Send to

Choose Destination
J Antimicrob Chemother. 2014 Sep;69(9):2376-82. doi: 10.1093/jac/dku164. Epub 2014 Jun 2.

Remarkable increase in fluoroquinolone-resistant Mycoplasma genitalium in Japan.

Author information

Department of Urology, Graduate School of Medicine, Gifu University, Gifu, Japan.
iClinic, Sendai, Japan.
Infectious Disease Testing Department, Mitsubishi Chemical Medience Corporation, Tokyo, Japan.
Department of Microbiology, Graduate School of Medicine, Gifu University, Gifu, Japan.
Department of Urology, Graduate School of Medicine, Gifu University, Gifu, Japan



We determined the prevalence of macrolide and fluoroquinolone resistance-associated mutations in Mycoplasma genitalium DNA specimens from men with non-gonococcal urethritis (NGU) and analysed their effects on antibiotic treatments of M. genitalium infections.


In this retrospective study, we examined antibiotic resistance-associated mutations in the 23S rRNA, gyrA and parC genes of M. genitalium and the association of the mutations with microbiological outcomes of antibiotic treatments in men with M. genitalium-positive NGU.


No macrolide resistance-associated mutations in the 23S rRNA gene were observed in 27 M. genitalium DNA specimens in 2011 and in 24 in 2012. However, 5 of 17 in 2013 had 23S rRNA mutations. Three of 15 in 2011, 6 of 19 in 2012 and 8 of 17 in 2013 had fluoroquinolone resistance-associated alterations in ParC. Three in 2013 had both the antibiotic resistance-associated alterations coincidentally. In two men with M. genitalium harbouring 23S rRNA mutations, the mycoplasma persisted after treatment with a regimen of 2 g of extended-release azithromycin (AZM-SR) once daily for 1 day. All nine men with mycoplasma harbouring ParC alterations were microbiologically cured with a regimen of 100 mg of sitafloxacin twice daily for 7 days.


Macrolide- or fluoroquinolone-resistant M. genitalium appears to be increasing, and the increase in fluoroquinolone-resistant mycoplasmas is especially remarkable in Japan. Mycoplasmas harbouring 23S rRNA mutations would be resistant to the AZM-SR regimen, but those harbouring ParC alterations would still be susceptible to the sitafloxacin regimen.


23S rRNA; GyrA; ParC; azithromycin; sitafloxacin

[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Silverchair Information Systems
Loading ...
Support Center