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Volume 31, Number 4—April 2025
Research Letter
Spread of Dual-Resistant Mycoplasma genitalium Clone among Men, France, 2021–2022
, C. Laurier-Nadalié, Carla Balcon, Nadège Hénin, Amandine Dolzy, Marie Gardette, Jennifer Guiraud, Cécile Bébéar, and investigator group1
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.
1Members of the investigator group are listed at the end of this article.