61: S802–S817.
3.
LiYLeWJLiSet al.
Meta-analysis of the efficacy of moxifloxacin in treating Mycoplasma genitalium infection. Int J STD AIDS2017;
28: 1106–1114.
4.
MurrayGBradshawSBissessorMet al.
Increasing macrolide and fluoroquinolone resistance in Mycoplasma genitalium. Emerging Infect Dis2017;
23: 809–812.
5.
DeguchiTItoSYasudaMet al.
Emergence of Mycoplasma genitalium with clinically significant fluoroquinolone resistance conferred by amino acid changes both in GyrA and ParC in Japan. J Infect Chemother2017;
23: 648–650.
6.
XiaoLWaitesKBWangHet al.
Evaluation of a real-time PCR assay for detection of Mycoplasma genitalium and macrolide resistance-mediating mutations from clinical specimens. Diagn Microbiol Infect Dis2018;
91: 123–125.
7.
JensenJSBradshawCSTabriziSNet al.
Azithromycin treatment failure in Mycoplasma genitalium-positive patients with nongonococcal urethritis is associated with induced macrolide resistance. Clin Infect Dis2008;
47: 1546–1553.
8.
ShimadaYDeguchiTNakaneKet al.
Emergence of clinical strains of Mycoplasma genitalium harbouring alterations in ParC associated with fluoroquinolone resistance. Int J Antimicrob Agents2010;
36: 255–258.
9.
Dionne-OdomJGeislerWAaronK.High prevalence of multidrug-resistant Mycoplasma genitalium in human immunodeficiency virus-infected men who have sex with men in Alabama. Clin Inf Dis2018;
66: 796–798.
10.
SethiSZamanKJainN.Mycoplasma genitalium infections: current treatment options and resistance issues. Infect Drug Resist2017;
10: 283–292.
11.
HamasunaRJensenJSOsadaY.Antimicrobial susceptibilities of Mycoplasma genitalium strains examined by broth dilution and quantitative PCR. Antimicrob Agents Chemother2009;
53: 4938–4939.
