Mycoplasma genitalium; pregnant women; azithromycin; macrolide resistance; 23S rRNA gene mutations; KwaZulu-Natal.
Background: Azithromycin regimens have been considered first-line treatment for Mycoplasma genitalium (M. genitalium), a sexually transmitted infection (STI) associated with adverse pregnancy outcomes. However, recent years have seen rapid emergence of macrolide resistance in M. genitalium as a resu...
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| Format: | Article |
| Language: | English |
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AOSIS
2021-01-01
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| Series: | Southern African Journal of Infectious Diseases |
| Subjects: | |
| Online Access: | https://sajid.co.za/index.php/sajid/article/view/209 |
| _version_ | 1818382712999772160 |
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| author | Meleshni Naicker Ravesh Singh Donald van der Westhuizen Partson Tinarwo Nathlee S. Abbai |
| author_facet | Meleshni Naicker Ravesh Singh Donald van der Westhuizen Partson Tinarwo Nathlee S. Abbai |
| author_sort | Meleshni Naicker |
| collection | DOAJ |
| description | Background: Azithromycin regimens have been considered first-line treatment for Mycoplasma genitalium (M. genitalium), a sexually transmitted infection (STI) associated with adverse pregnancy outcomes. However, recent years have seen rapid emergence of macrolide resistance in M. genitalium as a result of widespread administration of azithromycin. Currently, there are limited data on macrolide resistance in pregnant women from KwaZulu-Natal (KZN), South Africa. This study investigated the prevalence of M. genitalium and emerging patterns of macrolide resistance in pregnant women from KZN.
Methods: This was a sub-study of a larger study which involved laboratory-based detection of STIs in pregnant women. In the main study, pregnant women provided urine samples for detection of STIs. For this study, deoxyribose nucleic acid (DNA) extracted from stored urine was used to determine emerging macrolide resistance by amplification of the 23S ribosomal ribonucleic acid (rRNA) gene of M. genitalium by polymerase chain reaction (PCR) and sequencing of amplicons to identify mutations associated with resistance. The Allplex™ MG AziR assay was used as a confirmatory assay.
Results: The prevalence of M. genitalium in pregnant women was 5.9% (13 out of 221). Sequencing of PCR amplicons did not reveal the presence of the A2059G and A2058G mutations associated with macrolide resistance. These findings were confirmed by the Allplex™ MG AziR assay.
Conclusion: Despite the lack of resistance to macrolides in this study population, continued antimicrobial resistance surveillance for M. genitalium in pregnant women is important because azithromycin is now part of the South African national STI syndromic management guidelines for vaginal discharge syndrome. |
| first_indexed | 2024-12-14T02:54:50Z |
| format | Article |
| id | doaj.art-806db7a564534e928474b1d73349699e |
| institution | Directory Open Access Journal |
| issn | 2312-0053 2313-1810 |
| language | English |
| last_indexed | 2024-12-14T02:54:50Z |
| publishDate | 2021-01-01 |
| publisher | AOSIS |
| record_format | Article |
| series | Southern African Journal of Infectious Diseases |
| spelling | doaj.art-806db7a564534e928474b1d73349699e2022-12-21T23:19:40ZengAOSISSouthern African Journal of Infectious Diseases2312-00532313-18102021-01-01361e1e710.4102/sajid.v36i1.209167Mycoplasma genitalium; pregnant women; azithromycin; macrolide resistance; 23S rRNA gene mutations; KwaZulu-Natal.Meleshni Naicker0Ravesh Singh1Donald van der Westhuizen2Partson Tinarwo3Nathlee S. Abbai4School of Clinical Medicine Research Laboratory, College of Health Sciences, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, DurbanDepartment of Medical Microbiology, College of Health Sciences, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa; and Department of Microbiology, National Health Laboratory Services, KwaZulu-Natal Academic Complex, Inkosi Albert Luthuli Central Hospital, DurbanInqaba Biotechnical Industries (Pty) Ltd, PretoriaDepartment of Biostatistics, College of Health Sciences, University of KwaZulu-Natal, Nelson R Mandela School of Medicine, DurbanSchool of Clinical Medicine Research Laboratory, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, DurbanBackground: Azithromycin regimens have been considered first-line treatment for Mycoplasma genitalium (M. genitalium), a sexually transmitted infection (STI) associated with adverse pregnancy outcomes. However, recent years have seen rapid emergence of macrolide resistance in M. genitalium as a result of widespread administration of azithromycin. Currently, there are limited data on macrolide resistance in pregnant women from KwaZulu-Natal (KZN), South Africa. This study investigated the prevalence of M. genitalium and emerging patterns of macrolide resistance in pregnant women from KZN. Methods: This was a sub-study of a larger study which involved laboratory-based detection of STIs in pregnant women. In the main study, pregnant women provided urine samples for detection of STIs. For this study, deoxyribose nucleic acid (DNA) extracted from stored urine was used to determine emerging macrolide resistance by amplification of the 23S ribosomal ribonucleic acid (rRNA) gene of M. genitalium by polymerase chain reaction (PCR) and sequencing of amplicons to identify mutations associated with resistance. The Allplex™ MG AziR assay was used as a confirmatory assay. Results: The prevalence of M. genitalium in pregnant women was 5.9% (13 out of 221). Sequencing of PCR amplicons did not reveal the presence of the A2059G and A2058G mutations associated with macrolide resistance. These findings were confirmed by the Allplex™ MG AziR assay. Conclusion: Despite the lack of resistance to macrolides in this study population, continued antimicrobial resistance surveillance for M. genitalium in pregnant women is important because azithromycin is now part of the South African national STI syndromic management guidelines for vaginal discharge syndrome.https://sajid.co.za/index.php/sajid/article/view/209mycoplasma genitaliumpregnant womenazithromycinmacrolide resistance23s rrna gene mutationskwazulu-natal |
| spellingShingle | Meleshni Naicker Ravesh Singh Donald van der Westhuizen Partson Tinarwo Nathlee S. Abbai Mycoplasma genitalium; pregnant women; azithromycin; macrolide resistance; 23S rRNA gene mutations; KwaZulu-Natal. Southern African Journal of Infectious Diseases mycoplasma genitalium pregnant women azithromycin macrolide resistance 23s rrna gene mutations kwazulu-natal |
| title | Mycoplasma genitalium; pregnant women; azithromycin; macrolide resistance; 23S rRNA gene mutations; KwaZulu-Natal. |
| title_full | Mycoplasma genitalium; pregnant women; azithromycin; macrolide resistance; 23S rRNA gene mutations; KwaZulu-Natal. |
| title_fullStr | Mycoplasma genitalium; pregnant women; azithromycin; macrolide resistance; 23S rRNA gene mutations; KwaZulu-Natal. |
| title_full_unstemmed | Mycoplasma genitalium; pregnant women; azithromycin; macrolide resistance; 23S rRNA gene mutations; KwaZulu-Natal. |
| title_short | Mycoplasma genitalium; pregnant women; azithromycin; macrolide resistance; 23S rRNA gene mutations; KwaZulu-Natal. |
| title_sort | mycoplasma genitalium pregnant women azithromycin macrolide resistance 23s rrna gene mutations kwazulu natal |
| topic | mycoplasma genitalium pregnant women azithromycin macrolide resistance 23s rrna gene mutations kwazulu-natal |
| url | https://sajid.co.za/index.php/sajid/article/view/209 |
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