parC Variants in Mycoplasma genitalium: Trends over Time and Association with Moxifloxacin Failure

Gerald L Murray; Kaveesha Bodiyabadu; Lenka A Vodstrcil; Dorothy A Machalek; Jennifer Danielewski; Erica L Plummer; Suzanne M Garland; David M Whiley; Emma L Sweeney; Catriona S Bradshaw

doi:10.1128/aac.00278-22

parC Variants in Mycoplasma genitalium: Trends over Time and Association with Moxifloxacin Failure

Antimicrob Agents Chemother. 2022 May 17;66(5):e0027822. doi: 10.1128/aac.00278-22. Epub 2022 Apr 27.

Authors

Gerald L Murray^{1

2

3}, Kaveesha Bodiyabadu^{1

2

3}, Lenka A Vodstrcil^{4

5}, Dorothy A Machalek^{1

2

6}, Jennifer Danielewski^{1

2}, Erica L Plummer^{1

2

4

5}, Suzanne M Garland^{1

2

3}, David M Whiley^{7

8}, Emma L Sweeney⁷, Catriona S Bradshaw^{4

5

9}

Affiliations

¹ Centre for Women's Infectious Diseases, The Royal Women's Hospital, Parkville, Victoria, Australia.
² Molecular Microbiology Research Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia.
³ Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Victoria, Australia.
⁴ Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia.
⁵ Central Clinical School, Monash Universitygrid.1002.3, Melbourne, Victoria, Australia.
⁶ The Kirby Institute, University of New South Wales, Kensington, Sydney, New South Wales, Australia.
⁷ The University of Queensland Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
⁸ Pathology Queensland Central Laboratory, Brisbane, Queensland, Australia.
⁹ Melbourne School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia.

Abstract

Prevalence, trends, and treatment outcome estimates were generated for parC variants in macrolide-resistant Mycoplasma genitalium. Among 539 cases, the most common amino acid change was S83I, which increased from 13% in 2012 to 2013, to 23% in 2019 to 2020 (P_trend = 0.046). From 381 moxifloxacin treatments, failure occurred in 58.7% (95% confidence interval [CI], 46.7 to 69.9) of cases with S83I. Other changes affecting S83 or D87 were uncommon and minor contributors to failure. The absence of S83I was highly predictive of moxifloxacin cure (96.4%; 95% CI, 93.7 to 98.2), highlighting diagnostic potential.

Keywords: Mycoplasma genitalium; antibiotic resistance; fluoroquinolone; moxifloxacin; parC.

MeSH terms

Anti-Bacterial Agents / pharmacology
Anti-Bacterial Agents / therapeutic use
Drug Resistance, Bacterial / genetics
Fluoroquinolones / therapeutic use
Humans
Macrolides
Moxifloxacin / therapeutic use
Mycoplasma Infections* / drug therapy
Mycoplasma Infections* / epidemiology
Mycoplasma genitalium* / genetics

Substances

Anti-Bacterial Agents
Fluoroquinolones
Macrolides
Moxifloxacin