{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T22:36:10Z","timestamp":1792449370768,"version":"4.5.0"},"reference-count":38,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2017,6,23]]},"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Resistance to both macrolides and fluoroquinolones has been reported in <jats:italic>Mycoplasma genitalium;<\/jats:italic> however, due to limited diagnostics, studies are often small and confined to specific geographical areas. This study sought to determine the rate of predicted resistance in <jats:italic>M. genitalium<\/jats:italic>-positive specimens referred for diagnostic testing.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Seventy-four <jats:italic>M. genitalium<\/jats:italic>-positive specimens, referred to the national reference laboratory (2010-2013) from 19 centres across England, were blinded and anonymised. Specimens were examined for markers predictive of resistance to macrolides and fluoroquinolones using PCR followed by sequence analysis of 23<jats:italic>S<\/jats:italic> rRNA gene, or <jats:italic>gyrA<\/jats:italic> and <jats:italic>parC<\/jats:italic>, respectively.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>23<jats:italic>S<\/jats:italic> rRNA gene PCR sequencing revealed that 82.4% (61\/74) of specimens harboured a single nucleotide polymorphism (SNP) associated with macrolide resistance. Differences were observed between the rates of predicted macrolide resistance in male (95.1% (58\/61)) and female (23.1% (3\/13)) patients (P = &lt;0.001). By contrast, all specimens for which sequencing data were available (73\/74) yielded wild-type <jats:italic>gyrA<\/jats:italic> sequences; and 58\/61 (95.1%) had wild-type <jats:italic>parC<\/jats:italic> genes. Three specimens (3\/61 4.9%) had SNPs in the <jats:italic>parC gene<\/jats:italic> associated with fluoroquinolone treatment failure, and all three also had predicted resistance to macrolides.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Eighty-two per cent and 4.9% of <jats:italic>M. genitalium<\/jats:italic> specimens had SNPs associated with macrolide and fluoroquinolone resistance, respectively. Due to lack of widespread availability of testing for <jats:italic>M. genitalium<\/jats:italic> in the UK, this study sample was likely to be sourced from patients who may have already failed first-line macrolide therapy. Nevertheless, this study highlights the need for both greater access to <jats:italic>M. genitalium<\/jats:italic> diagnostics and genetic antimicrobial resistance testing.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/sextrans-2017-053164","type":"journal-article","created":{"date-parts":[[2017,7,17]],"date-time":"2017-07-17T20:50:20Z","timestamp":1500324620000},"page":"9-13","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":34,"title":["Detection of markers predictive of macrolide and fluoroquinolone resistance in <i>Mycoplasma genitalium<\/i> from patients attending sexual health services in England"],"prefix":"10.1136","volume":"94","author":[{"given":"Rachel","family":"Pitt","sequence":"first","affiliation":[{"name":"Sexually Transmitted Bacteria Reference Unit, National Infection Service, Public Health England, London, UK"},{"name":"Antimicrobial Resistance and Healthcare Acquired Associated Infections (AMRHAI) Reference Unit, National Infection Service, Public Health England, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen","family":"Fifer","sequence":"additional","affiliation":[{"name":"Sexually Transmitted Bacteria Reference Unit, National Infection Service, Public Health England, London, UK"},{"name":"Antimicrobial Resistance and Healthcare Acquired Associated Infections (AMRHAI) Reference Unit, National Infection Service, Public Health England, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil","family":"Woodford","sequence":"additional","affiliation":[{"name":"Antimicrobial Resistance and Healthcare Acquired Associated Infections (AMRHAI) Reference Unit, National Infection Service, Public Health England, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Alexander","sequence":"additional","affiliation":[{"name":"Sexually Transmitted Bacteria Reference Unit, National Infection Service, Public Health England, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2017,7,17]]},"reference":[{"key":"2025081305285488000_94.1.9.1","doi-asserted-by":"publisher","DOI":"10.1097\/QCO.0000000000000030"},{"key":"2025081305285488000_94.1.9.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2012.02.036"},{"key":"2025081305285488000_94.1.9.3","doi-asserted-by":"crossref","unstructured":"Wiesenfeld HC , Hillier SL , Meyn L , et al . 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Pelvic inflammatory disease (PID), Mycoplasma genitalium and macrolide resistance in England [abstract]. 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