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High cure rates of Mycoplasma genitalium following empiric treatment with azithromycin alongside frequent detection of macrolide resistance in Austria.
Chromy, David; Starossek, Lisa; Grabmeier-Pfistershammer, Katharina; Adamek, Sarah; Maischack, Felix; Sammet, Stefanie; Sadoghi, Birgit; Stary, Georg; Willinger, Birgit; Weninger, Wolfgang; Esser, Stefan; Makristathis, Athanasios; Bauer, Wolfgang Michael.
Afiliación
  • Chromy D; Department of Dermatology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
  • Starossek L; Department of Dermatology and Venereology, University Hospital Essen, University Duisburg-Essen, Essen, Germany.
  • Grabmeier-Pfistershammer K; Department of Dermatology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
  • Adamek S; Department of Dermatology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
  • Maischack F; Department of Dermatology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
  • Sammet S; Department of Dermatology and Venereology, University Hospital Essen, University Duisburg-Essen, Essen, Germany.
  • Sadoghi B; Department of Dermatology and Venereology, University Hospital Essen, University Duisburg-Essen, Essen, Germany.
  • Stary G; Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria.
  • Willinger B; Department of Dermatology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
  • Weninger W; Division of Clinical Microbiology, Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria.
  • Esser S; Department of Dermatology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
  • Makristathis A; Department of Dermatology and Venereology, University Hospital Essen, University Duisburg-Essen, Essen, Germany.
  • Bauer WM; Division of Clinical Microbiology, Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria.
Infection ; 52(5): 1921-1930, 2024 Oct.
Article en En | MEDLINE | ID: mdl-38649669
ABSTRACT

BACKGROUND:

Mycoplasma genitalium (MG) is an emerging sexually transmitted infection, often harboring resistance-associated mutations to azithromycin (AZM). Global surveillance has been mandated to tackle the burden caused by MG, yet no data are available for Austria. Thus, we aimed to investigate the prevalence of MG, disease characteristics, and treatment outcomes at the largest Austrian HIV-and STI clinic.

METHODS:

All MG test results at the Medical University of Vienna from 02/2019 to 03/2022 were evaluated. Azithromycin resistance testing was implemented in 03/2021.

RESULTS:

Among 2671 MG tests, 199 distinct and mostly asymptomatic (68%; 135/199) MG infections were identified, affecting 10% (178/1775) of all individuals. This study included 83% (1479/1775) men, 53% (940/1775) men who have sex with men (MSM), 31% (540/1754) HIV+, and 15% (267/1775) who were using HIV pre-exposure prophylaxis (PrEP). In logistic regression analysis, 'MSM' (aOR 2.55 (95% CI 1.65-3.92)), 'use of PrEP' (aOR 2.29 (95% CI 1.58-3.32)), and 'history of syphilis' (aOR 1.57 (95% CI 1.01-2.24) were independent predictors for MG infections. Eighty-nine percent (178/199) received treatment 11% (21/178) doxycycline (2 weeks), 52% (92/178) AZM (5 days), and 37% ( 65/178) moxifloxacin (7-10 days) and 60% (106/178) had follow-up data available showing negative tests in 63% (5/8), 76% (44/58) and 85% (34/40), respectively. AZM resistance analysis was available for 57% (114/199)) and detected in 68% (78/114). Resistance-guided therapy achieved a cure in 87% (53/61), yet, empiric AZM-treatment (prior to 03/2021) cleared 68% (26/38).

CONCLUSIONS:

Mycoplasma genitalium was readily detected in this Austrian observational study, affected predominantly MSM and often presented as asymptomatic disease. We observed a worryingly high prevalence of AZM resistance mutations; however, empiric AZM treatment cleared twice as many MG infections as expected.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Azitromicina / Macrólidos / Farmacorresistencia Bacteriana / Mycoplasma genitalium / Antibacterianos / Infecciones por Mycoplasma Límite: Adult / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: Infection Año: 2024 Tipo del documento: Article País de afiliación: Austria Pais de publicación: Alemania
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Azitromicina / Macrólidos / Farmacorresistencia Bacteriana / Mycoplasma genitalium / Antibacterianos / Infecciones por Mycoplasma Límite: Adult / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: Infection Año: 2024 Tipo del documento: Article País de afiliación: Austria Pais de publicación: Alemania