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Volume 31, Number 4—April 2025
Research Letter

Spread of Dual-Resistant Mycoplasma genitalium Clone among Men, France, 2021–2022

Sabine PereyreComments to Author , C. Laurier-Nadalié, Carla Balcon, Nadège Hénin, Amandine Dolzy, Marie Gardette, Jennifer Guiraud, Cécile Bébéar, and investigator group1
Author affiliation: University of Bordeaux–National Centre for Scientific Research, Bordeaux, France (S. Pereyre, N. Henin, C. Bébéar); Bordeaux University Hospital, Bordeaux (S. Pereyre, C. Laurier-Nadalié, C. Balcon, A. Dolzy, M. Gardette, J. Guiraud, C. Bébéar)

Main Article

Table

Characteristics of the 327 Mycoplasma genitalium–positive men with successful determination of the 23S rRNA sequence from a study investigating the spread of a dual-resistant Mycoplasma genitalium clone among men, France, 2021–2022*

Characteristic A2058T Other defined 23S rRNA macrolide resistance–associated mutations Wild type p value†
No. patients
55
109
163

Age
Mean age, y 35.0 34.3 33.2 NS
Median age, y 33.4 31.5 30.1
Range, y
(18–68)
(19–71)
(2 mo–67 y)

Reason for M. genitalium detection
Urogenital symptoms 11 (34.4) 23 (40.4) 37 (44.6) NS
No urogenital symptoms‡ 21 (65.6) 34 (59.6) 46 (55.4)
Unknown
23
52
80

Sexual behavior in men
MSM or bisexual men 26 (86.7) 31 (77.5) 34 (50.0) <0.05§
MSW 4 (13.3) 9 (22.5) 34 (50.0)
Unknown
25
69
95

HIV status
Positive 7 (22.6) 8 (12.1) 11 (12.8) NS
Negative 24 (77.4) 58 (87.9) 75 (87.2)
Unknown
24
43
77

Geographic origin
Paris area 27 (49.1) 34 (31.2) 58 (35.6) <0.05¶
Other regions of France
28 (50.9)
75 (68.8)
105 (64.4)
ParC QRDR mutations (M. genitalium numbering)
None 12 (22.6) 83 (80.6) 129 (91.5) <0.05
Ser83 Ileu 35 (66.0) 15 (14.6) 6 (4.3) <0.05
Other ParC mutations associated with FQ resistance (Asp87Asn, Asp87Tyr, or Gly81Cys) 4 (7.5) 4 (3.9) 5 (3.5) NS
Other undefined ParC mutations associated with FQ resistance# 2 (3.8) 1(0.9) 1(0.7) NS
Undetermined
2
6
22

GyrA QRDR mutations (M. genitalium numbering)**
Mutations in Asp99 (Asp99Asn or Asp99Gly) 4 (10.8) 0 0 NS
Other GyrA mutations with unknown significance 0 2 (10.0) 0
Wild type 33 (89.2) 18 (90.0) 7 (100.0)
Undetermined 3 0 5
Chlamydia trachomatis coinfection 4 (8.7) 4 (4.8) 18 (13.4) <0.05††
Neisseria gonorrhoeae coinfection 5 (10.9) 5 (6.0) 7 (5.2) NS

*Data are no. (%), except as indicated. A2058T is numbered according to Escherichia coli numbering. FQ, fluoroquinolone; MSM, men who have sex with men; MSW, men who have sex with women; NS, not significant; QRDR, quinolone resistance–determining region. †p value calculated by using the χ2 or Fisher test, as appropriate. ‡Sexually transmitted infection screening, HIV follow-up, or pre-exposure prophylaxis for HIV follow-up. §p value calculated between the numbers for A2058T and wild type, and between other defined 23S rRNA macrolide resistance–associated mutations and wild type. ¶p value calculated between numbers for A2058T and other defined 23S rRNA macrolide resistance–associated mutations and wild type. #Fluoroquinolone resistance–associated mutations were detected using the MGMO quantitative PCR kit (NYtor, https://www.nytor.nl), which does not specify the nature or location of the mutation. **GyrA mutations were only searched in the ParC-mutated strains. ††p value calculated between the numbers for other defined 23S rRNA macrolide resistance–associated mutations and wild type.

Main Article

1Members of the investigator group are listed at the end of this article.

Page created: February 12, 2025
Page updated: March 17, 2025
Page reviewed: March 17, 2025
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