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Int J STD AIDS. 2013 Oct;24(10):822-8. doi: 10.1177/0956462413502008. Epub 2013 Aug 29.

Failure of moxifloxacin treatment in Mycoplasma genitalium infections due to macrolide and fluoroquinolone resistance.

Author information

1
Western Sydney Sexual Health Centre, Westmead Hospital, Parramatta, NSW, Australia.

Abstract

Increasing azithromycin treatment failure in sexually transmitted Mycoplasma genitalium infection, is linked to macrolide resistance and second-line treatment relies on the fluoroquinolone, moxifloxacin. We recently detected fluoroquinolone and macrolide resistance-associated mutations in 15% and 43%, respectively, of 143 initial M. genitalium PCR-positive specimens. For a subset of 33 Western Sydney Sexual Health Centre patients, clinical information and results of sequence analysis of M. genitalium macrolide and fluoroquinolone target genes - the 23S rRNA gene, and parC and gyrA, respectively - were used to examine whether mutations were associated with treatment failure. Macrolide resistance-associated mutations correlated with microbiological (p = 0.013) and clinical (p = 0.024) treatment failure, and fluoroquinolone resistance-associated mutations with microbiological moxifloxacin treatment failure (p = 0.005). We describe the first reported cases of clinical and microbiological moxifloxacin treatment failure. Failure of first- and second-line antibiotic treatment of M. genitalium infection is occurring and likely to increase with current treatment strategies.

KEYWORDS:

Australia; Mycoplasma genitalium; STI; Sexually transmitted infections; antibiotic; bacterial disease; location; non-gonococcal urethritis; resistance; treatment; treatment failure

PMID:
24052013
DOI:
10.1177/0956462413502008
[Indexed for MEDLINE]

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