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Effectiveness of sitafloxacin monotherapy for quinolone-resistant rectal and urogenital Mycoplasma genitalium infections: a prospective cohort study

BACKGROUND: Mycoplasma genitalium has a tendency to develop macrolide and quinolone resistance. OBJECTIVES: We investigated the microbiological cure rate of a 7 day course of sitafloxacin for the treatment of rectal and urogenital infections in MSM. PATIENTS AND METHODS: This open-label, prospective...

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Autores principales: Ando, Naokatsu, Mizushima, Daisuke, Takano, Misao, Mitobe, Morika, Kobayashi, Kai, Kubota, Hiroaki, Miyake, Hirofumi, Suzuki, Jun, Sadamasu, Kenji, Aoki, Takahiro, Watanabe, Koji, Uemura, Haruka, Yanagawa, Yasuaki, Gatanaga, Hiroyuki, Oka, Shinichi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10393875/
https://www.ncbi.nlm.nih.gov/pubmed/37376970
http://dx.doi.org/10.1093/jac/dkad208
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author Ando, Naokatsu
Mizushima, Daisuke
Takano, Misao
Mitobe, Morika
Kobayashi, Kai
Kubota, Hiroaki
Miyake, Hirofumi
Suzuki, Jun
Sadamasu, Kenji
Aoki, Takahiro
Watanabe, Koji
Uemura, Haruka
Yanagawa, Yasuaki
Gatanaga, Hiroyuki
Oka, Shinichi
author_facet Ando, Naokatsu
Mizushima, Daisuke
Takano, Misao
Mitobe, Morika
Kobayashi, Kai
Kubota, Hiroaki
Miyake, Hirofumi
Suzuki, Jun
Sadamasu, Kenji
Aoki, Takahiro
Watanabe, Koji
Uemura, Haruka
Yanagawa, Yasuaki
Gatanaga, Hiroyuki
Oka, Shinichi
author_sort Ando, Naokatsu
collection PubMed
description BACKGROUND: Mycoplasma genitalium has a tendency to develop macrolide and quinolone resistance. OBJECTIVES: We investigated the microbiological cure rate of a 7 day course of sitafloxacin for the treatment of rectal and urogenital infections in MSM. PATIENTS AND METHODS: This open-label, prospective cohort study was conducted at the National Center for Global Health and Medicine, Tokyo, Japan from January 2019 to August 2022. Patients with M. genitalium urogenital or rectal infections were included. The patients were treated with sitafloxacin 200 mg daily for 7 days. M. genitalium isolates were tested for parC, gyrA and 23S rRNA resistance-associated mutations. RESULTS: In total, 180 patients (median age, 35 years) were included in this study, of whom 77.0% (97/126) harboured parC mutations, including 71.4% (90/126) with G248T(S83I) in parC, and 22.5% (27/120) harboured gyrA mutations. The median time to test of cure was 21 days. The overall microbiological cure rate was 87.8%. The cure rate was 100% for microbes harbouring parC and gyrA WTs, 92.9% for microbes harbouring parC G248T(S83I) and gyrA WT, and 41.7% for microbes harbouring parC G248T(S83I) and gyrA with mutations. The cure rate did not differ significantly between urogenital and rectal infection (P = 0.359). CONCLUSIONS: Sitafloxacin monotherapy was highly effective against infection caused by M. genitalium, except strains with combined parC and gyrA mutations. Sitafloxacin monotherapy can be used as a first-line treatment for M. genitalium infections in settings with a high prevalence of parC mutations and a low prevalence of gyrA mutations.
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spelling pubmed-103938752023-08-03 Effectiveness of sitafloxacin monotherapy for quinolone-resistant rectal and urogenital Mycoplasma genitalium infections: a prospective cohort study Ando, Naokatsu Mizushima, Daisuke Takano, Misao Mitobe, Morika Kobayashi, Kai Kubota, Hiroaki Miyake, Hirofumi Suzuki, Jun Sadamasu, Kenji Aoki, Takahiro Watanabe, Koji Uemura, Haruka Yanagawa, Yasuaki Gatanaga, Hiroyuki Oka, Shinichi J Antimicrob Chemother Original Research BACKGROUND: Mycoplasma genitalium has a tendency to develop macrolide and quinolone resistance. OBJECTIVES: We investigated the microbiological cure rate of a 7 day course of sitafloxacin for the treatment of rectal and urogenital infections in MSM. PATIENTS AND METHODS: This open-label, prospective cohort study was conducted at the National Center for Global Health and Medicine, Tokyo, Japan from January 2019 to August 2022. Patients with M. genitalium urogenital or rectal infections were included. The patients were treated with sitafloxacin 200 mg daily for 7 days. M. genitalium isolates were tested for parC, gyrA and 23S rRNA resistance-associated mutations. RESULTS: In total, 180 patients (median age, 35 years) were included in this study, of whom 77.0% (97/126) harboured parC mutations, including 71.4% (90/126) with G248T(S83I) in parC, and 22.5% (27/120) harboured gyrA mutations. The median time to test of cure was 21 days. The overall microbiological cure rate was 87.8%. The cure rate was 100% for microbes harbouring parC and gyrA WTs, 92.9% for microbes harbouring parC G248T(S83I) and gyrA WT, and 41.7% for microbes harbouring parC G248T(S83I) and gyrA with mutations. The cure rate did not differ significantly between urogenital and rectal infection (P = 0.359). CONCLUSIONS: Sitafloxacin monotherapy was highly effective against infection caused by M. genitalium, except strains with combined parC and gyrA mutations. Sitafloxacin monotherapy can be used as a first-line treatment for M. genitalium infections in settings with a high prevalence of parC mutations and a low prevalence of gyrA mutations. Oxford University Press 2023-06-28 /pmc/articles/PMC10393875/ /pubmed/37376970 http://dx.doi.org/10.1093/jac/dkad208 Text en © The Author(s) 2023. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Original Research
Ando, Naokatsu
Mizushima, Daisuke
Takano, Misao
Mitobe, Morika
Kobayashi, Kai
Kubota, Hiroaki
Miyake, Hirofumi
Suzuki, Jun
Sadamasu, Kenji
Aoki, Takahiro
Watanabe, Koji
Uemura, Haruka
Yanagawa, Yasuaki
Gatanaga, Hiroyuki
Oka, Shinichi
Effectiveness of sitafloxacin monotherapy for quinolone-resistant rectal and urogenital Mycoplasma genitalium infections: a prospective cohort study
title Effectiveness of sitafloxacin monotherapy for quinolone-resistant rectal and urogenital Mycoplasma genitalium infections: a prospective cohort study
title_full Effectiveness of sitafloxacin monotherapy for quinolone-resistant rectal and urogenital Mycoplasma genitalium infections: a prospective cohort study
title_fullStr Effectiveness of sitafloxacin monotherapy for quinolone-resistant rectal and urogenital Mycoplasma genitalium infections: a prospective cohort study
title_full_unstemmed Effectiveness of sitafloxacin monotherapy for quinolone-resistant rectal and urogenital Mycoplasma genitalium infections: a prospective cohort study
title_short Effectiveness of sitafloxacin monotherapy for quinolone-resistant rectal and urogenital Mycoplasma genitalium infections: a prospective cohort study
title_sort effectiveness of sitafloxacin monotherapy for quinolone-resistant rectal and urogenital mycoplasma genitalium infections: a prospective cohort study
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10393875/
https://www.ncbi.nlm.nih.gov/pubmed/37376970
http://dx.doi.org/10.1093/jac/dkad208
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