Mycoplasmoides genitalium nucleic acid semi-quantitation and molecular macrolide resistance detection via automated assays: gender and specimen source considerations

Erik Munson*, Josephine Moore, Trinity Krueger, Amanda Zapp, Stephen C. Lavey, Kimber L. Munson, Irene A. Stafford, Brian Mustanski

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

A laboratory-developed test (LDT) using analyte-specificreagents has been optimized on a commercial platform to detect macrolide resistance-associated mutations (MRM) in 23S rRNA from Mycoplasmoides genitalium from primary clinical specimens. In this study, MRM-LDT was applied to a multi-specimen source study set. One thousand four hundred ninety-fiveprimary specimens testing positive for M. genitalium by commercial transcription-mediated amplification(TMA) were initially titered by the TMA assay using serial 10-fold dilutions to semi-quantitate target nucleic acid burden. Primary specimens were then processed for MRM detection using the MRM-LDT. Findings were stratifiedby gender and specimen source. The mean log10 target nucleic acid titer of a TMA-positive specimen was 3.51 (median 3; range 0-10). Male specimens (n = 1145) demonstrated a mean log10 M. genitalium TMA titer of 3.67; that value observed in 350 female specimens was 2.98 (P < 0.0001). The MRM-LDT detection rate (88.7%) from specimens with log10 M. genitalium TMA titers ≥ 4 was increased over specimens with log10 titers ≤ 1 (4.5%; P < 0.0002). In females, MRM-LDT was positive from 51.3% of vaginal swab and 34.7% of urine specimens (P = 0.01). In males, MRM-LDT was positive from 65.0% of rectal swab and 55.7% of urine specimens (P = 0.002). Differenceswere also observed in log10 M. genitalium TMA titers as a function of specimen source. M. genitalium macrolide resistance rates among multiple specimen sources, as determined by MRM-LDT, are high in the United States and can be consistent with target nucleic acid burden within the primary specimen. Caveats experienced within subgroupings support MRM reflextesting on primary M. genitalium-positive specimens.

Original languageEnglish (US)
JournalJournal of clinical microbiology
Volume62
Issue number6
DOIs
StatePublished - Jun 2024

Keywords

  • Mycoplasmoides genitalium
  • transcription-mediated amplification,macrolide resistance

ASJC Scopus subject areas

  • Microbiology (medical)

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