Abstract
Objective To estimate the prevalence of Mycoplasma genitalium in Toronto, Ont; detect mutations associated with macrolide and fluoroquinolone resistance; and describe treatment outcomes.
Design Prospective, cross-sectional study.
Setting A sexual health clinic in Toronto.
Participants A consecutive sample of men and women attending the sexual health clinic between September 1, 2013, and December 20, 2013.
Interventions Participants underwent testing for M genitalium, along with standard sexually transmitted infection screening. All samples that had positive results for M genitalium were tested for mutations associated with resistance to macrolides and fluoroquinolones. Mycoplasma genitalium treatment was based on resistance profile and verified with a test of cure.
Main outcome measures Positive results for M genitalium and antibiotic resistance.
Results A total of 1193 men and women participated in the study. Overall, 4.5% of the 884 men and 3.2% of the 309 women had positive test results for M genitalium. Asymptomatic infection was common (52.0%). Macrolide resistance–mediating mutations were found in 58.0% of the M genitalium infections. No treatment failure was observed for azithromycin-treated cases. Treatment failure was suspected for 16.7% of cases treated with moxifloxacin.
Conclusion Mycoplasma genitalium is present in Canada, with a prevalence comparable to chlamydia and gonorrhea, and has high macrolide and fluoroquinolone resistance.
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