{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T17:54:20Z","timestamp":1785434060011,"version":"3.56.0"},"reference-count":34,"publisher":"American Society for Microbiology","issue":"5","license":[{"start":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T00:00:00Z","timestamp":1778025600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T00:00:00Z","timestamp":1778025600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"name":"French National Reference Centre for Bacterial STIs","award":["Internal funding"],"award-info":[{"award-number":["Internal funding"]}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Antimicrob Agents Chemother"],"published-print":{"date-parts":[[2026,5,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      Pristinamycin, a streptogramin combination, is recommended as a third-line treatment for\n                      <jats:italic toggle=\"yes\">Mycoplasma genitalium<\/jats:italic>\n                      infections according to European guidelines. However, the molecular mechanisms underlying pristinamycin resistance have not yet been elucidated. We investigated the\n                      <jats:italic toggle=\"yes\">in vitro<\/jats:italic>\n                      development of pristinamycin-resistant\n                      <jats:italic toggle=\"yes\">M. genitalium<\/jats:italic>\n                      mutants under exposure to subinhibitory concentrations of pristinamycin or josamycin. Resistant mutants were characterized by determining the MICs of seven antibiotics, performing Sanger sequencing of 23S rRNA and the ribosomal protein L4 and L22 genes, and conducting whole-genome sequencing in comparison with the parental, susceptible G37 reference strain. Mutants selected in the presence of pristinamycin harbored either an A2062C or A2062G mutation in 23S rRNA, both associated with a marked increase in the MICs of pristinamycin and josamycin. By contrast, selection with josamycin produced a mutant carrying the A2059G mutation, which exhibited elevated MICs for erythromycin, azithromycin, josamycin, and clindamycin, but not for pristinamycin. None of the three resistant mutants showed any detectable growth defect in culture. To mimic pristinamycin treatment in a macrolide-resistant background, further selection was performed using subinhibitory concentrations of pristinamycin on the azithromycin-resistant A2059G mutant. This led to the emergence of an additional C2611T substitution in 23S rRNA, resulting in a pristinamycin MIC of 8 mg\/L. No stable mutations were observed in the ribosomal protein L4 or L22 genes during the selection process. In conclusion, this study demonstrates that pristinamycin resistance in\n                      <jats:italic toggle=\"yes\">M. genitalium<\/jats:italic>\n                      is mediated by mutations in the 23S rRNA gene. These laboratory-derived mutations may foreshadow resistance mechanisms emerging in clinical isolates.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1128\/aac.00094-26","type":"journal-article","created":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T12:00:10Z","timestamp":1774958410000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":1,"title":["<i>In vitro<\/i>\n                    selection and characterization of resistance to pristinamycin in\n                    <i>Mycoplasma genitalium<\/i>"],"prefix":"10.1128","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3235-9264","authenticated-orcid":true,"given":"Chlo\u00e9","family":"Le Roy","sequence":"first","affiliation":[{"name":"University of Bordeaux, CNRS, MFP, Fundamental Microbiology and Pathology, UMR 5234","place":["Bordeaux, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Guiraud","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/057qpr032","id-type":"ROR","asserted-by":"publisher"}],"name":"Bacteriology Department, Bordeaux University Hospital, National Reference Centre for bacterial sexually transmitted infections","place":["Bordeaux, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Otgonjargal","family":"Byambaa","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00gcpds33","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Microbiology and Infection prevention control, Mongolian National University of Medical Science, School of Biomedicine","place":["Ulaanbaatar, Mongolia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla","family":"Balcon","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/057qpr032","id-type":"ROR","asserted-by":"publisher"}],"name":"Bacteriology Department, Bordeaux University Hospital, National Reference Centre for bacterial sexually transmitted infections","place":["Bordeaux, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8854-6732","authenticated-orcid":true,"given":"L\u00e9o","family":"Gillet","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/057qpr032","id-type":"ROR","asserted-by":"publisher"}],"name":"Bacteriology Department, Bordeaux University Hospital, National Reference Centre for bacterial sexually transmitted infections","place":["Bordeaux, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7464-7435","authenticated-orcid":true,"given":"Jorgen S.","family":"Jensen","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/0417ye583","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Bacteria, Parasites and Fungi, Statens Serum Institut","place":["Copenhagen, Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6065-2332","authenticated-orcid":true,"given":"C\u00e9cile","family":"B\u00e9b\u00e9ar","sequence":"additional","affiliation":[{"name":"University of Bordeaux, CNRS, MFP, Fundamental Microbiology and Pathology, UMR 5234","place":["Bordeaux, France"]},{"id":[{"id":"https:\/\/ror.org\/057qpr032","id-type":"ROR","asserted-by":"publisher"}],"name":"Bacteriology Department, Bordeaux University Hospital, National Reference Centre for bacterial sexually transmitted infections","place":["Bordeaux, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1757-4206","authenticated-orcid":true,"given":"Sabine","family":"Pereyre","sequence":"additional","affiliation":[{"name":"University of Bordeaux, CNRS, MFP, Fundamental Microbiology and Pathology, UMR 5234","place":["Bordeaux, France"]},{"id":[{"id":"https:\/\/ror.org\/057qpr032","id-type":"ROR","asserted-by":"publisher"}],"name":"Bacteriology Department, Bordeaux University Hospital, National Reference Centre for bacterial sexually transmitted infections","place":["Bordeaux, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"On behalf of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Mycoplasma and Chlamydia Infections (ESGMAC)","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.idc.2023.02.009"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.17972"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41579-024-01023-3"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanmic.2024.101047"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1086\/593188"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.3201\/eid\/1706.101055"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.3201\/eid2402.170902"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.36.4.870"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciu1162"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofaa291"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2023-056093"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.48.2.460-465.2004"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.02411-14"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.42.2.683-692.2004"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkac281"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00020-21"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.45.10.2958-2960.2001"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkae430"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00819-21"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.39.12.2770"},{"key":"e_1_3_4_22_2","unstructured":"Soci\u00e9t\u00e9 Fran\u00e7aise de Microbiologie. 2025. CA-SFM \/ EUCAST. Soci\u00e9t\u00e9 Fran\u00e7aise de Microbiologie ed V1.1"},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.1017\/s135583829998202x"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/s1097-2765(02)00570-1"},{"key":"e_1_3_4_25_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-015-0781-7"},{"key":"e_1_3_4_26_2","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2022-055466"},{"key":"e_1_3_4_27_2","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0000000000001415"},{"key":"e_1_3_4_28_2","doi-asserted-by":"publisher","DOI":"10.1101\/cshperspect.a025437"},{"key":"e_1_3_4_29_2","doi-asserted-by":"publisher","DOI":"10.1128\/aac.01006-24"},{"key":"e_1_3_4_30_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrmicro2319"},{"key":"e_1_3_4_31_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkl026"},{"key":"e_1_3_4_32_2","doi-asserted-by":"publisher","DOI":"10.1128\/microbiolspec.ARBA-0030-2018"},{"key":"e_1_3_4_33_2","doi-asserted-by":"publisher","DOI":"10.1089\/mdr.2022.0131"},{"key":"e_1_3_4_34_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01478-19"},{"key":"e_1_3_4_35_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijms24087218"}],"container-title":["Antimicrobial Agents and Chemotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/aac.00094-26","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/aac.00094-26","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T13:04:16Z","timestamp":1778072656000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.asm.org\/doi\/10.1128\/aac.00094-26"}},"subtitle":[],"editor":[{"given":"Laurent","family":"Poirel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,5,6]]},"references-count":34,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5,6]]}},"alternative-id":["10.1128\/aac.00094-26"],"URL":"https:\/\/doi.org\/10.1128\/aac.00094-26","relation":{},"ISSN":["0066-4804","1098-6596"],"issn-type":[{"value":"0066-4804","type":"print"},{"value":"1098-6596","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,6]]},"assertion":[{"value":"2026-01-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-27","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-31","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e00094-26"}}