{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T07:05:27Z","timestamp":1790665527106,"version":"4.1.0"},"reference-count":33,"publisher":"BMJ","issue":"7","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2019,3,24]]},"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Mass drug administration (MDA) of 20 mg\/kg (maximum 1 g in adults) azithromycin for ocular<jats:italic>Chlamydia trachomatis<\/jats:italic>(CT) infection is a key component of the WHO trachoma elimination strategy. However, this dose may be suboptimal in<jats:italic>Mycoplasma genitalium<\/jats:italic>infection and may encourage emergence of antimicrobial resistance (AMR) to azithromycin.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To determine the effect of MDA for trachoma elimination on<jats:italic>M. genitalium<\/jats:italic>prevalence, strain type and azithromycin resistance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A secondary analysis of CT-negative vulvovaginal swabs from three outpatient antenatal clinics (Honiara, Solomon Islands) from patients recruited either pre-MDA, or 10 months post-MDA in two cross-sectional surveys was carried out. Swabs were tested for<jats:italic>M. genitalium<\/jats:italic>infection using Fast Track Diagnostics Urethritis Plus nucleic acid amplification assay.<jats:italic>M. genitalium<\/jats:italic>-positive samples were subsequently tested for azithromycin resistance by sequencing domain V of the 23S rRNA DNA region of<jats:italic>M. genitalium<\/jats:italic>and underwent phylogenetic analysis by dual locus sequence typing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p><jats:italic>M. genitalium<\/jats:italic>prevalence was 11.9% (28\/236) in women pre-MDA and 10.9% (28\/256) 10 months post-MDA (p=0.7467). Self-reported receipt of azithromycin as part of MDA was 49.2% in women recruited post-MDA and 17.9% (5\/28) in those who tested<jats:italic>M. genitalium<\/jats:italic>positive. Of samples sequenced (21\/28 pre-MDA, 22\/28 post-MDA), all showed a macrolide susceptible genotype. Strain typing showed that sequence types diverged into two lineages, with a suggestion of strain replacement post-MDA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A single round of azithromycin MDA in an island population with high baseline<jats:italic>M. genitalium<\/jats:italic>prevalence did not appear to impact on either prevalence or azithromycin resistance, in contrast to reported decreased genital CT prevalence in the same population. This may be due to limitations such as sample size, including CT-negative samples only, and low MDA coverage. Further investigation of the impact of multiple rounds of MDA on<jats:italic>M. genitalium<\/jats:italic>azithromycin AMR in antibiotic experienced and na\u00efve populations is warranted.<\/jats:p><\/jats:sec>","DOI":"10.1136\/sextrans-2018-053938","type":"journal-article","created":{"date-parts":[[2019,4,13]],"date-time":"2019-04-13T21:15:29Z","timestamp":1555190129000},"page":"522-528","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":19,"title":["Impact of mass drug administration of azithromycin for trachoma elimination on prevalence and azithromycin resistance of genital<i>Mycoplasma genitalium<\/i>infection"],"prefix":"10.1136","volume":"95","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5586-0655","authenticated-orcid":false,"given":"Mark Andrew","family":"Harrison","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1432-8109","authenticated-orcid":false,"given":"Emma Michele","family":"Harding-Esch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7585-4743","authenticated-orcid":false,"given":"Michael","family":"Marks","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcus James","family":"Pond","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Butcher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony W","family":"Solomon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liqing","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"NgeeKeong","family":"Tan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Achyuta V","family":"Nori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry","family":"Kako","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver","family":"Sokana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David C W","family":"Mabey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0608-3818","authenticated-orcid":false,"given":"Syed Tariq","family":"Sadiq","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,4,13]]},"reference":[{"key":"2024092304402117000_95.7.522.1","doi-asserted-by":"publisher","DOI":"10.1155\/2011\/942937"},{"key":"2024092304402117000_95.7.522.2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-3083.2004.00923.x"},{"key":"2024092304402117000_95.7.522.3","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cit752"},{"key":"2024092304402117000_95.7.522.4","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.13849"},{"key":"2024092304402117000_95.7.522.5","doi-asserted-by":"crossref","first-page":"e339","DOI":"10.1016\/S2214-109X(13)70113-X","article-title":"Causes of vision loss worldwide, 1990-2010: a systematic analysis","volume":"1","author":"Bourne","year":"2013","journal-title":"Lancet Glob Health"},{"key":"2024092304402117000_95.7.522.6","unstructured":"Solomon AW , Zondervan M , Kuper H , et al . 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