{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T22:36:14Z","timestamp":1792449374728,"version":"4.5.0"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2023,2,1]],"date-time":"2023-02-01T00:00:00Z","timestamp":1675209600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000923","name":"an Australian Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000923","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,6,16]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Although single nucleotide polymorphisms (SNPs) in Mycoplasma genitalium parC contribute to fluoroquinolone treatment failure, data are limited for the homologous gene, gyrA. This study investigated the prevalence of gyrA SNPs and their contribution to fluoroquinolone failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Samples from 411 patients (male and female) undergoing treatment for M. genitalium infection (Melbourne Sexual Health Centre, March 2019\u2013February 2020) were analyzed by Sanger sequencing (gyrA and parC). For patients treated with moxifloxacin (n = 194), the association between SNPs and microbiologic treatment outcome was analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The most common parC SNP was G248T\/S83I (21.1% of samples), followed by D87N (2.3%). The most common gyrA SNP was G285A\/M95I (7.1%). Dual parC\/gyrA SNPs were found in 8.6% of cases. One third of infections harboring parC G248T\/S83I SNP had a concurrent SNP in gyrA conferring M95I. SNPs in gyrA cooccurred with parC S83I variations. Treatment failure was higher in patients with parC S83I\/gyrA dual SNPs when compared with infections with single S83I SNP alone from analysis of (1) 194 cases in this study (81.2% vs 45.8%, P = .047), and (2) pooled analysis of a larger population of 535 cases (80.6% vs 43.2%; P = .0027), indicating a strong additive effect.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Compared with parC S83I SNP alone, M. genitalium infections with dual mutations affecting parC\/gyrA had twice the likelihood of failing moxifloxacin. Although antimicrobial resistance varies by region globally, these data indicate that gyrA should be considered as a target for future resistance assays in Australasia. We propose a strategy for the next generation of resistance-guided therapy incorporating parC and gyrA testing.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciad057","type":"journal-article","created":{"date-parts":[[2023,2,1]],"date-time":"2023-02-01T17:03:04Z","timestamp":1675270984000},"page":"2187-2195","source":"Crossref","is-referenced-by-count":55,"title":["<i>gyrA<\/i>\n                    Mutations in\n                    <i>Mycoplasma genitalium<\/i>\n                    and Their Contribution to Moxifloxacin Failure: Time for the Next Generation of Resistance-Guided Therapy"],"prefix":"10.1093","volume":"76","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3330-4433","authenticated-orcid":false,"given":"Gerald L","family":"Murray","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology, The University of Melbourne , Parkville, Victoria , Australia"},{"name":"Women's Centre for Infectious Diseases, The Royal Women's Hospital , Parkville, Victoria , Australia"},{"name":"Murdoch Children's Research Institute , Parkville, Victoria , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica L","family":"Plummer","sequence":"additional","affiliation":[{"name":"Women's Centre for Infectious Diseases, The Royal Women's Hospital , Parkville, Victoria , Australia"},{"name":"Murdoch Children's Research Institute , Parkville, Victoria , Australia"},{"name":"Melbourne Sexual Health Centre, Alfred Health , Carlton, Victoria , Australia"},{"name":"Central Clinical School, Monash University , Melbourne, Victoria , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaveesha","family":"Bodiyabadu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, The University of Melbourne , Parkville, Victoria , Australia"},{"name":"Women's Centre for Infectious Diseases, The Royal Women's Hospital , Parkville, Victoria , Australia"},{"name":"Murdoch Children's Research Institute , Parkville, Victoria , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lenka A","family":"Vodstrcil","sequence":"additional","affiliation":[{"name":"Melbourne Sexual Health Centre, Alfred Health , Carlton, Victoria , Australia"},{"name":"Central Clinical School, Monash University , Melbourne, Victoria , Australia"},{"name":"Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne , Melbourne, Victoria , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose L","family":"Huaman","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, The University of Melbourne , Parkville, Victoria , Australia"},{"name":"Women's Centre for Infectious Diseases, The Royal Women's Hospital , Parkville, Victoria , Australia"},{"name":"Murdoch Children's Research Institute , Parkville, Victoria , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer A","family":"Danielewski","sequence":"additional","affiliation":[{"name":"Women's Centre for Infectious Diseases, The Royal Women's Hospital , Parkville, Victoria , Australia"},{"name":"Murdoch Children's Research Institute , Parkville, Victoria , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teck Phui","family":"Chua","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, The University of Melbourne , Parkville, Victoria , Australia"},{"name":"Women's Centre for Infectious Diseases, The Royal Women's Hospital , Parkville, Victoria , Australia"},{"name":"Murdoch Children's Research Institute , Parkville, Victoria , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorothy A","family":"Machalek","sequence":"additional","affiliation":[{"name":"Women's Centre for Infectious Diseases, The Royal Women's Hospital , Parkville, Victoria , Australia"},{"name":"Kirby Institute, University of New South Wales , Sydney, New South Wales , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne","family":"Garland","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, The University of Melbourne , Parkville, Victoria , Australia"},{"name":"Women's Centre for Infectious Diseases, The Royal Women's Hospital , Parkville, Victoria , Australia"},{"name":"Murdoch Children's Research Institute , Parkville, Victoria , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Doyle","sequence":"additional","affiliation":[{"name":"Melbourne Sexual Health Centre, Alfred Health , Carlton, Victoria , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma L","family":"Sweeney","sequence":"additional","affiliation":[{"name":"The University of Queensland Centre for Clinical Research (UQ-CCR) , Queensland , Australia"},{"name":"SpeeDx Pty Ltd , Sydney, New South Wales , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David M","family":"Whiley","sequence":"additional","affiliation":[{"name":"The University of Queensland Centre for Clinical Research (UQ-CCR) , Queensland , Australia"},{"name":"Pathology Queensland Central Laboratory , Queensland , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catriona S","family":"Bradshaw","sequence":"additional","affiliation":[{"name":"Melbourne Sexual Health Centre, Alfred Health , Carlton, Victoria , Australia"},{"name":"Central Clinical School, Monash University , Melbourne, Victoria , Australia"},{"name":"Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne , Melbourne, Victoria , 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