Background/introduction Macrolide resistance has been previously reported in Mycoplasma genitalium (MG), however due to limited diagnostics, studies have been mainly restricted to specific geographical areas and small numbers of positive samples.

Aim(s)/objectives To determine the rate of macrolide resistance in MG specimens.

Methods Eighty-five MG positive specimens (72 from males, 13 from females) that had been referred for MG centralised testing (between 2010–2014), from 17 centres across England and Wales were blinded and anonymised. Specimens were then examined using a 23S rRNA PCR followed by full DNA sequence analysis. The Chi Square test was used to compare data sets.

Results 23S rRNA PCR was successful in 86% (73/85) of specimens. Of the specimens examined, 84% (61/73) harboured single nucleotide polymorphisms (SNP) associated with macrolide resistance (Table 1). Significant differences were observed between the rates of macrolide resistance in male [95% (58/61)] and female [25% (3/12)] patients [P = <0.001]. Twelve specimens 17% (12/73) [male (3/61 (5%) and female 9/12 (75%)] were wild-type and therefore assumed to be sensitive to macrolides.

Discussion/conclusion Eighty-four percent of MG specimens examined had SNPs associated with macrolide resistance. These levels of resistance are higher than previously documented in other studies and highlight the need for (i) greater access to MG diagnostic testing and (ii) a requirement for more effective antimicrobials if MG infection is to remain a treatable in the future.