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Clinical sciences poster session 7: vaginal infections
P3-S7.09 Mutations on gyrA or parC genes of Mycoplasma genitalium and efficacies of treatment with fluoroquinolones against M genitalium-related urethritis
  1. R Hamasuna1,
  2. S Takahashi2,
  3. M Matsumoto1,
  4. T Sho1,
  5. T Matsumoto1
  1. 1University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
  2. 2Sapporo Medical University of Medicine, Sapporo, Japan

Abstract

Background Mycoplasma genitalium is one of the pathogens of male urethritis. Macrolides as azithromycin can be the first line-treatment, but macrolides-resistant M genitalium strains were isolated. We tried to use some fluoroquinolones against M genitalium-related urethritis. In these studies, some patients could not treated by fluoroquinolone. In any bacteria, genetic mutations on gyrase genes were related to fluoroquinolone-resistance. In this study, quinolone-resistant determining regions (QRDR) on gyrase genes of M genitalium were analysed and the relationship between the efficacies of fluoroquinolone against M genitalium-related urethritis and genetic mutations on QRDR of M genitalium was examined.

Methods The QRDR on gyrA and parC genes of M genitalium were sequenced and analysed. DNA samples were purified from M genitalium-positive first-voided urine specimens before and after the treatment with fluoroquinolones as gatifloxacin or sitafloxacin. The QRDR of gyrA and parC genes of M genitalium were analysed by using primers according to Shimada's report (Int J Antimicrob Agent, 2010).

Results Twenty-two genomes of M genitalium before the treatment with fluoroquinolones and four genomes from patients with treatment-failure were analysed. Before the treatment, M genitalium genomes have no mutation on gyrA, but had four mutations on parC gene with amino-changes (Ala-69 to Thr, Pro-72 to Ser, Asp-87 to His and Ser-83 to Ile). After the treatment, M genitalium was found in four patients and all remained M genitalium were found mutations on gyrA or parC with amino-changes. M genitalium with mutation on parC (Pro-72 to Ser and Ser-83 to Ile) before treatment was remained. M genitalium with mutation on parC (Pro-72 to Se and Ser-83 to Ile) before treatment was remained and was found additional gyrA mutation (Asp-99 to Asn). In two patients, M genitalium without mutations before treatment remained after treatment. However, these genomes were found with newer mutations on gyrA (Asp-99 to Asn) or on parC (Ser-83 to Ile).

Conclusion From the urine specimens of patients with treatment-failure of fluoroquinolones, some mutations with amino-change were found on QRDR of gyrA or parC genes of M genitalium. It was suggested that these mutations are related with treatment-failure with fluoroquinolones.

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