title: Mycoplasma genitaliummacrolide resistance in Stockholm, Sweden.
abstract: Mycoplasma genitaliumis an important cause of STI in men and women. Worldwide evidence suggests a reduction in efficacy of azithromycin treatment due to the prevalence of macrolide resistantM. genitalium.The aim of this study was to describe the prevalence of macrolide resistance in patients with a positive test forM. genitaliumwithin our setting.
  
  
  
  Two STI clinics in Stockholm offered tests forM. genitaliumas part of a routine care pathway. Positive specimens were analysed for macrolide resistance mediating mutations by sequencing.
  
  
  
  During the study period, 171 (7.5%) of 2276 patients had a positiveM. genitaliumtest; 7% of women and 8% of men. Macrolide resistance was detected in 31 (18%) of theM. genitaliumpositive; treatment with azithromycin within the previous 6 months was strongly associated with macrolide resistance.
  
  
  
  The prevalence of macrolide resistance was lower in Sweden than in other Northern European settings. We hypothesise that this observation may be due to use of doxycycline as primary treatment ofChlamydia trachomatis. The efficacy of empirical treatment is challenged by azithromycin resistantM. genitalium. Clinically available and enhanced diagnostics targeting this pathogen are urgently required. We suggest a test of cure 3-4 weeks after start of azithromycin therapy since macrolide resistance develop during treatment.
authors: Section of Dermatology I 43, Department of Medicine, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden.
authors: Eva
authors: E
authors: Björnelius
authors: Section of Dermatology, Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden.
authors: Charlotta
authors: C
authors: Magnusson
authors: Department of Microbiology and Infection Control, Statens Serum Institut, Copenhagen, Denmark.
authors: Jørgen Skov
authors: JS
authors: Jensen
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D017963:Azithromycin / Q000494:pharmacology*; D004269:DNA, Bacterial / Q000235:genetics; D024881:Drug Resistance, Bacterial / Q000187:drug effects* / Q000235:genetics; D006801:Humans; D008826:Microbial Sensitivity Tests; D009175:Mycoplasma Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology*; D045704:Mycoplasma genitalium / Q000187:drug effects* / Q000235:genetics; D012329:RNA, Bacterial / Q000235:genetics; D012189:Retrospective Studies; D013548:Sweden / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial; D012329:RNA, Bacterial; D017963:Azithromycin
keywords: ANTIMICROBIAL RESISTANCE; GENITAL TRACT INFECT; M GENITALIUM; SURVEILLANCE