{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T22:26:02Z","timestamp":1787955962537,"version":"build-2784847793"},"reference-count":21,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>We aimed to estimate the prevalence of <jats:italic>Mycoplasma genitalium<\/jats:italic> infection and of mutations linked to macrolide resistance using the ResistancePlus MG assay (SpeeDx, Sydney, New South Wales, Australia) in first-void urine (FVU), anorectal and oropharyngeal samples from men who have sex with men (MSM) attending Western Sydney Sexual Health Centre (WSSHC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Consecutive symptomatic and asymptomatic MSM attending for STI testing were prospectively enrolled. <jats:italic>M. genitalium<\/jats:italic> testing using the ResistancePlus MG assay was performed on FVU, anorectal and oropharyngeal samples routinely collected for <jats:italic>Chlamydia trachomatis<\/jats:italic> and <jats:italic>Neisseria gonorrhoeae<\/jats:italic> assays.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, the prevalence of <jats:italic>M. genitalium<\/jats:italic> infection in the study group was 13.4% (68\/508). Most (79.4%, 54\/68) <jats:italic>M. genitalium<\/jats:italic> harboured macrolide resistance mutations (87.5% of urethral and 75.6% of anorectal infections). The anorectum was the most commonly infected site (45\/505, 8.9%), followed by the urethra (24\/508, 4.7%). No oropharyngeal <jats:italic>M. genitalium<\/jats:italic> infections were detected (0\/508). Most of the anorectal (93.3%) and urethral (79.2%) infections were asymptomatic.<\/jats:p><jats:p>MSM who were taking HIV pre-exposure prophylaxis (PrEP) were twice as likely to be infected with <jats:italic>M. genitalium<\/jats:italic> compared with MSM who were not on PrEP (OR 2.1, 95%\u2009CI 1.3 to 3.6; P=0.0041). Always using condoms for anal sex in the last 3\u2009months was protective of infection (OR 0.8, 95%\u2009CI 0.6 to 1.0; P=0.0186).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We demonstrated a high prevalence of <jats:italic>M. genitalium<\/jats:italic> and very high levels of macrolide resistance among MSM attending WSSHC. Our findings support the routine use of an assay to detect macrolide resistance mutations in <jats:italic>M. genitalium<\/jats:italic> infections. This will ensure, in regions or populations with high rates of macrolide resistance among <jats:italic>M. genitalium<\/jats:italic> strains, that first-line treatment with azithromycin will only be used if a macrolide-sensitive strain is identified.<\/jats:p><\/jats:sec>","DOI":"10.1136\/sextrans-2017-053480","type":"journal-article","created":{"date-parts":[[2018,3,22]],"date-time":"2018-03-22T16:18:26Z","timestamp":1521735506000},"page":"406-410","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":69,"title":["<i>Mycoplasma genitalium<\/i>: high prevalence of resistance to macrolides and frequent anorectal infection in men who have sex with men in western Sydney"],"prefix":"10.1136","volume":"94","author":[{"given":"Deborah L","family":"Couldwell","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dean","family":"Jalocon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Power","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neisha J","family":"Jeoffreys","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon C-A","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A","family":"Lewis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,3,22]]},"reference":[{"key":"2020050723333941000_94.6.406.1","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0b013e318177ec39"},{"key":"2020050723333941000_94.6.406.2","doi-asserted-by":"publisher","DOI":"10.1136\/sti.2008.035535"},{"key":"2020050723333941000_94.6.406.3","doi-asserted-by":"publisher","DOI":"10.1136\/sti.2009.038190"},{"key":"2020050723333941000_94.6.406.4","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1071\/SH12092","article-title":"Anatomic distribution of Neisseria gonorrhoeae, Chlamydia trachomatis and Mycoplasma genitalium infections in men who have sex with men","volume":"10","author":"Reinton","year":"2013","journal-title":"Sex Health"},{"key":"2020050723333941000_94.6.406.5","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-14-195"},{"key":"2020050723333941000_94.6.406.6","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1111\/bjd.14288","article-title":"Asymptomatic anal sexually transmitted infections in HIV-positive men attending anal cancer screening","volume":"174","author":"Fuchs","year":"2016","journal-title":"Br J Dermatol"},{"key":"2020050723333941000_94.6.406.7","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.13849"},{"key":"2020050723333941000_94.6.406.8","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1097\/OLQ.0000000000000665","article-title":"Mycoplasma genitalium on the loose: time to sound the alarm","volume":"44","author":"Manhart","year":"2017","journal-title":"Sex Transm Dis"},{"key":"2020050723333941000_94.6.406.9","doi-asserted-by":"publisher","DOI":"10.1258\/ijsa.2009.009411"},{"key":"2020050723333941000_94.6.406.10","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-015-1041-6"},{"key":"2020050723333941000_94.6.406.11","doi-asserted-by":"publisher","DOI":"10.2147\/IDR.S48813"},{"key":"2020050723333941000_94.6.406.12","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00495-13"},{"key":"2020050723333941000_94.6.406.13","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciu1162"},{"key":"2020050723333941000_94.6.406.14","doi-asserted-by":"crossref","unstructured":"Tabrizi SN , Tan LY , Walker S , et al . 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