{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T07:05:39Z","timestamp":1790665539701,"version":"4.1.0"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2022,3,30]],"date-time":"2022-03-30T00:00:00Z","timestamp":1648598400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Pathology Queensland Study Education and Research Committee","award":["SERC5920"],"award-info":[{"award-number":["SERC5920"]}]},{"DOI":"10.13039\/501100000923","name":"Australian Research Council Research","doi-asserted-by":"crossref","award":["IH190100021"],"award-info":[{"award-number":["IH190100021"]}],"id":[{"id":"10.13039\/501100000923","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,5,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Mycoplasma genitalium infection is a sexually transmitted infection that has rapidly become resistant to mainstay treatments. While individualized treatment approaches have been recommended and adopted for macrolides, individualized therapy for fluoroquinolones has not yet been explored, due to a lack of commercial molecular assays and a lack of confidence in specific mutations associated with resistance. In another recent study, we defined a clear role and diagnostic utility in focusing on the absence of resistance mutations to inform microbial cure with fluoroquinolone antimicrobials.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We developed two proof-of-concept molecular tests that focus on detection of M. genitalium and characterization of WT parC sequences that are strongly linked to fluoroquinolone susceptibility.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We screened a total of 227 M. genitalium-positive samples using novel molecular beacon and dual hybridization probe assays. These assays were able to detect M. genitalium and characterize fluoroquinolone susceptibility in 143\/227 (63%) samples, based on clear differences in melting peak temperatures. The results of these molecular assays were in 100% agreement with \u2018gold standard\u2019 Sanger sequencing. Additionally, WT parC sequences were readily distinguished from M. genitalium samples harbouring parC mutations of known or suspected clinical significance. The ability of the assays to successfully characterize fluoroquinolone susceptibility and resistance was reduced in low M. genitalium load samples.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>These proof-of-concept assays have considerable potential to improve individualized treatment approaches and rationalize tests of cure for M. genitalium infection. The ability to initiate individualized treatment in up to two-thirds of cases will enhance antimicrobial stewardship for this challenging pathogen.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jac\/dkac097","type":"journal-article","created":{"date-parts":[[2022,3,14]],"date-time":"2022-03-14T12:06:43Z","timestamp":1647259603000},"page":"1592-1599","source":"Crossref","is-referenced-by-count":9,"title":["Novel probe-based melting curve assays for the characterization of fluoroquinolone resistance in <i>Mycoplasma genitalium<\/i>"],"prefix":"10.1093","volume":"77","author":[{"given":"Jacob A.","family":"Tickner","sequence":"first","affiliation":[{"name":"The University of Queensland Centre for Clinical Research (UQ-CCR), Faculty of Medicine, The University of Queensland , Brisbane, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catriona S.","family":"Bradshaw","sequence":"additional","affiliation":[{"name":"Melbourne Sexual Health Centre, Alfred Hospital and Central Clinical School, Monash University , Melbourne, Victoria, Australia"},{"name":"Central Clinical School, Monash University , Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerald L.","family":"Murray","sequence":"additional","affiliation":[{"name":"The Department of Obstetrics and Gynaecology, University of Melbourne , Parkville, Victoria, Australia"},{"name":"Centre for Women\u2019s Infectious Diseases, The Royal Women\u2019s Hospital , Parkville, Victoria, Australia"},{"name":"Molecular Microbiology Research Group, Murdoch Children\u2019s Research Institute , Parkville, Victoria, 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), Faculty of Medicine, The University of Queensland , Brisbane, Queensland, Australia"},{"name":"Pathology Queensland Central Laboratory , Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3199-6432","authenticated-orcid":false,"given":"Emma L.","family":"Sweeney","sequence":"additional","affiliation":[{"name":"The University of Queensland Centre for Clinical Research (UQ-CCR), Faculty of Medicine, The University of Queensland , Brisbane, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,3,30]]},"reference":[{"key":"2022053122483252500_dkac097-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":"2022053122483252500_dkac097-B2","first-page":"1017","article-title":"Moxifloxacin and sitafloxacin treatment failure in Mycoplasma genitalium infection: association with parC mutation G248\u2005T (S83I) and concurrent gyrA mutations","volume":"221","author":"Murray","year":"2020","journal-title":"J Infect Dis"},{"key":"2022053122483252500_dkac097-B3","doi-asserted-by":"crossref","first-page":"1302","DOI":"10.1016\/S1473-3099(20)30154-7","article-title":"Prevalence of mutations associated with resistance to macrolides and fluoroquinolones in Mycoplasma genitalium: a systematic review and meta-analysis","volume":"20","author":"Machalek","year":"2020","journal-title":"Lancet Infect Dis"},{"key":"2022053122483252500_dkac097-B4","doi-asserted-by":"crossref","first-page":"e01555-18","DOI":"10.1128\/JCM.01555-18","article-title":"Levels of Mycoplasma genitalium antimicrobial resistance differ by both region and gender in the state of Queensland, Australia: implications for treatment guidelines","volume":"57","author":"Sweeney","year":"2019","journal-title":"J Clin Microbiol"},{"key":"2022053122483252500_dkac097-B5","article-title":"Antibiotic Resistance Threats in the United States, 2019","author":"US CDC","year":"2019"},{"key":"2022053122483252500_dkac097-B6","doi-asserted-by":"crossref","first-page":"809","DOI":"10.3201\/eid2305.161745","article-title":"Increasing macrolide and fluoroquinolone resistance in Mycoplasma genitalium","volume":"23","author":"Murray","year":"2017","journal-title":"Emerg Infect Dis"},{"key":"2022053122483252500_dkac097-B7","doi-asserted-by":"crossref","first-page":"950","DOI":"10.1186\/s12879-020-05659-3","article-title":"Macrolide and fluoroquinolone associated mutations in Mycoplasma genitalium in a retrospective study of male and female patients seeking care at a STI Clinic in Guangzhou, China, 2016-2018","volume":"20","author":"Ke","year":"2020","journal-title":"BMC Infect Dis"},{"key":"2022053122483252500_dkac097-B8","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":"2022053122483252500_dkac097-B9","doi-asserted-by":"crossref","first-page":"1915","DOI":"10.1128\/JCM.02312-16","article-title":"Prospective evaluation of ResistancePlus MG, a new multiplex quantitative PCR assay for detection of Mycoplasma genitalium and macrolide resistance","volume":"55","author":"Tabrizi","year":"2017","journal-title":"J Clin Microbiol"},{"key":"2022053122483252500_dkac097-B10","doi-asserted-by":"crossref","first-page":"e00020-21","DOI":"10.1128\/JCM.00020-21","article-title":"Performance of three commercial molecular diagnostic assays for the simultaneous detection of Mycoplasma genitalium and macrolide resistance","volume":"59","author":"Le Roy","year":"2021","journal-title":"J Clin Microbiol"},{"key":"2022053122483252500_dkac097-B11","article-title":"Australian STI management guidelines: Mycoplasma genitalium","author":"The Australian Government Department of Health","year":"2019"},{"key":"2022053122483252500_dkac097-B12","article-title":"British Association for Sexual Health and HIV national guideline for the management of infection with Mycoplasma genitalium (2018)","author":"British Association for Sexual Health and HIV","year":"2018"},{"key":"2022053122483252500_dkac097-B13","article-title":"Sexually Transmitted Infections Treatment Guidelines, 2021","author":"CDC","year":"2021"},{"key":"2022053122483252500_dkac097-B14","doi-asserted-by":"crossref","first-page":"e0198355","DOI":"10.1371\/journal.pone.0198355","article-title":"Mutations in ParC and GyrA of moxifloxacin-resistant and susceptible Mycoplasma genitalium strains","volume":"13","author":"Hamasuna","year":"2018","journal-title":"PLoS One"},{"key":"2022053122483252500_dkac097-B15","doi-asserted-by":"crossref","first-page":"648","DOI":"10.1016\/j.jiac.2017.03.008","article-title":"Emergence of Mycoplasma genitalium with clinically significant fluoroquinolone resistance conferred by amino acid changes both in GyrA and ParC in Japan","volume":"23","author":"Deguchi","year":"2017","journal-title":"J Infect Chemother"},{"key":"2022053122483252500_dkac097-B16","doi-asserted-by":"crossref","first-page":"2376","DOI":"10.1093\/jac\/dku164","article-title":"Remarkable increase in fluoroquinolone-resistant Mycoplasma genitalium in Japan","volume":"69","author":"Kikuchi","year":"2014","journal-title":"J Antimicrob Chemother"},{"key":"2022053122483252500_dkac097-B17","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1097\/OLQ.0000000000001132","article-title":"Quinolone resistance-associated mutations in Mycoplasma genitalium: not ready for prime time","volume":"47","author":"Manhart","year":"2020","journal-title":"Sex Transm Dis"},{"key":"2022053122483252500_dkac097-B18","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/j.jiac.2021.11.011","article-title":"Analysis of fluoroquinolone-resistance using MIC determination and homology modelling of ParC of contemporary Mycoplasma genitalium strains","volume":"28","author":"Hamasuna","year":"2022","journal-title":"J Infect Chemother"},{"key":"2022053122483252500_dkac097-B19","doi-asserted-by":"crossref","DOI":"10.1093\/cid\/ciab1058","article-title":"Combination therapy for Mycoplasma genitalium, and new insights into the utility of parC mutant detection to improve cure","author":"Vodstrcil","year":"2022","journal-title":"Clin Infect Dis"},{"key":"2022053122483252500_dkac097-B20","doi-asserted-by":"crossref","DOI":"10.1016\/S1473-3099(21)00629-0","article-title":"Individualised treatment of Mycoplasma genitalium infection \u2013 incorporation of fluoroquinolone resistance testing into clinical care.","author":"Sweeney","year":"2022","journal-title":"Lancet Infect Dis"},{"key":"2022053122483252500_dkac097-B21","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1128\/JCM.42.2.683-692.2004","article-title":"Use of TaqMan 5\u2032 nuclease real-time PCR for quantitative detection of Mycoplasma genitalium DNA in males with and without urethritis who were attendees at a sexually transmitted disease clinic","volume":"42","author":"Jensen","year":"2004","journal-title":"J Clin Microbiol"},{"key":"2022053122483252500_dkac097-B22","article-title":"Seegene Allplex MG & MoxiR Assay","author":"Seegene"},{"key":"2022053122483252500_dkac097-B23","article-title":"NYtor MG fluoroquinolone RES real-time PCR","author":"NYtor"},{"key":"2022053122483252500_dkac097-B24","article-title":"TibMolBiol Mycoplasma genitalium fluoroquinolone resistance assay (RUO)","author":"TibMolBiol"},{"key":"2022053122483252500_dkac097-B25","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1093\/jac\/dkaa542","article-title":"Mycoplasma genitalium infections can comprise a mixture of both fluoroquinolone-susceptible and fluoroquinolone-resistant strains","volume":"76","author":"Sweeney","year":"2021","journal-title":"J Antimicrob Chemother"},{"key":"2022053122483252500_dkac097-B26","doi-asserted-by":"crossref","first-page":"328","DOI":"10.3201\/eid2402.170902","article-title":"Use of pristinamycin for macrolide-resistant Mycoplasma genitalium infection","volume":"24","author":"Read","year":"2018","journal-title":"Emerg Infect Dis"},{"key":"2022053122483252500_dkac097-B27","doi-asserted-by":"crossref","DOI":"10.1093\/ofid\/ofaa291","article-title":"Nonquinolone options for the treatment of Mycoplasma genitalium in the era of increased resistance","volume":"7","author":"Doyle","year":"2020","journal-title":"Open Forum Infect Dis"}],"container-title":["Journal of Antimicrobial Chemotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jac\/article-pdf\/77\/6\/1592\/43893425\/dkac097.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jac\/article-pdf\/77\/6\/1592\/43893425\/dkac097.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,31]],"date-time":"2022-05-31T22:51:15Z","timestamp":1654037475000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jac\/article\/77\/6\/1592\/6555777"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,30]]},"references-count":27,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2022,3,30]]},"published-print":{"date-parts":[[2022,5,29]]}},"URL":"https:\/\/doi.org\/10.1093\/jac\/dkac097","relation":{},"ISSN":["0305-7453","1460-2091"],"issn-type":[{"value":"0305-7453","type":"print"},{"value":"1460-2091","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,6,1]]},"published":{"date-parts":[[2022,3,30]]}}}