French Prospective Clinical Evaluation of the Aptima Mycoplasma genitalium CE-IVD Assay and Macrolide Resistance Detection Using Three Distinct Assays

J Clin Microbiol. 2017 Nov;55(11):3194-3200. doi: 10.1128/JCM.00579-17. Epub 2017 Aug 9.

Abstract

The aim of this study was to evaluate the clinical performance of the Aptima Mycoplasma genitalium transcription-mediated amplification (MG-TMA) CE-marked for in vitro diagnosis (CE-IVD) assay for the detection of Mycoplasma genitalium in male and female clinical samples in comparison with the in-house real-time PCR (in-house PCR) assay routinely used in our laboratory. A total of 1,431 clinical specimens obtained from 1,235 patients were prospectively collected at the Bacteriology Department of Bordeaux University Hospital (France). Additional research-use-only Aptima M. genitalium transcription-mediated amplification (TMA) assays, Alt1-TMA and Alt2-TMA, were performed on discordant specimens to determine M. genitalium infection status. All confirmed M. genitalium-positive specimens were tested for macrolide resistance using three assays: the in-house 23S rRNA FRET PCR assay, the SpeeDx ResistancePlus MG assay and the nested reverse transcription-PCR (RT-PCR) sequencing assay. The comparison of the MG-TMA assay with the in-house PCR results showed a moderate correlation (kappa value, 0.69). The MG-TMA assay had higher clinical sensitivity compared to that of the in-house PCR assay (100% versus 59.74%, respectively) and similar specificity (99.10% versus 100%, respectively) for M. genitalium detection. In this study, the prevalence of M. genitalium infection was 5.90% (72/1,220 patients). The nested RT-PCR sequencing assay was the most sensitive but the most laborious assay for detecting macrolide-resistance-associated mutations. The prevalence of resistance was 8.33% (6/72). To our knowledge, this is the first clinical evaluation of the MG-TMA CE-IVD assay. The MG-TMA assay performed on the automated Panther system is a very sensitive and specific method for the detection of M. genitalium in clinical specimens.

Keywords: Mycoplasma genitalium; clinical specimens; macrolide resistance; real-time PCR; transcription-mediated amplification.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Anti-Bacterial Agents / pharmacology*
  • Bacteriological Techniques / methods*
  • Drug Resistance, Bacterial*
  • Female
  • France
  • Humans
  • Macrolides / pharmacology*
  • Male
  • Molecular Diagnostic Techniques / methods*
  • Mycoplasma Infections / diagnosis*
  • Mycoplasma genitalium / drug effects
  • Mycoplasma genitalium / isolation & purification*
  • Nucleic Acid Amplification Techniques / methods
  • Prospective Studies
  • Sensitivity and Specificity

Substances

  • Anti-Bacterial Agents
  • Macrolides