{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T13:21:40Z","timestamp":1787664100641,"version":"build-2736575974"},"reference-count":137,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T00:00:00Z","timestamp":1787616000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:p>\n                    <jats:italic>Mycoplasma genitalium<\/jats:italic>\n                    is a significant sexually transmitted pathogen associated with various urogenital diseases and severe complications in both men and women. In recent years, advances in molecular diagnostic technologies have progressively revealed its global prevalence. Concurrently, the escalating issue of antibiotic resistance poses a major public health challenge. This review aims to summarize the clinical manifestations and resistance mechanisms of\n                    <jats:italic>M. genitalium<\/jats:italic>\n                    infection, the global epidemiological characteristics of antibiotic resistance, as well as the limitations and challenges of existing research, thereby providing a scientific basis for formulating effective control measures. Key acquired resistance mechanisms of\n                    <jats:italic>M. genitalium<\/jats:italic>\n                    include macrolide resistance due to 23S rRNA gene mutations; fluoroquinolone resistance triggered by\n                    <jats:italic>parC<\/jats:italic>\n                    and\n                    <jats:italic>gyrA<\/jats:italic>\n                    gene mutations; and tetracycline resistance associated with the mutations in the 16S rRNA gene. Major external drivers of resistance emergence and spread include antibiotic misuse, sexual transmission networks, latent transmission by asymptomatic carriers, and limitations in detection methods. In recent years,\n                    <jats:italic>M. genitalium<\/jats:italic>\n                    infections have been prevalent in many countries worldwide, with rising resistance rates observed in some regions. Resistance rates remain persistently high in Oceania, Asia, and parts of North America, while regions such as Africa exhibit relatively lower levels of resistance. The clinical management of\n                    <jats:italic>M. genitalium<\/jats:italic>\n                    infections exhibits significant heterogeneity across major countries in North America, Europe, and the Asia-Pacific region. These differences primarily stem from regional variations in antibiotic resistance patterns, drug accessibility, and differing approaches to antimicrobial stewardship. Antibiotic resistance in\n                    <jats:italic>M. genitalium<\/jats:italic>\n                    has become an urgent global public health issue. Future efforts should prioritize strengthening global collaboration on antimicrobial resistance surveillance, promoting the application of molecular epidemiological methods in future research, deepening research into resistance mechanisms, advancing rapid diagnostic technologies and novel drug development, and refining regional clinical management guidelines based on local resistance patterns to effectively curb this evolving threat.\n                  <\/jats:p>","DOI":"10.3389\/fcimb.2026.1789671","type":"journal-article","created":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T12:49:30Z","timestamp":1787662170000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Drug resistance of Mycoplasma genitalium: mechanism and regional distribution"],"prefix":"10.3389","volume":"16","author":[{"given":"Yuhang","family":"Ouyang","sequence":"first","affiliation":[{"name":"Hunan Provincial Key Laboratory for Special 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