{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T15:54:26Z","timestamp":1787759666962,"version":"build-2784847793"},"reference-count":28,"publisher":"American Society for Microbiology","issue":"2","license":[{"start":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T00:00:00Z","timestamp":1770163200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T00:00:00Z","timestamp":1770163200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["24K10540"],"award-info":[{"award-number":["24K10540"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["25K10733"],"award-info":[{"award-number":["25K10733"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Antimicrob Agents Chemother"],"published-print":{"date-parts":[[2026,2,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      The increasing prevalence of\n                      <jats:italic toggle=\"yes\">Mycoplasma genitalium<\/jats:italic>\n                      (MG) strains harboring macrolide and quinolone resistance-associated mutations (MRMs and QRMs, respectively) is a growing global concern. However, data on resistance patterns and genetic diversity in Japan remain limited. This study investigated MRMs and QRMs, genetic diversity using\n                      <jats:italic toggle=\"yes\">mgpB<\/jats:italic>\n                      and\n                      <jats:italic toggle=\"yes\">MG309<\/jats:italic>\n                      typing, and their association with treatment outcome in MG strains collected in Tokyo, Japan, between 2023 and 2025. Between 2023 and 2025, 188 clinical samples from 162 MG-positive patients were analyzed. Resistance mutations in 23S rRNA,\n                      <jats:italic toggle=\"yes\">parC<\/jats:italic>\n                      , and\n                      <jats:italic toggle=\"yes\">gyrA<\/jats:italic>\n                      were sequenced, and molecular typing was performed. Treatment outcomes were assessed using test-of-cure results. MRMs in 23S rRNA and QRMs in\n                      <jats:italic toggle=\"yes\">parC<\/jats:italic>\n                      S83I and\n                      <jats:italic toggle=\"yes\">gyrA<\/jats:italic>\n                      were identified in 94.4%, 65.5%, and 22.5% of samples, respectively. Dual-class resistance (MRMs + QRMs) was found in 89.4% of strains. Phylogenetic analysis based on\n                      <jats:italic toggle=\"yes\">mgpB<\/jats:italic>\n                      and\n                      <jats:italic toggle=\"yes\">MG309<\/jats:italic>\n                      typing revealed the emergence of dual-class drug-resistant clonal complexes, particularly those harboring\n                      <jats:italic toggle=\"yes\">mgpB<\/jats:italic>\n                      alleles 79, 140, 161, and 184. Dual-QRMs were significantly associated with quinolone treatment failure (52.4% vs 23.5%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.016). Dual-class drug-resistant MG strains, including emerging clonal complexes, are spreading in Tokyo, Japan. These findings emphasize the need for continued molecular surveillance and prudent antimicrobial use to preserve treatment efficacy.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1128\/aac.01367-25","type":"journal-article","created":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T20:27:57Z","timestamp":1767126477000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":5,"title":["Spread of dual-class drug-resistant\n                    <i>Mycoplasma genitalium<\/i>\n                    in Tokyo, Japan, 2023\u20132025"],"prefix":"10.1128","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-2509-8950","authenticated-orcid":true,"given":"Ryuha","family":"Omachi","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02tyjnv32","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Clinical Laboratory Medicine, Saitama Medical University","place":["Saitama, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8416-7371","authenticated-orcid":true,"given":"Kazuo","family":"Imai","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02tyjnv32","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Clinical Laboratory Medicine, Saitama Medical University","place":["Saitama, Japan"]},{"id":[{"id":"https:\/\/ror.org\/04zb31v77","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Infectious Disease and Infection Control, Saitama Medical University","place":["Saitama, Japan"]},{"name":"KARADA Internal Medicine Clinic","place":["Tokyo, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akihiro","family":"Sato","sequence":"additional","affiliation":[{"name":"KARADA Internal Medicine Clinic","place":["Tokyo, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masashi","family":"Tanaka","sequence":"additional","affiliation":[{"name":"KARADA Internal Medicine Clinic","place":["Tokyo, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hitomi","family":"Mizushina","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02tyjnv32","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Clinical Laboratory Medicine, Saitama Medical University","place":["Saitama, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keita","family":"Takeuchi","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02tyjnv32","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Clinical Laboratory Medicine, Saitama Medical University","place":["Saitama, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1433-0276","authenticated-orcid":false,"given":"Nobuaki","family":"Mori","sequence":"additional","affiliation":[{"name":"KARADA Internal Medicine Clinic","place":["Tokyo, Japan"]},{"name":"Department of Medicine, Division of Clinical Infectious Diseases, Showa Medical University School of Medicine","place":["Tokyo, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0912-4643","authenticated-orcid":false,"given":"Takuya","family":"Maeda","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02tyjnv32","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Clinical Laboratory Medicine, Saitama Medical University","place":["Saitama, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1099\/mic.0.000830"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/iju.13044"},{"key":"e_1_3_4_4_2","volume-title":"Guidelines for the diagnosis and treatment of sexually transmitted infections 2020","author":"Japanese Society for Sexually Transmitted Infections","year":"2020","unstructured":"Japanese Society for Sexually Transmitted Infections. 2020. Guidelines for the diagnosis and treatment of sexually transmitted infections 2020. Shindan To Chiryo Sha, Inc, Tokyo."},{"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":"10.1371\/journal.pone.0198355"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciad057"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.3201\/eid2305.161745"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1177\/0956462413502008"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkad208"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/jacamr\/dlab091"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jiac.2018.08.009"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00003-06"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.42.10.4876-4878.2004"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2022.904494"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2024-056374"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00641-20"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cit752"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2011-050035"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dku164"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.42.2.683-692.2004"},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01053-16"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiz550"},{"key":"e_1_3_4_25_2","doi-asserted-by":"publisher","DOI":"10.12688\/wellcomeopenres.14826.1"},{"key":"e_1_3_4_26_2","doi-asserted-by":"publisher","DOI":"10.1093\/molbev\/msu300"},{"key":"e_1_3_4_27_2","doi-asserted-by":"publisher","DOI":"10.3201\/eid3104.241602"},{"key":"e_1_3_4_28_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciy477"},{"key":"e_1_3_4_29_2","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.17972"}],"container-title":["Antimicrobial Agents and Chemotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/aac.01367-25","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/aac.01367-25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T14:01:37Z","timestamp":1770213697000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.asm.org\/doi\/10.1128\/aac.01367-25"}},"subtitle":[],"editor":[{"given":"Anne-Catrin","family":"Uhlemann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,2,4]]},"references-count":28,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,2,4]]}},"alternative-id":["10.1128\/aac.01367-25"],"URL":"https:\/\/doi.org\/10.1128\/aac.01367-25","relation":{},"ISSN":["0066-4804","1098-6596"],"issn-type":[{"value":"0066-4804","type":"print"},{"value":"1098-6596","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,4]]},"assertion":[{"value":"2025-09-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-01","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-30","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e01367-25"}}