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Short report
Macrolide and fluoroquinolone resistance of Mycoplasma genitalium in southern Spain, 2018–2019
  1. Adolfo de Salazar1,
  2. Antonio Barrientos-Durán1,
  3. Beatriz Espadafor2,
  4. Ana Fuentes-López1,
  5. Natalia Chueca1,
  6. Federico Garcia1
  1. 1 Microbiology Department, Instituto de Investigación Ibs.Granada, Hospital Universitario San Cecilio, Granada, Spain
  2. 2 Dermatology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain
  1. Correspondence to Dr Federico Garcia, Microbiology Department, Hospital Universitario San Cecilio, 18016 Granada, Spain; fegarcia{at}


Objectives In recent years, resistance in Mycoplasma genitalium (MG) to first-line (azithromycin) and second-line (moxifloxacin) treatment has been increasingly reported worldwide, however, no data regarding the south of Spain are available.

Methods To determine resistance rates, MG-positive samples collected from June 2018 to June 2019 were analysed by sequencing the 23S rRNA and parC genes.

Results A total of 77 patients (24 men having sex with men (MSM), 30 heterosexual men and 23 women) were included. Resistance-associated mutations against macrolide and fluoroquinolones were found in 36.4% (95% CI 25.7% to 48.1%) and 9.1% (95% CI 3.7% to 17.8%) of the patients, respectively. Being MSM and having had another STI in the last year were significantly associated with macrolide-resistant MG infection, while no associations were found with resistance to fluoroquinolones.

Conclusions Testing for resistance to first-line and second-line drugs against MG should be recommended for the general population and mandatory for the MSM population. We suggest that empiric azithromycin use for STI management should be avoided.

  • M. genitalium
  • antimicrobial resistance
  • risk factors

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  • Handling editor Gwenda Hughes

  • AdS and AB-D contributed equally.

  • Funding This work was supported in part by Plan Nacional de I+D+I and Fondo Europeo de Desarrollo Regional-FEDER (RD16/0025/0040 and PI18/00819).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The study was designed and conducted according to the principles expressed in the Declaration of Helsinki and it has been approved by the local Ethics Committee of San Cecilio University Hospital. Verbal informed consent was obtained from all participants.

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

  • Data availability statement Data are available upon request.