Mycoplasma genitalium Antimicrobial Resistance Surveillance (MARS) – Takeaways

MARS 2nd pilot report is out. It included data from all consecutive M. genitalium specimens collected from 15 SHCs between January and March 2020.

M. genitalium diagnostic testing was done on
1. for those presenting with non-gonococcal urethritis or pelvic inflammatory disease, and
2. for the current sex partners of those who tested positive for M. genitalium.

Positive results were tested for molecular markers predictive of macrolide and fluoroquinolone resistance in the M. genitalium 23S rRNA and parC genes, respectively.

Points from the report –

251 sample tested
190 (76%) patients were symptomatic

Of the submitted specimens, 92-93% were tested for resistance. Predicted resistance –

Resistance in specific situations/group

Macrolide resistance mutations were more commonly detected among specimens from people
of Black or Black British (80%) ethnicity and individuals who had a previous sexually transmitted infection (STI) in the past year (79%)

Note:

Macrolide resistance has previously been reported to be around 40% in the UK, although reference laboratory data shows higher resistance. However, there is a possibility of bias as the sample would have come from those patients who failed treatment. BASHH guideline (2018) commented that “despite this,
M. genitalium still responds to azithromycin in the majority of cases.”

How do the BASHH and CDC guidelines compare