Moxifloxacin and Sitafloxacin Treatment Failure in Mycoplasma genitalium Infection: Association with parC Mutation G248T (S83I) and Concurrent gyrA Mutations.
J Infect Dis
; 221(6): 1017-1024, 2020 03 02.
Article
em En
| MEDLINE
| ID: mdl-32031634
ABSTRACT
BACKGROUND:
The basis of fluoroquinolone treatment failure for Mycoplasma genitalium is poorly understood.METHODS:
To identify mutations associated with failure we sequenced key regions of the M. genitalium parC and gyrA genes for patients undergoing sequential therapy with doxycycline-moxifloxacin (201 patients, including 21 with failure) or doxycycline-sitafloxacin (126 patients, including 13 with failure).RESULTS:
The parC G248T/S83I mutation was more common among patients with failed sequential doxycycline-moxifloxacin (present in 76.2% of failures vs 7.8% cures, P < .001) or doxycycline-sitafloxacin (50% vs 16.8%, respectively; P = .01) treatment. Doxycycline-sitafloxacin was more efficacious than doxycycline-moxifloxacin against infections carrying the parC mutation conferring S83I amino acid change. Treatment was more likely to fail in these infections if they had a concurrent gyrA mutation (M95I or D99N) (P = .07 for doxycycline-moxifloxacin group and P = .009 for doxycycline-sitafloxacin group), suggesting an additive effect.CONCLUSIONS:
This study indicates that parC G248T/S83I mutations contribute to failure of moxifloxacin and sitafloxacin, and the findings will inform the development of quinolone resistance assays needed to ensure optimal selection of antimicrobials for M. genitalium.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Fluoroquinolonas
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Farmacorresistência Bacteriana
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Mycoplasma genitalium
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Moxifloxacina
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Antibacterianos
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Infecções por Mycoplasma
Tipo de estudo:
Prognostic_studies
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Risk_factors_studies
Limite:
Female
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Humans
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Male
Idioma:
En
Revista:
J Infect Dis
Ano de publicação:
2020
Tipo de documento:
Article
País de afiliação:
Austrália