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We investigated the mutations associated with macrolide and fluoroquinolone resistance, two commonly used medical regimens for treatment in China. Our aim is to analyze the prevalence and diversity of mutations among\n                      <jats:italic>M. genitalium<\/jats:italic>\n                      -positive clinical specimens in Guangzhou, south China.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A total of 154 stored\n                      <jats:italic>M. genitalium<\/jats:italic>\n                      positive specimens from men and women attending a STI clinic were tested for macrolide and fluoroquinolone mutations.\n                      <jats:italic>M. genitalium<\/jats:italic>\n                      was detected via TaqMan MGB real-time PCR. Mutations associated with macrolide resistance were detected using primers targeting region V of the 23S rRNA gene. Fluoroquinolone resistant mutations were screened via primers targeting topoisomerase IV (\n                      <jats:italic>parC<\/jats:italic>\n                      ) and DNA gyrase (\n                      <jats:italic>gyrA<\/jats:italic>\n                      ).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      98.7% (152\/154), 95.5% (147\/154) and 90.3% (139\/154) of\n                      <jats:italic>M. genitalium<\/jats:italic>\n                      positive samples produced sufficient amplicon for detecting resistance mutations in 23S rRNA,\n                      <jats:italic>gyrA<\/jats:italic>\n                      and\n                      <jats:italic>parC<\/jats:italic>\n                      genes, respectively. 66.4% (101\/152), 0.7% (1\/147) and 77.7% (108\/139) samples manifested mutations in 23S rRNA,\n                      <jats:italic>gyrA<\/jats:italic>\n                      and\n                      <jats:italic>parC<\/jats:italic>\n                      genes, respectively. A2072G (59\/101, 58.4%) and S83I (79\/108, 73.1%) were highly predominating in 23S rRNA and\n                      <jats:italic>parC<\/jats:italic>\n                      genes, respectively. Two samples had amino acid substitutions in\n                      <jats:italic>gyrA<\/jats:italic>\n                      (M95I and A96T, respectively). Two samples had two amino acid substitutions in\n                      <jats:italic>parC<\/jats:italic>\n                      (S83I\u2009+\u2009D87Y). 48.6% (67\/138) of samples harbored both macrolide and fluoroquinolone resistance-associated mutations. The most common combination of mutations was A2072G (23S rRNA) and S83I (\n                      <jats:italic>parC<\/jats:italic>\n                      ) (40\/67, 59.7%). One sample had three amino acid changes in 23S rRNA,\n                      <jats:italic>gyrA<\/jats:italic>\n                      and\n                      <jats:italic>parC<\/jats:italic>\n                      genes (A2072G\u2009+\u2009A96T\u2009+\u2009S83I).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      The high antimicrobial resistance rate of\n                      <jats:italic>M. genitalium<\/jats:italic>\n                      in Guangzhou is a very worrying problem and suggests that antimicrobial resistance testing and the development of new antibiotic regimens are crucially needed.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12879-020-05659-3","type":"journal-article","created":{"date-parts":[[2020,12,11]],"date-time":"2020-12-11T07:18:49Z","timestamp":1607671129000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["Macrolide and fluoroquinolone associated mutations in Mycoplasma genitalium in a retrospective study of male and female patients seeking care at a STI Clinic in Guangzhou, China, 2016-2018"],"prefix":"10.1186","volume":"20","author":[{"given":"Wujian","family":"Ke","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongling","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lai Sze","family":"Tso","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ran","family":"Wei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yinyuan","family":"Lan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhengyu","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaohui","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liuyuan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunmei","family":"Liang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuying","family":"Liao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huiru","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yahui","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heping","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6775-8970","authenticated-orcid":false,"given":"Ligang","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,12,11]]},"reference":[{"issue":"suppl 2","key":"5659_CR1","doi-asserted-by":"publisher","first-page":"S420","DOI":"10.1093\/infdis\/jix200","volume":"216","author":"MR Golden","year":"2017","unstructured":"Golden MR, Workowski KA, Bolan G. 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