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Mycoplasma genitalium co-infection with Chlamydia trachomatis and Neisseria gonorrhoeae among asymptomatic patients: the silent wick for macrolide resistance spread
  1. Miguel Fernández-Huerta1,
  2. Mateu Espasa1,2
  1. 1 Microbiology Department, Vall d’Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
  2. 2 Drassanes Exprés STI Program, Vall d’Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
  1. Correspondence to Dr Mateu Espasa, Microbiology Department, Vall ďHebron University Hospital, Barcelona 08035, Spain; mespasa{at}, mespasa2002{at}

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The screening strategies for Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) implemented among asymptomatic carriers to control STI transmission1 might also result in selection for antibiotic resistance in NG and Mycoplasma genitalium (MG).2 The aim of this study was to determine the MG co-infection rate among asymptomatic people positive for CT and/or NG. A total of 249 users (table 1) attending a STI screening service in Barcelona (Spain), between November 2016 and September 2017, were retrospectively tested for MG and macrolide resistance (McrR) using the ResistancePlus MG assay (SpeeDx, Australia). The MG positive rate was 4.8% without differences between CT-infected (4.0%) and NG-infected (5.2%) individuals (p=0.649). Seven MG infections, all in men who have sex with men, harboured McrR (58.3%). The research provides further data regarding MG infection among asymptomatic people. Consequently, it might be considered to limit the azitromycin’s (AZM’s) use when dealing against CT or NG infections to avoid future resistances.

Table 1

Baseline characteristics of the individuals studied


We especially thank Martí Vall, Alberto Rojo-Fabregat, Candela Fernández-Naval, Maider Arando, María-Jesús Barberá, Francesc Zarzuela, Desideria Martínez-Rascon, Tomás Pumarola, Judith Serra-Pladevall and Juliana Esperalba, who also contributed to the manuscript. We also thank all the staff of DraSexp, nursing and laboratory teams, for their essential work at the STI screening service. Last, we thank SpeeDx Pty Ltd for their support.



  • Handling editor Jackie A Cassell

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Disclaimer SpeeDx Pty Ltd had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.

  • Competing interests SpeeDx Pty Ltd supplied all the reagents for molecular testing of M. genitalium. CF-N is a researcher receiving partial salary support from SpeeDx Pty Ltd. MF-H and ME have participated in symposiums organised by SpeeDx Pty Ltd.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; internally peer reviewed.