Bacterial Load in Daily Urine Samples of Patients Infected withMycoplasma genitalium, Mutation Analysis, and Response to Treatment.
Objective. Increasing macrolide resistant strains ofMycoplasma genitaliumis a challenge, and to differentiate between treatment failure and reinfection a timely test of cure (TOC) is warranted. The aim of this study was to evaluate the best time for TOC after five days' treatment ofMycoplasma genitaliuminfection with azithromycin.Methods. Nineteen patients with positive PCR forMycoplasma genitaliumin urine provided urine samples daily for 2 weeks and on days 21, 28, and 35. Samples were tested by a commercial qPCR and by sequencing of the 23S rRNA gene.Results. Eight patients with a wild type ofMycoplasma genitaliumresponded successfully within four days after treatment initiation. Eleven patients had a mutation in the 23S rRNA gene. These samples exhibited high variations in bacterial load, and some patients tested negative at several time points during the observation period.Conclusions. Day-to-day fluctuations in the mutation samples allow for false negative TOC during the first 5 weeks after start of treatment. Due to increasing macrolide resistance ofMycoplasma genitalium, pretreatment mutation analysis is recommended. When a wild type is verified, TOC performed one week after initiation of treatment is suggested.
Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
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0000-0001-5536-4248
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Gossé
Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway; Department of Medical Microbiology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
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Nordbø
Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway; Department of Dermatology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
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Pukstad
D000293:Adolescent; D000328:Adult; D058491:Bacterial Load; D005260:Female; D006801:Humans; D008297:Male; D009154:Mutation / Q000235:genetics; D009175:Mycoplasma Infections / Q000382:microbiology* / Q000652:urine*; D045704:Mycoplasma genitalium / Q000235:genetics*; D055815:Young Adult