Prevalence and macrolide resistance of Mycoplasma genitalium from patients seeking sexual health care in Southern Ghana

BMC Infect Dis. 2024 Sep 16;24(1):981. doi: 10.1186/s12879-024-09880-2.

Abstract

Background: Mycoplasma genitalium (MG), a sexually transmitted infection (STI), has emerged as a common cause of non-gonococcal urethritis and cervicitis worldwide, with documented resistance to commonly used antibiotics including doxycycline and azithromycin. Data in Ghana regarding the prevalence of MG is limited.

Methods: This retrospective study investigated MG presence and macrolide resistance among patients who previously reported to selected clinics for STI symptoms between December 2012 and June 2020. Samples were screened for MG and mutations associated with azithromycin resistance were investigated using Nucleic Acid Amplification Testing (NAAT) including the Resistance Plus MG® kit from SpeeDx and the LightMix® kit for MG, combined with the Modular Mycoplasma Macrolide from TIB Molbiol.

Results: A total of 1,015 samples were screened, out of which MG infection rate by TIB Molbiol and SpeeDx were 3.1% and 3.4%, respectively. The mutation responsible for macrolide resistance was detected in one MG positive sample by both assays. Both diagnostic tests revealed no significant association between MG infection and socio-demographic characteristics, clinical symptoms, gonorrhea, and chlamydia infection status. There was no significant difference in the mycoplasma percentage positivity rate detected using SpeeDx (3.4%) and TIB Molbiol (3.1%).

Conclusions: While not commonly tested as a cause of STI symptoms, MG is widespread in Ghana, exhibiting symptoms and prevalence comparable to those in other countries and linked to antimicrobial resistance. Future research using various molecular techniques is essential to monitor resistance trends and guide future antibiotic choices.

Keywords: Macrolide resistance; Mycoplasma genitalium; Nucleic Acid Amplification Test (NAAT); Prevalence; Sexually Transmitted Infections (STI).

MeSH terms

  • Adolescent
  • Adult
  • Anti-Bacterial Agents* / pharmacology
  • Anti-Bacterial Agents* / therapeutic use
  • Azithromycin / pharmacology
  • Azithromycin / therapeutic use
  • Drug Resistance, Bacterial* / genetics
  • Female
  • Ghana / epidemiology
  • Humans
  • Macrolides* / pharmacology
  • Macrolides* / therapeutic use
  • Male
  • Microbial Sensitivity Tests
  • Middle Aged
  • Mutation
  • Mycoplasma Infections* / drug therapy
  • Mycoplasma Infections* / epidemiology
  • Mycoplasma Infections* / microbiology
  • Mycoplasma genitalium* / drug effects
  • Mycoplasma genitalium* / genetics
  • Mycoplasma genitalium* / isolation & purification
  • Prevalence
  • Retrospective Studies
  • Sexual Health
  • Young Adult

Substances

  • Macrolides
  • Anti-Bacterial Agents
  • Azithromycin