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Research letter
Lack of macrolide resistance in Mycoplasma genitalium infections in a cohort of pregnant women in South Africa
  1. Remco P H Peters1,2,3,
  2. Hyun-Sul Jung3,
  3. Etienne E Muller4,
  4. Marleen M Kock3,5,
  5. Landon Myer6,
  6. Jeffrey D Klausner7,
  7. Dvora Joseph Davey6,8
  1. 1 Research Unit, Foundation for Professional Development, East London, South Africa
  2. 2 Department of Medical Microbiology, Maastricht University Medical Centre+, Maastricht, The Netherlands
  3. 3 Medical Microbiology, University of Pretoria, Pretoria, Gauteng, South Africa
  4. 4 STI Reference Centre, National Institute for Communicable Diseases, Johannesburg, South Africa
  5. 5 Medical Microbiology, National Health Laboratory Service, Pretoria, Gauteng, South Africa
  6. 6 Division of Epidemiology & Biostatistics, School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa
  7. 7 Medicine, University of California, Los Angeles, San Francisco, California, USA
  8. 8 Department of Epidemiology, University of California, Los Angeles, Fielding School of Public Health, Los Angeles, California, USA
  1. Correspondence to Professor Remco P H Peters, Research Unit, Foundation for Professional Development, East London 5217, South Africa; rph.peters{at}gmail.com

http://dx.doi.org/10.1136/sextrans-2020-054583

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    Macrolide resistance in Mycoplasma genitalium infection is emerging worldwide and is largely driven by use of azithromycin in STI treatment. South Africa has used azithromycin in its syndromic management regimen of male urethritis and vaginal discharge since 2015, but prevalence of macrolide resistance in M. genitalium remains largely unknown.

    This study determined azithromycin resistance in M. genitalium in remnant vulvovaginal specimens that had been obtained from pregnant women in Cape Town, South Africa, between November 2017 and February 2019.1 In brief, vulvovaginal swabs were self-collected at participants’ first antenatal care (ANC), third trimester ANC and postnatal care visits. In-facility GeneXpert testing (Cepheid, Sunnyvale, California) for Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis was done, followed by treatment if indicated. The Aptima Vaginal Swab Specimen Collection Kit (Hologic, San Diego, California) was used to collect …

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    Footnotes

    • Handling editor Deborah Williamson

    • Contributors RPHP conceptualised the study, analysed the data and wrote the draft and final version of the manuscript. HS-J performed the laboratory work, analysed the data and provided comments on the manuscript. MMK and LM provided supervision to the evaluation and commented on the manuscript. JK and DJD organised funding, led the clinical study and commented on the manuscript.

    • Funding DJD received funding from the National Institute of Health and Fogarty International Centre (K01TW011187). DJD and LM received funding from the National Institute of Mental Health. (R01MH116771). We received donation of diagnostic kits for the detection of Mycoplasma genitalium (Hologic, San Diego, California, USA) and the determination of macrolide resistance (SpeedX, Australia).

    • Competing interests We received donation of diagnostic kits for the detection of Mycoplasma genitalium (Hologic, San Diego, CA) and the determination of macrolide resistance (SpeedX, Australia).

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