title: High Resistance to Azithromycin in Clinical Samples from Patients with Sexually Transmitted Diseases in Guangxi Zhuang Autonomous Region, China.
abstract: Azithromycin is used as an alternative medicine in patients with syphilis who are intolerant to penicillin. Nevertheless, the report of treatment failure of azithromycin for patients with syphilis has raised concerns in China in the past years. In this study, 178 patients with early syphilis, who were treated in sexually transmitted infections clinics in four cities in Guangxi Zhuang Autonomous Region were enrolled to investigate the regional prevalence of Treponema pallidum strain resistant to azithromycin. Nested PCR was performed to amplify the 23S ribosomal RNA (23SrRNA) gene. The point mutation of A2058G in 23SrRNA, which confers Treponema pallidum resistance to azithromycin, was measured by endonuclease digestion of PCR amplification products using MboII. A2058G point mutation was detected in 91.0% (162/178; 95% CI, 86.8%, 95.2%) of the specimens, but no difference in prevalence of azithromycin resistance was found between the patients who had taken antibiotics before enrollment and the patients who had not (91.8% vs. 89.4%), nor between the patients with and without past sexually transmitted infections (87.1% vs. 93.1%). We concluded that azithromycin may not be suitable for syphilis as a treatment option in Guangxi Zhuang Autonomous Region because of the extremely high prevalence of resistance in the general syphilis population.
authors.affiliation: Central laboratory, Guangxi Institute of Dermatology, Nanning, Guangxi Zhuang Autonomous Region, China.
authors.forename: Bangyong
authors.initials: B
authors.lastname: Zhu
authors.affiliation: Editorial Department of Journals of Nanjing Medical University, Nanjing Medical University, Nanjing, Jiangsu, China.
authors.forename: Jin
authors.identifier: http://orcid.org/0000-0001-8555-0922
authors.initials: J
authors.lastname: Bu
authors.affiliation: Department of Dermatology, Guangxi Institute of Dermatology, Nanning, Guangxi Zhuang Autonomous Region, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Li
authors.affiliation: Department of Dermatology, Guangxi Institute of Dermatology, Nanning, Guangxi Zhuang Autonomous Region, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Dermatology, Guangxi Institute of Dermatology, Nanning, Guangxi Zhuang Autonomous Region, China.
authors.forename: Geng
authors.initials: G
authors.lastname: Huang
authors.affiliation: Department of Dermatology, Guangxi Institute of Dermatology, Nanning, Guangxi Zhuang Autonomous Region, China.
authors.forename: Juan
authors.initials: J
authors.lastname: Cao
authors.affiliation: Department of Dermatology, Guangxi Institute of Dermatology, Nanning, Guangxi Zhuang Autonomous Region, China.
authors.forename: Zhongshu
authors.initials: Z
authors.lastname: Tang
authors.affiliation: Central laboratory, Guangxi Institute of Dermatology, Nanning, Guangxi Zhuang Autonomous Region, China.
authors.forename: Quan
authors.initials: Q
authors.lastname: Gan
authors.affiliation: Central laboratory, Guangxi Institute of Dermatology, Nanning, Guangxi Zhuang Autonomous Region, China.
authors.forename: Pingjiang
authors.initials: P
authors.lastname: Wei
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D017963:Azithromycin / Q000494:pharmacology / Q000627:therapeutic use*; D002681:China / Q000453:epidemiology; D024881:Drug Resistance, Bacterial / Q000235:genetics; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017354:Point Mutation; D016133:Polymerase Chain Reaction; D013587:Syphilis / Q000188:drug therapy* / Q000453:epidemiology; D014210:Treponema pallidum / Q000187:drug effects / Q000235:genetics
chemical_list: D000900:Anti-Bacterial Agents; D017963:Azithromycin