Antimicrobial resistance of Mycoplasma genitalium in Korea for two decades.

IF 2.1 3区医学 Q2 UROLOGY & NEPHROLOGY

Investigative and Clinical Urology Pub Date : 2025-09-01 DOI:10.4111/icu.20250106

Gilho Lee, Heeyoon Park, Yumi Seo, Seung-Ju Lee

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Abstract

Purpose: Antimicrobial-resistant (AMR) Mycoplasma genitalium has become a global concern. To assess AMR patterns in Korea, we analyzed the genetic diversity of the AMR-determining sites (ARDS) in M. genitalium across in 285 samples collected over two decades.

Materials and methods: Mycoplasma-positive samples were collected from various groups: males at one referral center (ORC) from 2014 to 2019 (G1; 43) and from 2020 to 2023 (G2; 54), males at primary care clinics (PCCs) in 2018-2019 (G3; 84), female sex workers at a regional healthcare center in 2004 (G4; 51), and females at PCCs in 2018-2019 (G5; 53). Sanger sequencing was performed at positions 2058/2059 in the 23S rRNA gene and positions GyrA95, GyrA99, ParC83, and ParC87 of topoisomerase IV genes in M. genitalium.

Results: In 2004, mutations were rare with S83I (0.0%), M95I (3.4%), and A2059G (10.5%). By 2020-2023, ARDS mutations had become common, peaking at S83I (83.3%) and A2059G (70.4%). No sex differences were observed in ARDS mutations between G3 and G5. A comparison of mutations in males at the ORC showed significant differences in A2059G and S83I between pre-2020 (G1) and post-2020 (G2). Males at the ORC (G1) had higher mutation rates in A2059G, GyrA95, and GyrA99 compared to males at PCCs (G3).

Conclusions: Currently, referred males exhibit a rapid increase in AMR, and the synergy between A2059G and S83I/R/N mutations raises concerns regarding the emergence of pan-drug-resistant M. genitalium, potentially leading to an irreversible crisis in treatment options in Korea.

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20年来韩国生殖支原体的抗微生物药物耐药性。

目的：生殖支原体耐药（AMR）已成为全球关注的问题。为了评估韩国的AMR模式，我们分析了20年来收集的285个样本中生殖支原体AMR决定位点（ARDS）的遗传多样性。材料与方法：支原体阳性样本来自不同人群：2014 -2019年在一家转诊中心（ORC）的男性（G1; 43）和2020 - 2023年（G2; 54）， 2018-2019年在初级保健诊所（PCCs）的男性（G3; 84）， 2004年在一家地区卫生保健中心的女性性工作者（G4; 51）， 2018-2019年在PCCs的女性（G5; 53）。对生殖支链菌23S rRNA基因2058/2059位点和拓扑异构酶IV基因GyrA95、GyrA99、ParC83、ParC87位点进行Sanger测序。结果：2004年突变少见，分别为S83I（0.0%）、M95I（3.4%）和A2059G（10.5%）。到2020-2023年，ARDS突变变得普遍，峰值为S83I（83.3%）和A2059G（70.4%）。G3和G5间ARDS突变无性别差异。男性ORC的突变比较显示，2020年前（G1）和2020年后（G2）的A2059G和S83I存在显著差异。ORC （G1）的男性与PCCs （G3）的男性相比，A2059G、GyrA95和GyrA99的突变率更高。结论：目前，参考的男性AMR迅速增加，A2059G和S83I/R/N突变之间的协同作用引起了人们对泛耐药生殖支链杆菌出现的担忧，可能导致韩国治疗方案出现不可逆转的危机。

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来源期刊

Investigative and Clinical Urology Medicine-Urology

CiteScore

4.10

自引率

4.30%

发文量

审稿时长

4 weeks

期刊介绍： Investigative and Clinical Urology (Investig Clin Urol, ICUrology) is an international, peer-reviewed, platinum open access journal published bimonthly. ICUrology aims to provide outstanding scientific and clinical research articles, that will advance knowledge and understanding of urological diseases and current therapeutic treatments. ICUrology publishes Original Articles, Rapid Communications, Review Articles, Special Articles, Innovations in Urology, Editorials, and Letters to the Editor, with a focus on the following areas of expertise: • Precision Medicine in Urology • Urological Oncology • Robotics/Laparoscopy • Endourology/Urolithiasis • Lower Urinary Tract Dysfunction • Female Urology • Sexual Dysfunction/Infertility • Infection/Inflammation • Reconstruction/Transplantation • Geriatric Urology • Pediatric Urology • Basic/Translational Research One of the notable features of ICUrology is the application of multimedia platforms facilitating easy-to-access online video clips of newly developed surgical techniques from the journal''s website, by a QR (quick response) code located in the article, or via YouTube. ICUrology provides current and highly relevant knowledge to a broad audience at the cutting edge of urological research and clinical practice.