We report a case of management failure of male urethritis syndrome due to macrolide-resistant Mycoplasma genitalium in South Africa. We detected mutations in 23S rRNA and one of the quinolone resistance-determining regions. This report confirms that drug-resistant M. genitalium infection can undermine the effectiveness of syndromic management in Africa.
MhlongoSMagooaPMüllerEEet al.
Etiology and STI/HIV coinfections among patients with urethral and vaginal discharge syndromes in South Africa. Sex Transm Dis2010;
37: 566–570.
2.
CouldwellDLLewisDA.Mycoplasma genitalium infection: current treatment options, therapeutic failure, and resistance-associated mutations. Infect Drug Resist2015;
8: 147.
De WaaijDJOuburgSDubbinkJHet al.
Evaluation of Prestoplus assay and LightMix kit Trichomonas vaginalis assay for detection of Trichomonas vaginalis in dry vaginal swabs. J Microbiol Methods2016;
127: 102–104.
5.
EdbergAJurstrandMJohanssonEet al.
A comparative study of three different PCR assays for detection of Mycoplasma genitalium in urogenital specimens from men and women. J Med Microbiol2008;
57: 304–309.
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.
HamasunaRLePTKutsunaSet al.
Mutations in ParC and GyrA of moxifloxacin-resistant and susceptible Mycoplasma genitalium strains. PloS One2018;
13: e0198355.
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.
HayBDubbinkJHOuburgSet al.
Prevalence and macrolide resistance of Mycoplasma genitalium in South African women. Sex Transm Dis2015;
42: 140–142.
10.
Le RouxMCMafuniseMde VilliersBEet al.
Antimicrobial susceptibility of Mycoplasma genitalium isolates from Pretoria, South Africa in 2012 and 2016. S Afr J Infect Dis2018;
33: 46–49.