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Publication type: Article in scientific journal
Type of review: Peer review (publication)
Title: Understanding the spread of de novo and transmitted macrolide-resistance in Mycoplasma genitalium
Authors: Cadosch, Dominique
Garcia, Victor
Jensen, Jørgen S.
Low, Nicola
Althaus, Christian L.
et. al: No
DOI: 10.7717/peerj.8913
Published in: PeerJ
Volume(Issue): 8
Issue Date: 16-Jun-2020
Publisher / Ed. Institution: PeerJ
ISSN: 2167-8359
Language: English
Subjects: Antibiotic resistance; Mathematical model; Mycoplasma genitalium; Sexually transmitted infection
Subject (DDC): 616: Internal medicine and diseases
Abstract: Background The rapid spread of azithromycin resistance in sexually transmitted Mycoplasma genitalium infections is a growing concern. It is not yet clear to what degree macrolide resistance in M. genitalium results from the emergence of de novo mutations or the transmission of resistant strains. Methods We developed a compartmental transmission model to investigate the contribution of de novo macrolide resistance mutations to the spread of antimicrobial-resistant M. genitalium. We fitted the model to resistance data from France, Denmark and Sweden, estimated the time point of azithromycin introduction and the rates at which infected individuals receive treatment, and projected the future spread of resistance. Results The high probability of de novo resistance in M. genitalium accelerates the early spread of antimicrobial resistance. The relative contribution of de novo resistance subsequently decreases, and the spread of resistant infections in France, Denmark and Sweden is now mainly driven by transmitted resistance. If treatment with single-dose azithromycin continues at current rates, macrolide-resistant M. genitalium infections will reach 25% (95% confidence interval, CI [9–30]%) in France, 84% (95% CI [36–98]%) in Denmark and 62% (95% CI [48–76]%) in Sweden by 2025. Conclusions Blind treatment of urethritis with single-dose azithromycin continues to select for the spread of macrolide resistant M. genitalium. Clinical management strategies for M. genitalium should limit the unnecessary use of macrolides.
Fulltext version: Published version
License (according to publishing contract): CC BY 4.0: Attribution 4.0 International
Departement: Life Sciences and Facility Management
Organisational Unit: Institute of Computational Life Sciences (ICLS)
Published as part of the ZHAW project: Exploring the silent fitness landscape
Appears in collections:Publikationen Life Sciences und Facility Management

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