{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T16:40:28Z","timestamp":1792255228679,"version":"4.4.0"},"reference-count":30,"publisher":"BMJ","issue":"6","license":[{"start":{"date-parts":[[2020,1,10]],"date-time":"2020-01-10T00:00:00Z","timestamp":1578614400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","award":["G0701757"],"award-info":[{"award-number":["G0701757"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004440","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["084840"],"award-info":[{"award-number":["084840"]}],"id":[{"id":"10.13039\/100004440","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2019,12,12]]},"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>\n<jats:italic>Mycoplasma genitalium<\/jats:italic>\nis a common sexually transmitted infection. Treatment guidelines focus on those with symptoms and sexual contacts, generally with regimens including doxycycline and\/or azithromycin as first-line and moxifloxacin as second-line treatment. We investigated the prevalence of antimicrobial resistance (AMR)-conferring mutations in\n<jats:italic>M. genitalium<\/jats:italic>\namong the sexually-active British general population.\n<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>\nThe third national survey of sexual attitudes and lifestyles (Natsal-3) is a probability sample survey of 15 162 men and women aged 16\u201374 years in Britain conducted during 2010\u201312. Urine test results for\n<jats:italic>M. genitalium<\/jats:italic>\nwere available for 4507 participants aged 16\u201344 years reporting\n<jats:underline>&gt;<\/jats:underline>\n1 lifetime sexual partner. In this study, we sequenced regions of the 23S rRNA and\n<jats:italic>parC<\/jats:italic>\ngenes to detect known genotypic determinants for resistance to macrolides and fluoroquinolones respectively.\n<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>\n94% (66\/70) of specimens were re-confirmed as\n<jats:italic>M. genitalium<\/jats:italic>\npositive, with successful sequencing in 85% (56\/66) for 23S rRNA and 92% (61\/66) for\n<jats:italic>parC<\/jats:italic>\ngenes. Mutations in 23S rRNA gene (position A2058\/A2059) were detected in 16.1% (95%CI: 8.6% to 27.8%) and in\n<jats:italic>parC<\/jats:italic>\n(encoding\n<jats:italic>ParC<\/jats:italic>\nD87N\/D87Y) in 3.3% (0.9%\u201311.2%). Macrolide resistance was more likely in participants reporting STI diagnoses (past 5\u2009years) (44.4% (18.9%\u201373.3%) vs 10.6% (4.6%\u201322.6%); p=0.029) or sexual health clinic attendance (past year) (43.8% (23.1%\u201366.8%) vs 5.0% (1.4%\u201316.5%); p=0.001). All 11 participants with AMR-conferring mutations had attended sexual health clinics (past 5\u2009years), but none reported recent symptoms.\n<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>\nThis study highlights challenges in\n<jats:italic>M. genitalium<\/jats:italic>\nmanagement and control. Macrolide resistance was present in one in six specimens from the general population in 2010\u20132012, but no participants with AMR\n<jats:italic>M. genitalium<\/jats:italic>\nreported symptoms. Given anticipated increases in diagnostic testing, new strategies including novel antimicrobials, AMR-guided therapy, and surveillance of AMR and treatment failure are recommended.\n<\/jats:p>\n<\/jats:sec>","DOI":"10.1136\/sextrans-2019-054129","type":"journal-article","created":{"date-parts":[[2020,1,10]],"date-time":"2020-01-10T22:15:44Z","timestamp":1578694544000},"page":"464-468","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":29,"title":["Antimicrobial resistance in\n<i>Mycoplasma genitalium<\/i>\nsampled from the British general population"],"prefix":"10.1136","volume":"96","author":[{"given":"Rachel","family":"Pitt","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magnus","family":"Unemo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pam","family":"Sonnenberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9086-9222","authenticated-orcid":false,"given":"Sarah","family":"Alexander","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Beddows","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6707-6910","authenticated-orcid":false,"given":"Michelle Jayne","family":"Cole","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soazig","family":"Clifton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine H","family":"Mercer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne M","family":"Johnson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine A","family":"Ison","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2825-6652","authenticated-orcid":false,"given":"Nigel","family":"Field","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,1,10]]},"reference":[{"key":"2024092304150697000_96.6.464.1","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2017-053384"},{"key":"2024092304150697000_96.6.464.2","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00006-11"},{"key":"2024092304150697000_96.6.464.3","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/civ312"},{"key":"2024092304150697000_96.6.464.4","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cir702"},{"key":"2024092304150697000_96.6.464.5","doi-asserted-by":"publisher","DOI":"10.1136\/sti.2010.044487"},{"key":"2024092304150697000_96.6.464.6","doi-asserted-by":"publisher","DOI":"10.1136\/sti.2009.038190"},{"key":"2024092304150697000_96.6.464.7","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyv194"},{"key":"2024092304150697000_96.6.464.8","doi-asserted-by":"crossref","first-page":"1795","DOI":"10.1016\/S0140-6736(13)61947-9","article-title":"Prevalence, risk factors, and uptake of interventions for sexually transmitted infections in Britain: findings from the National surveys of sexual attitudes and lifestyles (Natsal)","volume":"382","author":"Sonnenberg","year":"2013","journal-title":"The Lancet"},{"key":"2024092304150697000_96.6.464.9","doi-asserted-by":"crossref","unstructured":"Soni S , Horner P , Rayment M , et al . 2018 BASHH UK national guidleine for the management of infection with Mycoplasma genitalium 2018.","DOI":"10.1177\/0956462419825948"},{"key":"2024092304150697000_96.6.464.10","unstructured":"Workowski KA , Bolan G . 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