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Prevalence and antibiotic resistance of Mycoplasma genitalium among STI clinic attendees in Western Canada: a cross-sectional analysis

OBJECTIVES: To determine the prevalence and correlates of Mycoplasma genitalium (MG) infection among men and women, determine the prevalence of gene mutations conferring resistance and compare test performance of female specimen types. METHODS: A cross-sectional study was conducted on specimens coll...

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Autores principales: Gratrix, Jennifer, Plitt, Sabrina, Turnbull, LeeAnn, Smyczek, Petra, Brandley, Judith, Scarrott, Ron, Naidu, Prenilla, Parker, Penny, Blore, Brenda, Bull, Amy, Shokoples, Sandy, Bertholet, Lindsay, Martin, Irene, Chernesky, Max, Read, Ron, Singh, Ameeta
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5541599/
https://www.ncbi.nlm.nih.gov/pubmed/28698342
http://dx.doi.org/10.1136/bmjopen-2017-016300
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author Gratrix, Jennifer
Plitt, Sabrina
Turnbull, LeeAnn
Smyczek, Petra
Brandley, Judith
Scarrott, Ron
Naidu, Prenilla
Parker, Penny
Blore, Brenda
Bull, Amy
Shokoples, Sandy
Bertholet, Lindsay
Martin, Irene
Chernesky, Max
Read, Ron
Singh, Ameeta
author_facet Gratrix, Jennifer
Plitt, Sabrina
Turnbull, LeeAnn
Smyczek, Petra
Brandley, Judith
Scarrott, Ron
Naidu, Prenilla
Parker, Penny
Blore, Brenda
Bull, Amy
Shokoples, Sandy
Bertholet, Lindsay
Martin, Irene
Chernesky, Max
Read, Ron
Singh, Ameeta
author_sort Gratrix, Jennifer
collection PubMed
description OBJECTIVES: To determine the prevalence and correlates of Mycoplasma genitalium (MG) infection among men and women, determine the prevalence of gene mutations conferring resistance and compare test performance of female specimen types. METHODS: A cross-sectional study was conducted on specimens collected for gonorrhoea (NG, Neisseria gonorrhoeae) and chlamydia (CT, Chlamydia trachomatis) among male and female Alberta STI clinic attendees using the M. genitalium transcription-mediated amplification-research use only test. Positive specimens were sequenced for 23SrRNA, parC and gyrA genes. Gender-stratified analysis compared test results using χ(2) or Fisher’s exact test, Mann-Whitney U test and logistic regression. Female endocervical and urine specimens were compared. RESULTS: A total of 2254 individuals were tested; 53.8% (n=1212) were male. Male prevalence of MG was 5.3%; CT was 5.9% and NG was 1.8%. Correlates of male infection were a non-gonococcal urethritis diagnosis and NG coinfection. MG prevalence for women was 7.2%; CT was 5.8% and NG was 1.8%. Correlates of female infection were younger age, Indigenous/Other ethnicity and CT/NG coinfection. Nearly two-thirds of eligible specimens had mutations associated with macrolide resistance and 12.2% of specimens had a parC mutation signifying possible moxifloxacin resistance. There was high concordance (98.1%) of results between urine and endocervical swabs. CONCLUSIONS: The high prevalence of MG relative to CT and NG supports the incorporation of MG testing into routine sexually transmissible infection screening. The high rate of resistance to macrolides and moxifloxacin raises concerns about treatment options. The good concordance of results between urine and endocervical swabs supports the use of female urine specimens for testing.
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spelling pubmed-55415992017-08-18 Prevalence and antibiotic resistance of Mycoplasma genitalium among STI clinic attendees in Western Canada: a cross-sectional analysis Gratrix, Jennifer Plitt, Sabrina Turnbull, LeeAnn Smyczek, Petra Brandley, Judith Scarrott, Ron Naidu, Prenilla Parker, Penny Blore, Brenda Bull, Amy Shokoples, Sandy Bertholet, Lindsay Martin, Irene Chernesky, Max Read, Ron Singh, Ameeta BMJ Open Epidemiology OBJECTIVES: To determine the prevalence and correlates of Mycoplasma genitalium (MG) infection among men and women, determine the prevalence of gene mutations conferring resistance and compare test performance of female specimen types. METHODS: A cross-sectional study was conducted on specimens collected for gonorrhoea (NG, Neisseria gonorrhoeae) and chlamydia (CT, Chlamydia trachomatis) among male and female Alberta STI clinic attendees using the M. genitalium transcription-mediated amplification-research use only test. Positive specimens were sequenced for 23SrRNA, parC and gyrA genes. Gender-stratified analysis compared test results using χ(2) or Fisher’s exact test, Mann-Whitney U test and logistic regression. Female endocervical and urine specimens were compared. RESULTS: A total of 2254 individuals were tested; 53.8% (n=1212) were male. Male prevalence of MG was 5.3%; CT was 5.9% and NG was 1.8%. Correlates of male infection were a non-gonococcal urethritis diagnosis and NG coinfection. MG prevalence for women was 7.2%; CT was 5.8% and NG was 1.8%. Correlates of female infection were younger age, Indigenous/Other ethnicity and CT/NG coinfection. Nearly two-thirds of eligible specimens had mutations associated with macrolide resistance and 12.2% of specimens had a parC mutation signifying possible moxifloxacin resistance. There was high concordance (98.1%) of results between urine and endocervical swabs. CONCLUSIONS: The high prevalence of MG relative to CT and NG supports the incorporation of MG testing into routine sexually transmissible infection screening. The high rate of resistance to macrolides and moxifloxacin raises concerns about treatment options. The good concordance of results between urine and endocervical swabs supports the use of female urine specimens for testing. BMJ Publishing Group 2017-07-10 /pmc/articles/PMC5541599/ /pubmed/28698342 http://dx.doi.org/10.1136/bmjopen-2017-016300 Text en © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
spellingShingle Epidemiology
Gratrix, Jennifer
Plitt, Sabrina
Turnbull, LeeAnn
Smyczek, Petra
Brandley, Judith
Scarrott, Ron
Naidu, Prenilla
Parker, Penny
Blore, Brenda
Bull, Amy
Shokoples, Sandy
Bertholet, Lindsay
Martin, Irene
Chernesky, Max
Read, Ron
Singh, Ameeta
Prevalence and antibiotic resistance of Mycoplasma genitalium among STI clinic attendees in Western Canada: a cross-sectional analysis
title Prevalence and antibiotic resistance of Mycoplasma genitalium among STI clinic attendees in Western Canada: a cross-sectional analysis
title_full Prevalence and antibiotic resistance of Mycoplasma genitalium among STI clinic attendees in Western Canada: a cross-sectional analysis
title_fullStr Prevalence and antibiotic resistance of Mycoplasma genitalium among STI clinic attendees in Western Canada: a cross-sectional analysis
title_full_unstemmed Prevalence and antibiotic resistance of Mycoplasma genitalium among STI clinic attendees in Western Canada: a cross-sectional analysis
title_short Prevalence and antibiotic resistance of Mycoplasma genitalium among STI clinic attendees in Western Canada: a cross-sectional analysis
title_sort prevalence and antibiotic resistance of mycoplasma genitalium among sti clinic attendees in western canada: a cross-sectional analysis
topic Epidemiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5541599/
https://www.ncbi.nlm.nih.gov/pubmed/28698342
http://dx.doi.org/10.1136/bmjopen-2017-016300
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