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Lack of Association Between the S83I ParC Mutation in Mycoplasma genitalium and Treatment Outcomes Among Men Who Have Sex With Men with Nongonococcal Urethritis

Chambers, Laura C. PhD, MPH*; Jensen, Jørgen S. MD, PhD; Morgan, Jennifer L. ARNP, MSW; Lowens, M. Sylvan PA; Romano, Sarah S. MPH*; Totten, Patricia A. PhD, MS§,¶; Soge, Olusegun O. PhD, MS§,¶; Hughes, James P. PhD; Golden, Matthew R. MD, MPH*,‡,§; Manhart, Lisa E. PhD, MPH*,¶

doi: 10.1097/OLQ.0000000000001035
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From February 2015 to October 2017, among 20 men who have sex with men with Mycoplasma genitalium-associated nongonococcal urethritis, 15% had macrolide resistance and S83I ParC mutations. Azithromycin followed by moxifloxacin cleared Mycoplasma genitalium in 2 of 2 with and 11 of 13 without S83I mutations. Dual failures were cleared after doxycycline. S83I mutations were not associated with moxifloxacin failure.

Among men who have sex with men with Mycoplasma genitalium-associated nongonococcal urethritis, the S83I ParC mutation was present in 15% but not associated with moxifloxacin treatment failure.

From the *Department of Epidemiology, University of Washington, Seattle, WA

Statens Serum Institut, Copenhagen, Denmark

HIV/STD Program, Public Health-Seattle and King County

§Department of Medicine

Department of Global Health

Department of Biostatistics, University of Washington, Seattle, WA

Correspondence: Laura C. Chambers, PhD, MPH, Department of Epidemiology, University of Washington, 325 Ninth Ave, HMC 359931, Seattle, WA 98104. E-mail: lauracc@uw.edu.

A portion of this work was presented at the 2018 International Union Against Sexually Transmitted Infection World and European Conference, held June 27-30, 2018, in Dublin, Ireland.

Conflicts of Interest and Sources of Funding: This study was funded by the National Institutes of Health (grant U19 AI113173). L.C.C. was funded by the National Institutes of Health (grant TL1 TR002318 trainee support). Study data were collected and managed using Research Electronic Data Capture (REDCap) tools hosted at the University of Washington Institute of Translational Health Sciences and supported by the National Institutes of Health (grant UL1 TR002319). J.S.J. has received speaker's fees from Hologic, Cepheid, and SpeeDx and serves on the scientific advisory board of Roche Molecular Systems, Abbott Molecular Inc., and Cepheid. The Statens Serum Institut has received remuneration for contract work from SpeeDx, Hologic, NYtor, Diagenode, Nabriva, and GlaxoSmithKline. P.A.T. has received remuneration for honoraria, reagents, test kits, and contract work from Hologic; consulting services and contract work from SpeeDx; and contract work from Abbott and Cepheid. M.R.G. has conducted studies unrelated to this work supported by grants from Hologic and GlaxoSmithKline. L.E.M. has received honoraria, reagents, and test kits for diagnostic assays from Hologic. All other authors declare that they have no conflict of interest.

Acknowledgments: The authors thank the study participants and the Public Health-Seattle and King County STD Clinic staff. They also gratefully acknowledge Sean Proll for assisting with the figures; Linda Cles, Cynthia Khoury, and Sabina Astete for performing MG testing; and Gitte Jensen and the staff at the Statens Serum Institute Virus and Microbiological Special Diagnostics Department for technical assistance with tests for MG organism load and resistance-associated mutations in MG. Finally, they thank Hologic for donation of test collection kits and reagents.

Received for publication April 26, 2019, and accepted June 7, 2019.

Online date: June 27, 2019

© Copyright 2019 American Sexually Transmitted Diseases Association