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Title: De novo mutations drive the spread of macrolide resistant Mycoplasma genitalium : mathematical modelling study
Authors : Cadosch, Dominique
Garcia, Victor
Althaus, Christian L.
Jensen, Jorgen Skov
Low, Nicola
Extent : 25
Publisher / Ed. Institution : Cold Spring Harbor Laboratory
Issue Date: 24-May-2018
License (according to publishing contract) : CC BY 4.0: Attribution 4.0 International
Language : English
Subjects : Mycoplasma genitalium; Mathematical modelling; Sexually transmitted diseases
Subject (DDC) : 570: Biology
Abstract: The rapid spread of antimicrobial resistance in sexually transmitted infections caused by Mycoplasma genitalium 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. We analysed epidemiological data and developed a compartmental model to investigate the contribution of de novo macrolide resistance mutations to the spread of antimicrobial resistant M. genitalium. We fitted the model to data from France, Sweden and Denmark and estimated treatment rates and the time point of azithromycin introduction. In a meta-analysis of six studies, we estimated that de novo resistance develops in 12% (95% CI 7-17%, I2 44%) of azithromycin treated M. genitalium infections. Our model shows that the high probability of de novo resistance accelerates the spread of antimicrobial resistant M. genitalium in comparison with lower probabilities. The estimated per capita treatment rate in France was lower than in Denmark and Sweden but confidence intervals for the three estimates overlap. The estimated dates of introduction of azithromycin in each country are consistent with published reports. We conclude that clinical management strategies for M. genitalium should seek to limit the unnecessary use of macrolides.
Departement: Life Sciences and Facility Management
Organisational Unit: Institute of Applied Simulation (IAS)
Publication type: Other (textual)
DOI : 10.21256/zhaw-3856
Appears in Collections:Publikationen Life Sciences und Facility Management

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