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Antimicrobial resis...
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Pitt, RachelNational Infection Service, Public Health England, London, United Kingdom
(author)
Antimicrobial resistance in Mycoplasma genitalium sampled from the British general population
- Article/chapterEnglish2020
Publisher, publication year, extent ...
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2020-01-10
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BMJ Publishing Group Ltd,2020
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printrdacarrier
Numbers
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LIBRIS-ID:oai:DiVA.org:oru-78962
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https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-78962URI
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https://doi.org/10.1136/sextrans-2019-054129DOI
Supplementary language notes
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
Notes
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Funding Agencies:Medical Research Council UK (MRC) G0701757Economic & Social Research Council (ESRC)Department of Health
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Background: Mycoplasma genitaliumis a common sexually transmitted infection. Treatment guidelines focus on those with symptoms and sexual contacts, generally with regimens including doxycycline and/or azithromycin as first-line and moxifloxacin as second-line treatment. We investigated the prevalence of antimicrobial resistance (AMR)-conferring mutations inM. genitaliumamong the sexually-active British general population.Methods: The third national survey of sexual attitudes and lifestyles (Natsal-3) is a probability sample survey of 15 162 men and women aged 16-74 years in Britain conducted during 2010-12. Urine test results forM. genitaliumwere available for 4507 participants aged 16-44 years reporting>1 lifetime sexual partner. In this study, we sequenced regions of the 23S rRNA andparCgenes to detect known genotypic determinants for resistance to macrolides and fluoroquinolones respectively.Results: 94% (66/70) of specimens were re-confirmed asM. genitaliumpositive, with successful sequencing in 85% (56/66) for 23S rRNA and 92% (61/66) forparCgenes. Mutations in 23S rRNA gene (position A2058/A2059) were detected in 16.1% (95%CI: 8.6% to 27.8%) and inparC(encodingParCD87N/D87Y) in 3.3% (0.9%-11.2%). Macrolide resistance was more likely in participants reporting STI diagnoses (past 5 years) (44.4% (18.9%-73.3%) vs 10.6% (4.6%-22.6%); p=0.029) or sexual health clinic attendance (past year) (43.8% (23.1%-66.8%) vs 5.0% (1.4%-16.5%); p=0.001). All 11 participants with AMR-conferring mutations had attended sexual health clinics (past 5 years), but none reported recent symptoms.Conclusions: This study highlights challenges inM. genitaliummanagement and control. Macrolide resistance was present in one in six specimens from the general population in 2010-2012, but no participants with AMRM. genitaliumreported symptoms. Given anticipated increases in diagnostic testing, new strategies including novel antimicrobials, AMR-guided therapy, and surveillance of AMR and treatment failure are recommended.
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Unemo, Magnus,1970-Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,WHO Collaborating Centre for Gonorrhoea and Other STIs, National Reference Laboratory for STIs, Department of Laboratory Medicine, Microbiology(Swepub:oru)muo
(author)
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Sonnenberg, PamCentre for Population Research in Sexual Health and HIV, Institute for Global Health, UCL, London, United Kingdom
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Alexander, SarahNational Infection Service, Public Health England, London, United Kingdom
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Beddows, SimonNational Infection Service, Public Health England, London, United Kingdom
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Cole, Michelle JayneNational Infection Service, Public Health England, London, United Kingdom
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Clifton, SoazigCentre for Population Research in Sexual Health and HIV, Institute for Global Health, UCL, London, United Kingdom
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Mercer, Catherine H.Centre for Population Research in Sexual Health and HIV, Institute for Global Health, UCL, London, United Kingdom
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Johnson, Anne M.Centre for Molecular Epidemiology and Translational Research, Institute for Global Health, UCL, London, United Kingdom
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Ison, Catherine A.National Infection Service, Public Health England, London, United Kingdom
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Field, NigelCentre for Molecular Epidemiology and Translational Research, Institute for Global Health, UCL, London, United Kingdom
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National Infection Service, Public Health England, London, United KingdomInstitutionen för medicinska vetenskaper
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In:Sexually Transmitted Infections: BMJ Publishing Group Ltd96:6, s. 464-4681368-49731472-3263
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