Diversity of Mycoplasma genitalium strains in Australia: relationship with sexual networks and antimicrobial resistance

Abstract

Purpose Molecular typing can identify relationships between M. genitalium strains and antimicrobial resistance and demographic data. We examined the association of mgpB sequence types (STs) with sex/sexual orientation, antimicrobial resistance and geographical location for M. genitalium in Australia. Methods Sequence data derived from previous studies in Victoria and Queensland were obtained from 170 M. genitalium samples for the mgpB , 23 S rRNA, and parC genes. An additional 55 M. genitalium samples from Victoria were sequenced for the same three genes in this study. A combined data set of 225 samples collected between 2017 and 2019 were examined for associations between mgpB ST and (i) sex/sexual orientation, (ii) macrolide and fluoroquinolone resistance, and (iii) geographical location using chi-square test. Results Overall, 66 mgpB STs were identified; the most common were ST-7 (17.9%), ST-4 (11.6%), ST-105 (11.6%), and ST-2 (5.4%). There was a strong association between ST and sex/sexual orientation; ST-4 and ST-105 were most common among men-who-have-sex-with-men ( p < 0.0001) while ST-7 among women ( p < 0.0001). There was a strong association between ST and macrolide resistance ( p = 0.0028). Fluoroquinolone resistance was less common (28.0%) and did not differ by STs ( p = 0.20). There was no association between ST and geographic location ( p = 0.056). Conclusion In this Australian study, four mgpB STs were common and were strongly associated with sex/sexual orientation and macrolide resistance. This relationship was not seen for fluoroquinolone resistance nor geographic location. These findings highlight the sporadic nature of resistance, indicating a need for effective treatment approaches combined with routine antimicrobial resistance surveillance.

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