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Mycoplasma genitalium acquisition and macrolide resistance after initiation of HIV pre-exposure prophylaxis in men who have sex with men

Author
Organization
Abstract
<jats:sec><jats:title>Objectives</jats:title><jats:p>Recent evidence shows that patients using HIV pre-exposure prophylaxis (PrEP) have an increased rate of bacterial STIs, including syphilis, chlamydia and gonorrhoea. Our study aimed to describe the acquisition and the susceptibility for macrolides of <jats:italic>Mycoplasma genitalium</jats:italic> in men who have sex with men (MSM) on PrEP.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>We studied all MSM who started PrEP in the AZ Sint-Jan Hospital Bruges from 1 June 2017 to 31 March 2019 with at least one follow-up visit. Patients were screened for <jats:italic>M. genitalium</jats:italic> and other STIs with pooled rectal swabs, pharyngeal swabs and first-voided urine, and blood samples at baseline and quarterly intervals after initiating PrEP. TaqMan Array Card technology was used to detect <jats:italic>M. genitalium</jats:italic> and determine macrolide-resistance mediating mutations in region V of the 23S rRNA gene (A2058G, A2059G, A2058C and others). Patients with an STI were treated based on a national guideline.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>131 MSM (median age 40 years, range 20–79) were included in the study. The median follow-up time was 12 months (IQR 6.1–17). Baseline prevalence of <jats:italic>M. genitalium</jats:italic> was 6.9% and incidence rate after PrEP initiation was 28.8 per 100 person-years (95% CI 21.7 to 37.2), without significant differences in proportions between the first four quarterly intervals. All but one acquisitions were asymptomatic. Younger age and positivity for <jats:italic>M. genitalium</jats:italic> at baseline were significantly associated with incident <jats:italic>M. genitalium</jats:italic> acquisition. The observed proportion of macrolide resistance increased not significantly from 44% at baseline to 57%–86% after PrEP initiation. None of the 27 macrolide-resistant <jats:italic>M. genitalium</jats:italic> acquisitions could be linked to azithromycin exposure in the three preceding months.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>After initiation of PrEP, we found a stable incidence of almost exclusively asymptomatic <jats:italic>M. genitalium</jats:italic>. However, a non-significant trend of an increased percentage of macrolide-resistant strains was observed.</jats:p></jats:sec>
Keywords
Infectious Diseases, Dermatology

Citation

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MLA
Van Praet, Jens Tomas, et al. “Mycoplasma Genitalium Acquisition and Macrolide Resistance after Initiation of HIV Pre-Exposure Prophylaxis in Men Who Have Sex with Men.” Sexually Transmitted Infections, 2020, p. sextrans-2019.
APA
Van Praet, J. T., Steyaert, S., Vandecasteele, S., Van Den Bergh, B., Mahieu, H., De Buyser, S., … Reynders, M. (2020). Mycoplasma genitalium acquisition and macrolide resistance after initiation of HIV pre-exposure prophylaxis in men who have sex with men. Sexually Transmitted Infections, sextrans-2019.
Chicago author-date
Van Praet, Jens Tomas, Sanne Steyaert, Stefaan Vandecasteele, Barbara Van Den Bergh, Hilde Mahieu, Stefanie De Buyser, Veerle Grootaert, Patrick Descheemaeker, and Marijke Reynders. 2020. “Mycoplasma Genitalium Acquisition and Macrolide Resistance after Initiation of HIV Pre-Exposure Prophylaxis in Men Who Have Sex with Men.” Sexually Transmitted Infections, sextrans-2019.
Chicago author-date (all authors)
Van Praet, Jens Tomas, Sanne Steyaert, Stefaan Vandecasteele, Barbara Van Den Bergh, Hilde Mahieu, Stefanie De Buyser, Veerle Grootaert, Patrick Descheemaeker, and Marijke Reynders. 2020. “Mycoplasma Genitalium Acquisition and Macrolide Resistance after Initiation of HIV Pre-Exposure Prophylaxis in Men Who Have Sex with Men.” Sexually Transmitted Infections: sextrans-2019.
Vancouver
1.
Van Praet JT, Steyaert S, Vandecasteele S, Van Den Bergh B, Mahieu H, De Buyser S, et al. Mycoplasma genitalium acquisition and macrolide resistance after initiation of HIV pre-exposure prophylaxis in men who have sex with men. Sexually Transmitted Infections. 2020;sextrans-2019.
IEEE
[1]
J. T. Van Praet et al., “Mycoplasma genitalium acquisition and macrolide resistance after initiation of HIV pre-exposure prophylaxis in men who have sex with men,” Sexually Transmitted Infections, p. sextrans-2019, 2020.
@article{8642469,
  abstract     = {<jats:sec><jats:title>Objectives</jats:title><jats:p>Recent evidence shows that patients using HIV pre-exposure prophylaxis (PrEP) have an increased rate of bacterial STIs, including syphilis, chlamydia and gonorrhoea. Our study aimed to describe the acquisition and the susceptibility for macrolides of <jats:italic>Mycoplasma genitalium</jats:italic> in men who have sex with men (MSM) on PrEP.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>We studied all MSM who started PrEP in the AZ Sint-Jan Hospital Bruges from 1 June 2017 to 31 March 2019 with at least one follow-up visit. Patients were screened for <jats:italic>M. genitalium</jats:italic> and other STIs with pooled rectal swabs, pharyngeal swabs and first-voided urine, and blood samples at baseline and quarterly intervals after initiating PrEP. TaqMan Array Card technology was used to detect <jats:italic>M. genitalium</jats:italic> and determine macrolide-resistance mediating mutations in region V of the 23S rRNA gene (A2058G, A2059G, A2058C and others). Patients with an STI were treated based on a national guideline.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>131 MSM (median age 40 years, range 20–79) were included in the study. The median follow-up time was 12 months (IQR 6.1–17). Baseline prevalence of <jats:italic>M. genitalium</jats:italic> was 6.9% and incidence rate after PrEP initiation was 28.8 per 100 person-years (95% CI 21.7 to 37.2), without significant differences in proportions between the first four quarterly intervals. All but one acquisitions were asymptomatic. Younger age and positivity for <jats:italic>M. genitalium</jats:italic> at baseline were significantly associated with incident <jats:italic>M. genitalium</jats:italic> acquisition. The observed proportion of macrolide resistance increased not significantly from 44% at baseline to 57%–86% after PrEP initiation. None of the 27 macrolide-resistant <jats:italic>M. genitalium</jats:italic> acquisitions could be linked to azithromycin exposure in the three preceding months.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>After initiation of PrEP, we found a stable incidence of almost exclusively asymptomatic <jats:italic>M. genitalium</jats:italic>. However, a non-significant trend of an increased percentage of macrolide-resistant strains was observed.</jats:p></jats:sec>},
  author       = {Van Praet, Jens Tomas and Steyaert, Sanne and Vandecasteele, Stefaan and Van Den Bergh, Barbara and Mahieu, Hilde and De Buyser, Stefanie and Grootaert, Veerle and Descheemaeker, Patrick and Reynders, Marijke},
  issn         = {1368-4973},
  journal      = {Sexually Transmitted Infections},
  keywords     = {Infectious Diseases,Dermatology},
  language     = {eng},
  pages        = {sextrans--2019},
  title        = {Mycoplasma genitalium acquisition and macrolide resistance after initiation of HIV pre-exposure prophylaxis in men who have sex with men},
  url          = {http://dx.doi.org/10.1136/sextrans-2019-054335},
  year         = {2020},
}

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