{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T05:30:19Z","timestamp":1771306219825,"version":"3.50.1"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2022,7,23]],"date-time":"2022-07-23T00:00:00Z","timestamp":1658534400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Hologic, Inc"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,2,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>This study evaluated the distribution of macrolide-resistant Mycoplasma genitalium in multiple urogenital specimens collected from women enrolled in a prospective multicenter US clinical study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Four female urogenital specimens (vaginal swab, urine, endocervical swab, ectocervical brush\/spatula) collected from each subject were tested using a transcription-mediated amplification (TMA) assay for M. genitalium. TMA-positive specimens were evaluated by reverse transcription\u2013polymerase chain reaction and bidirectional Sanger sequencing of M. genitalium 23S rRNA to identify the presence of macrolide-resistance\u2013mediating mutations (MRMs) at base positions 2058\/2059.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 140 women with \u22651 TMA-positive specimens, 128 (91.4%) yielded M. genitalium 23S rRNA sequence. MRMs were found in 52% of vaginal specimens, 46.3% of urine specimens, 37.8% of endocervical specimens, and 46% of ectocervical specimens. There were 44 unique specimen type\/sequence phenotype combinations of M. genitalium infection. Most (81; 63.3%) women had single specimen-sequence phenotype (macrolide-susceptible, MRM, or both) infections, while 24 (18.8%) women had multiple specimen-sequence phenotype concordant infections, and 23 (17.9%) women had multiple specimen-sequence phenotype discordant infections. The sensitivity for any single specimen type to detect overall urogenital tract macrolide-resistant M. genitalium infection status was 96.3% for vaginal swab samples, 82.6% for urine samples, 70.8% for endocervical swab samples, and 82.1% for ectocervical brush\/spatula liquid Pap samples.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The distribution of M. genitalium infections in female urogenital tract specimens is highly complex, with multiple phenotypic combinations of the organism infecting a significant proportion of women at different anatomic specimen collection sites. Vaginal swab sampling yielded the highest sensitivity for identifying women with macrolide-resistant M. genitalium urogenital tract infections.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciac602","type":"journal-article","created":{"date-parts":[[2022,7,23]],"date-time":"2022-07-23T16:30:21Z","timestamp":1658593821000},"page":"e776-e782","source":"Crossref","is-referenced-by-count":5,"title":["Distribution of Macrolide Resistant <i>Mycoplasma genitalium<\/i> in Urogenital Tract Specimens From Women Enrolled in a US Clinical Study Cohort"],"prefix":"10.1093","volume":"76","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3530-2837","authenticated-orcid":false,"given":"Damon","family":"Getman","sequence":"first","affiliation":[{"name":"Research and Development, Hologic, Inc , San Diego, California , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seth","family":"Cohen","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, UT Southwestern Medical Center , Dallas, Texas , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alice","family":"Jiang","sequence":"additional","affiliation":[{"name":"Research and Development, Hologic, Inc , San Diego, California , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,7,23]]},"reference":[{"key":"2023020817091953200_ciac602-B1","doi-asserted-by":"crossref","first-page":"498","DOI":"10.1128\/CMR.00006-11","article-title":"Mycoplasma genitalium: from chrysalis to multicolored butterfly","volume":"24","author":"Taylor-Robinson","year":"2011","journal-title":"Clin Microbiol Rev"},{"key":"2023020817091953200_ciac602-B2","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1093\/cid\/civ312","article-title":"Mycoplasma genitalium infection and female reproductive tract disease: a meta-analysis","volume":"61","author":"Lis","year":"2015","journal-title":"Clin Infect Dis"},{"key":"2023020817091953200_ciac602-B3","doi-asserted-by":"crossref","first-page":"e00165-20","DOI":"10.1128\/JCM.00165-20","article-title":"Characteristics of Mycoplasma genitalium urogenital infections in a diverse patient sample from the United States: results from the Aptima Mycoplasma genitalium Evaluation Study (AMES)","volume":"58","author":"Manhart","year":"2020","journal-title":"J Clin Microbiol"},{"key":"2023020817091953200_ciac602-B4","doi-asserted-by":"crossref","first-page":"3013","DOI":"10.1007\/s43032-020-00399-w","article-title":"The associations of genital Mycoplasmas with female infertility and adverse pregnancy outcomes: a systematic review and meta-analysis","volume":"28","author":"Ma","year":"2021","journal-title":"Reprod Sci"},{"key":"2023020817091953200_ciac602-B5","doi-asserted-by":"crossref","first-page":"1118","DOI":"10.2105\/AJPH.2005.074062","article-title":"Mycoplasma genitalium among young adults in the United States: an emerging sexually transmitted infection","volume":"97","author":"Manhart","year":"2007","journal-title":"Am J Public Health"},{"key":"2023020817091953200_ciac602-B6","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1016\/j.diagmicrobio.2015.03.016","article-title":"Detection of Mycoplasma genitalium from male primary urine specimens: an epidemiologic dichotomy with Trichomonas vaginalis","volume":"82","author":"Napierala","year":"2015","journal-title":"Diagn Microbiol Infect Dis"},{"key":"2023020817091953200_ciac602-B7","doi-asserted-by":"crossref","first-page":"2278","DOI":"10.1128\/JCM.01053-16","article-title":"Mycoplasma genitalium prevalence, coinfection, and macrolide antibiotic resistance frequency in a multicenter clinical study cohort in the United States","volume":"54","author":"Getman","year":"2016","journal-title":"J Clin Microbiol"},{"key":"2023020817091953200_ciac602-B8","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1128\/JCM.02463-15","article-title":"Clinical laboratory assessment of Mycoplasma genitalium transcription-mediated amplification using primary female urogenital specimens","volume":"54","author":"Munson","year":"2016","journal-title":"J Clin Microbiol"},{"key":"2023020817091953200_ciac602-B9","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1136\/sextrans-2017-053384","article-title":"Prevalence of Mycoplasma genitalium in different population groups: systematic review and meta-analysis","volume":"94","author":"Baumann","year":"2018","journal-title":"Sex Transm Infect"},{"key":"2023020817091953200_ciac602-B10","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1007\/s15010-017-1002-7","article-title":"Simultaneous detection and identification of STI pathogens by multiplex real-time PCR in genital tract specimens in a selected area of Apulia, a region of southern Italy","volume":"45","author":"Del Prete","year":"2017","journal-title":"Infection"},{"key":"2023020817091953200_ciac602-B11","doi-asserted-by":"crossref","first-page":"e01125-19","DOI":"10.1128\/JCM.01125-19","article-title":"Molecular testing for Mycoplasma genitalium in the United States: results from the AMES prospective multicenter clinical study","volume":"57","author":"Gaydos","year":"2019","journal-title":"J Clin Microbiol"},{"key":"2023020817091953200_ciac602-B12","doi-asserted-by":"crossref","first-page":"e02124-19","DOI":"10.1128\/JCM.02124-19","article-title":"Mycoplasma genitalium detection in urogenital specimens from symptomatic and asymptomatic men and women by use of the Cobas TV\/MG test","volume":"58","author":"Pol B","year":"2020","journal-title":"J Clin Microbiol"},{"key":"2023020817091953200_ciac602-B13","doi-asserted-by":"crossref","first-page":"6675","DOI":"10.1128\/AAC.02904-14","article-title":"Development of a population pharmacokinetic model characterizing the tissue distribution of azithromycin in healthy subjects","volume":"58","author":"Zheng","year":"2014","journal-title":"Antimicrob Agents Chemother"},{"key":"2023020817091953200_ciac602-B14","doi-asserted-by":"crossref","first-page":"1546","DOI":"10.1086\/593188","article-title":"Azithromycin treatment failure in Mycoplasma genitalium-positive patients with nongonococcal urethritis is associated with induced macrolide resistance","volume":"47","author":"Jensen","year":"2008","journal-title":"Clin Infect Dis"},{"key":"2023020817091953200_ciac602-B15","doi-asserted-by":"crossref","first-page":"805","DOI":"10.1093\/cid\/ciz294","article-title":"Mycoplasma genitalium in symptomatic male urethritis: macrolide use is associated with increased resistance","volume":"70","author":"Li","year":"2020","journal-title":"Clin Infect Dis"},{"key":"2023020817091953200_ciac602-B16","doi-asserted-by":"crossref","first-page":"1","DOI":"10.15585\/mmwr.rr7004a1","article-title":"Sexually transmitted infections treatment guidelines, 2021","volume":"70","author":"Workowski","year":"2021","journal-title":"MMWR Recomm Rep"},{"key":"2023020817091953200_ciac602-B17","doi-asserted-by":"crossref","first-page":"3306","DOI":"10.1128\/JCM.00553-06","article-title":"Comparison of transcription-mediated amplification and PCR assay results for various genital specimen types for detection of Mycoplasma genitalium","volume":"44","author":"Wroblewski","year":"2006","journal-title":"J Clin Microbiol"},{"key":"2023020817091953200_ciac602-B18","doi-asserted-by":"crossref","first-page":"1328","DOI":"10.1016\/j.cmi.2018.03.013","article-title":"Identifying a consensus sample type to test for Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, Trichomonas vaginalis and human papillomavirus","volume":"24","author":"Coorevits","year":"2018","journal-title":"Clin Microbiol Infect"},{"key":"2023020817091953200_ciac602-B19","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1101\/gr.8.3.175","article-title":"Base-calling of automated sequencer traces using Phred. I. Accuracy assessment","volume":"8","author":"Ewing","year":"1998","journal-title":"Genome Res"},{"key":"2023020817091953200_ciac602-B20","volume-title":"Practical statistics for medical research","author":"Altman","year":"1991"},{"key":"2023020817091953200_ciac602-B21","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1093\/jac\/25.suppl_A.73","article-title":"The pharmacokinetics of azithromycin in human serum and tissues","volume":"25","author":"Foulds","year":"1990","journal-title":"J Antimicrob Chemother"},{"key":"2023020817091953200_ciac602-B22","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1136\/sextrans-2011-050035","article-title":"Selection of Mycoplasma genitalium strains harbouring macrolide resistance-associated 23S rRNA mutations by treatment with a single 1 g dose of azithromycin","volume":"87","author":"Ito","year":"2011","journal-title":"Sex Transm Infect"},{"key":"2023020817091953200_ciac602-B23","doi-asserted-by":"crossref","first-page":"e61481","DOI":"10.1371\/journal.pone.0061481","article-title":"Treatment of Mycoplasma genitalium. Observations from a Swedish STD clinic","volume":"8","author":"Anagrius","year":"2013","journal-title":"PLoS One"},{"key":"2023020817091953200_ciac602-B24","doi-asserted-by":"crossref","first-page":"1228","DOI":"10.1093\/cid\/ciu1162","article-title":"Macrolide resistance and azithromycin failure in a Mycoplasma genitalium-infected cohort and response of azithromycin failures to alternative antibiotic regimens","volume":"60","author":"Bissessor","year":"2015","journal-title":"Clin Infect Dis"},{"key":"2023020817091953200_ciac602-B25","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1136\/sti.2004.012062","article-title":"Mycoplasma genitalium: prevalence, clinical significance, and transmission","volume":"81","author":"Anagrius","year":"2005","journal-title":"Sex Transm Infect"},{"key":"2023020817091953200_ciac602-B26","doi-asserted-by":"crossref","first-page":"e624","DOI":"10.1093\/cid\/ciaa293","article-title":"Prevalence of Mycoplasma genitalium infection, antimicrobial resistance mutations, and symptom resolution following treatment of urethritis","volume":"71","author":"Bachmann","year":"2020","journal-title":"Clin Infect Dis"},{"key":"2023020817091953200_ciac602-B27","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1136\/sextrans-2019-054129","article-title":"Antimicrobial resistance in Mycoplasma genitalium sampled from the British general population","volume":"96","author":"Pitt","year":"2020","journal-title":"Sex Transm Infect"},{"key":"2023020817091953200_ciac602-B28","doi-asserted-by":"crossref","article-title":"Combination therapy for Mycoplasma genitalium, and new insights into the utility of parC mutant detection to improve cure","author":"Vodstrcil","DOI":"10.1093\/cid\/ciab1058"},{"key":"2023020817091953200_ciac602-B29","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1186\/s12879-021-05801-9","article-title":"Prevalence of urogenital, anal, and pharyngeal infections with Chlamydia trachomatis, Neisseria gonorrhoeae, and Mycoplasma genitalium: a cross-sectional study in Reunion Island","volume":"21","author":"Calas","year":"2021","journal-title":"BMC Infect Dis"},{"key":"2023020817091953200_ciac602-B30","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1097\/OLQ.0000000000001148","article-title":"High prevalence of vaginal and rectal Mycoplasma genitalium macrolide resistance among female sexually transmitted disease clinic patients in Seattle, Washington","volume":"47","author":"Khosropour","year":"2020","journal-title":"Sex Transm Dis"}],"container-title":["Clinical Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/cid\/advance-article-pdf\/doi\/10.1093\/cid\/ciac602\/45222273\/ciac602.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/cid\/article-pdf\/76\/3\/e776\/49125363\/ciac602.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/cid\/article-pdf\/76\/3\/e776\/49125363\/ciac602.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,2,8]],"date-time":"2023-02-08T17:48:28Z","timestamp":1675878508000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/cid\/article\/76\/3\/e776\/6649231"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,23]]},"references-count":30,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2022,7,23]]},"published-print":{"date-parts":[[2023,2,8]]}},"URL":"https:\/\/doi.org\/10.1093\/cid\/ciac602","relation":{},"ISSN":["1058-4838","1537-6591"],"issn-type":[{"value":"1058-4838","type":"print"},{"value":"1537-6591","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,2,1]]},"published":{"date-parts":[[2022,7,23]]}}}