Effectiveness of intramuscular spectinomycin in difficult-to-treat Mycoplasma genitalium urethritis in four cases

IF 1.5 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy Pub Date : 2025-07-24 DOI:10.1016/j.jiac.2025.102775

Yuichiro Nagase , Kayoko Hayakawa , Taketo Kubo , Nobumasa Okumura , Sho Saito , Norio Ohmagari

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引用次数: 0

Abstract

Objectives

Recently, Mycoplasma genitalium (MG) has been reported to have developed antimicrobial resistance. Sequential or combination therapy with doxycycline and fluoroquinolones has been effective in treating difficult-to-treat MG infections. However, therapeutic options are limited when these treatments fail. Hence, this study aimed to evaluate the effectiveness of spectinomycin, which has only been reported in a single case.

Methods

This retrospective observational study included patients ≥18 years who were diagnosed with MG infection and received at least one intramuscular injection of spectinomycin between December 2019 and May 2024 at the department of infectious diseases of the National Center for Global Health and Medicine.

Results

Four patients met the inclusion criteria. All patients were men and aged between 29 and 62 years, and had received a 7-day course of spectinomycin treatment. All patients had urethritis due to MG and experienced their first episode of MG infection. Two patients were men who had sex with men, one of whom was HIV-positive. All the patients had a history of multiple antimicrobial treatments. MG resistance gene test results were available in three patients. 23SrRNA and parC but not gyrA mutations were detected in all three patients. Three patients received oral doxycycline with spectinomycin for 7 days. After 7 days of spectinomycin treatment, three of the four patients tested negative for MG and were considered clinically and microbiologically effective. No adverse effects of spectinomycin were observed in any patient.

Conclusions

A7-day spectinomycin intramuscular injection therapy may a useful option for treating refractory MG urethritis.

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肌肉注射大观霉素治疗难治性支原体生殖道炎4例疗效观察

目的近年来，生殖支原体（Mycoplasma genitalium， MG）出现了耐药性。多西环素和氟喹诺酮类药物序贯或联合治疗对难治性MG感染有效。然而，当这些治疗失败时，治疗选择是有限的。因此，本研究旨在评估大观霉素的有效性，这只报道了一个病例。方法本回顾性观察研究纳入了2019年12月至2024年5月期间在国家全球卫生与医学中心传染病科诊断为MG感染并接受至少一次大观霉素肌肉注射的≥18岁患者。结果4例患者符合纳入标准。所有患者均为男性，年龄在29 - 62岁之间，接受了7天的大观霉素治疗。所有患者均有MG引起的尿道炎，并经历了MG感染的首次发作。两名患者是与男性发生性关系的男性，其中一人是艾滋病毒阳性。所有患者均有多种抗菌药物治疗史。3例患者有MG耐药基因检测结果。所有3例患者均检测到23SrRNA和parC突变，但未检测到gyrA突变。3例患者口服强力霉素联合大观霉素7天。大观霉素治疗7天后，4例患者中有3例MG检测呈阴性，认为临床和微生物学有效。在所有患者中未观察到大观霉素的不良反应。结论肌肉注射大霉素治疗难治性MG型尿道炎是一种有效的治疗方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Infection and Chemotherapy INFECTIOUS DISEASES-PHARMACOLOGY & PHARMACY

CiteScore

4.10

自引率

4.50%

发文量

303

审稿时长

47 days

期刊介绍： The Journal of Infection and Chemotherapy (JIC) — official journal of the Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases — welcomes original papers, laboratory or clinical, as well as case reports, notes, committee reports, surveillance and guidelines from all parts of the world on all aspects of chemotherapy, covering the pathogenesis, diagnosis, treatment, and control of infection, including treatment with anticancer drugs. Experimental studies on animal models and pharmacokinetics, and reports on epidemiology and clinical trials are particularly welcome.