{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T07:45:50Z","timestamp":1794037550969,"version":"4.8.0"},"reference-count":30,"publisher":"BMJ","issue":"12","license":[{"start":{"date-parts":[[2022,12,7]],"date-time":"2022-12-07T00:00:00Z","timestamp":1670371200000},"content-version":"unspecified","delay-in-days":6,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Hologic Inc, San Diego, USA","award":["Not applicable"],"award-info":[{"award-number":["Not applicable"]}]},{"name":"Public Health Laboratory","award":["Not applicable"],"award-info":[{"award-number":["Not applicable"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2022,11,14]]},"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      This study aimed to determine the prevalence of fluoroquinolone resistance-associated mutations (QRAMs) in\n                      <jats:italic>Mycoplasma genitalium<\/jats:italic>\n                      (MG) among clients of two sexual health centres (SHCs) in the Netherlands.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A cross-sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting and participants<\/jats:title>\n                    <jats:p>Between 2018 and 2019, 669 clients with MG were included from two previous studies: 375 male clients with urethritis from the SHC in Amsterdam; and 294 clients (male and female) from the SHC in Amsterdam and The Hague. Urogenital and anal samples (705 in total) that tested positive for MG by nucleic acid amplification tests were selected.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measures<\/jats:title>\n                    <jats:p>\n                      The presence of QRAM was detected by an MG-QRAM PCR targeting four mutations in the\n                      <jats:italic>parC<\/jats:italic>\n                      gene and investigated by sequence analysis of relevant regions of the\n                      <jats:italic>gyrA<\/jats:italic>\n                      and\n                      <jats:italic>parC<\/jats:italic>\n                      genes. Possible risk factors for the presence of QRAM were investigated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We found QRAM in 58 of 669 (9%) clients with an MG infection: 36 of 375 (10%) in the study population of men with urethritis and 22 of 294 (7%) in the study population of other clients (including both men and women; p=0.334). Most prevalent mutations in the\n                      <jats:italic>parC<\/jats:italic>\n                      gene were S83I and D87N, occurring in 31 of 60 (52%) and 20 of 60 (33%) samples, respectively. Factors associated with the presence of QRAM were: men who have sex with men (adjusted OR (aOR) 3.4, 95%\u2009CI 1.7 to 6.9) and Asian origin (aOR 2.5, 95%\u2009CI 1.2 to 5.6). Multidrug resistance (QRAM plus macrolide resistance-associated mutations) was found in 46 of 669 (7%) clients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Nine per cent of MG-positive clients from two Dutch SHCs had QRAM. New treatment strategies and antibiotics are needed to treat symptomatic patients with multidrug-resistant MG.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2022-066368","type":"journal-article","created":{"date-parts":[[2022,12,7]],"date-time":"2022-12-07T09:23:20Z","timestamp":1670405000000},"page":"e066368","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["Prevalence of fluoroquinolone resistance-associated mutations in\n                    <i>Mycoplasma genitalium<\/i>\n                    among clients of two sexual health centres in the Netherlands: a cross-sectional study"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5043-3424","authenticated-orcid":false,"given":"Joyce F","family":"Braam","sequence":"first","affiliation":[{"name":"Infectious Diseases, Public Health Laboratory, Public Health Service of Amsterdam, Amsterdam, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9230-7488","authenticated-orcid":false,"given":"Helene C A","family":"Zondag","sequence":"additional","affiliation":[{"name":"Infectious Diseases, Public Health Laboratory, Public Health Service of Amsterdam, Amsterdam, Netherlands"},{"name":"Department of Medical Microbiology, Amsterdam Institute for Infection & Immunity (AII), Amsterdam UMC Locatie AMC, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3967-550X","authenticated-orcid":false,"given":"Alje P","family":"van Dam","sequence":"additional","affiliation":[{"name":"Infectious Diseases, Public Health Laboratory, Public Health Service of Amsterdam, Amsterdam, Netherlands"},{"name":"Department of Medical Microbiology, Amsterdam Institute for Infection & Immunity (AII), Amsterdam UMC Locatie AMC, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry J C","family":"de Vries","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, The Netherlands"},{"name":"Department of Dermatology, Amsterdam UMC Locatie AMC, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clarissa","family":"Vergunst","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, The Netherlands"},{"name":"Department of Dermatology, Noordwest Ziekenhuisgroep-Locatie Den Helder, Den Helder, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8420-6863","authenticated-orcid":false,"given":"David","family":"Hetem","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Medical Centre Haaglanden, The Hague, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maarten F","family":"Schim van der Loeff","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, The Netherlands"},{"name":"Department of Internal Medicine, Amsterdam Institute for Infection & Immunity (AII), Amsterdam UMC Locatie AMC, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4897-4261","authenticated-orcid":false,"given":"Sylvia M","family":"Bruisten","sequence":"additional","affiliation":[{"name":"Infectious Diseases, Public Health Laboratory, Public Health Service of Amsterdam, Amsterdam, Netherlands"},{"name":"Department of Medical Microbiology, Amsterdam Institute for Infection & Immunity (AII), Amsterdam UMC Locatie AMC, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,12,7]]},"reference":[{"key":"2025121408423500000_12.12.e066368.1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jix145"},{"key":"2025121408423500000_12.12.e066368.2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/civ312"},{"key":"2025121408423500000_12.12.e066368.3","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2017-053384"},{"key":"2025121408423500000_12.12.e066368.4","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1097\/OLQ.0000000000001591","article-title":"Macrolide-Resistant Mycoplasma genitalium impairs clinical improvement of male urethritis after empirical treatment","volume":"49","author":"Braam","year":"2022","journal-title":"Sex Transm Dis"},{"key":"2025121408423500000_12.12.e066368.5","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-015-1041-6"},{"key":"2025121408423500000_12.12.e066368.6","unstructured":"Centers for Disease Control and Prevention . 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