Abstract
The cell wall-less species Mycoplasma genitalium is a sexually transmitted pathogen with strong tendency to acquire resistance. Current knowledge about trends of resistance rates and differences between the risk population of men who have sex with men (MSM) and heterosexual patients as well as about circulating genotypes in both groups is limited. Between August 2017 and December 2023, M. genitalium strains in 373 samples from patients (MSM: n=269, non-MSM: n=104) consulting a specialized STI-practice in Berlin, Germany, were characterized by molecular methods to detect the presence of mutations associated with macrolide (23S rRNA) and quinolone resistance (parC) and to determine the MgpB-type of strains. Overall, 37.5% (MSM) and 30.8% (heterosexual patients) carrying M. genitalium are asymptomatic. Among MSM, the rate of macrolide resistance remained relatively constant in the investigation period (mean: 85.9% of strains) whereas quinolone resistance (mean: 19.7%) increased from 6.8% (2017) to around 38% (2021-2023). In contrast, mean rates of 42.2% (macrolides) and 12.5% (quinolones) were measured in strains from heterosexual patients. Most common MgpB-types were type 4 (MSM, 38.4%) and type 7 (non-MSM, 16.7%), respectively. The results of the study confirmed a constantly high rate of macrolide resistant M. genitalium strains and a trend to increased quinolone resistance among MSM in an urban environment. Despite lower rates, the percentage of resistant strains from heterosexual patients has also reached an alarming extent. Determination of MgpB-types provides insights into the distribution of genotypes of an important agent of sexually transmitted infections in both population groups.
Published Version
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