Understanding the spread of de novo and transmitted macrolide-resistance in Mycoplasma genitalium

PeerJ

article

Dominique Cadosch¹  Victor Garcia¹  Jørgen S. Jensen³  Nicola Low¹  Christian L. Althaus¹ 

[1] Institute of Social and Preventive Medicine, University of Bern;School of Life Sciences and Facility Management, Zurich University of Applied Sciences;Research Unit for Reproductive Tract Microbiology, Statens Serum Institut

关键词: Mycoplasma genitalium;    Mathematical model;    Antibiotic resistance;    Sexually transmitted infection;   

DOI  :  10.7717/peerj.8913

学科分类：社会科学、人文和艺术（综合）

来源: Inra

【 摘 要 】

BackgroundThe rapid spread of azithromycin resistance in sexually transmitted Mycoplasma genitalium infections is a growing concern. It is not yet clear to what degree macrolide resistance in M. genitalium results from the emergence of de novo mutations or the transmission of resistant strains.MethodsWe developed a compartmental transmission model to investigate the contribution of de novo macrolide resistance mutations to the spread of antimicrobial-resistant M. genitalium. We fitted the model to resistance data from France, Denmark and Sweden, estimated the time point of azithromycin introduction and the rates at which infected individuals receive treatment, and projected the future spread of resistance.ResultsThe high probability of de novo resistance in M. genitalium accelerates the early spread of antimicrobial resistance. The relative contribution of de novo resistance subsequently decreases, and the spread of resistant infections in France, Denmark and Sweden is now mainly driven by transmitted resistance. If treatment with single-dose azithromycin continues at current rates, macrolide-resistant M. genitalium infections will reach 25% (95% confidence interval, CI [9–30]%) in France, 84% (95% CI [36–98]%) in Denmark and 62% (95% CI [48–76]%) in Sweden by 2025.ConclusionsBlind treatment of urethritis with single-dose azithromycin continues to select for the spread of macrolide resistant M. genitalium. Clinical management strategies for M. genitalium should limit the unnecessary use of macrolides.

【 授权许可】

CC BY