Abstract：
Gay sex workers (GSWs) within the population of men who have sex with men in China are known as money boys (MBs). Limited research has been conducted to investigate the infection rate and antimicrobial resistance of Mycoplasma genitalium (M. genitalium) among GSWs in China. This study aimed to evaluate the status of M. genitalium infection among in GSWs.
This study was performed among 349 GSWs who were followed up for four years by internet-based sampling collection. The participants were asked to complete an online questionnaire using a mobile app, and trained interviewers took urethral, anorectal, and saliva swab specimens. STIs, including HIV and M. genitalium, were detected. Detection of resistance-associated mutations (RAMs) to macrolides and fluoroquinolones was performed via Sanger sequencing of the 23S rRNA, parC and gyrA genes.
GSWs were enrolled by identifying 10 initial \"seeds\" from the Blued and WeChat apps. Face-to-face interviews were conducted with 349 GSWs from June 2017 to July 2021. The prevalence of M. genitalium and HIV positivity was 92/349 (26.4%, 95% confidence interval [CI] 21.7-31.0) and 71/349 (20.3%, 95% CI 16.3-24.4), respectively. The proportion of GSWs with M. genitalium infection alone in urethral swabs was 16, and the proportion with symptoms was 2/16 (12.5%). The proportion of GSWs with M. genitalium infection alone in anorectal swabs was 36, and the proportion with symptoms was 3/36 (8.3%). Multivariate regression analysis showed that using new types of drugs in the past 3 months and inconsistent condom usage with clients in the past 30 days were associated with M. genitalium infection. Macrolide resistance within the 23S rRNA gene was detected in 73/88 (83.0%) of the M. genitalium-positive GSWs. Moreover, 79.8% (71/89) of parC and 21.1% (19/90) of gyrA genes had mutations responsible for fluoroquinolone resistance. Three cases had no mutations in any of the three genes, 11 cases had mutations in all three genes, five cases had gyrA and parC gene mutations with no mutation in the 23S rRNA gene, and 42 cases had 23S rRNA and parC gene mutations with no mutation in the gyrA gene.
M. genitalium infections in our study displayed a high prevalence and very high levels of macrolide and fluoroquinolone resistance among GSWs in China. Asymptomatic M. genitalium infections are quite common among GSWs. Routine resistance testing of M. genitalium-positive specimens and antimicrobial resistance surveillance are crucial.
This study was performed among 349 GSWs who were followed up for four years by internet-based sampling collection. The participants were asked to complete an online questionnaire using a mobile app, and trained interviewers took urethral, anorectal, and saliva swab specimens. STIs, including HIV and M. genitalium, were detected. Detection of resistance-associated mutations (RAMs) to macrolides and fluoroquinolones was performed via Sanger sequencing of the 23S rRNA, parC and gyrA genes.
GSWs were enrolled by identifying 10 initial \"seeds\" from the Blued and WeChat apps. Face-to-face interviews were conducted with 349 GSWs from June 2017 to July 2021. The prevalence of M. genitalium and HIV positivity was 92/349 (26.4%, 95% confidence interval [CI] 21.7-31.0) and 71/349 (20.3%, 95% CI 16.3-24.4), respectively. The proportion of GSWs with M. genitalium infection alone in urethral swabs was 16, and the proportion with symptoms was 2/16 (12.5%). The proportion of GSWs with M. genitalium infection alone in anorectal swabs was 36, and the proportion with symptoms was 3/36 (8.3%). Multivariate regression analysis showed that using new types of drugs in the past 3 months and inconsistent condom usage with clients in the past 30 days were associated with M. genitalium infection. Macrolide resistance within the 23S rRNA gene was detected in 73/88 (83.0%) of the M. genitalium-positive GSWs. Moreover, 79.8% (71/89) of parC and 21.1% (19/90) of gyrA genes had mutations responsible for fluoroquinolone resistance. Three cases had no mutations in any of the three genes, 11 cases had mutations in all three genes, five cases had gyrA and parC gene mutations with no mutation in the 23S rRNA gene, and 42 cases had 23S rRNA and parC gene mutations with no mutation in the gyrA gene.
M. genitalium infections in our study displayed a high prevalence and very high levels of macrolide and fluoroquinolone resistance among GSWs in China. Asymptomatic M. genitalium infections are quite common among GSWs. Routine resistance testing of M. genitalium-positive specimens and antimicrobial resistance surveillance are crucial.
摘要：
背景：在中国与男性发生性关系的男性中，同性恋性工作者（GSWs）被称为金钱男孩（MBs）。已经进行了有限的研究来调查生殖道支原体的感染率和耐药性（M.生殖器）在中国的GSWs中。本研究旨在评估GSWs中生殖支原体的感染状况。
方法：这项研究是在349名GSWs中进行的，这些GSWs通过基于互联网的抽样收集进行了为期四年的随访。参与者被要求使用移动应用程序完成在线问卷，训练有素的面试官接受了尿道，肛门直肠,和唾液拭子标本.性传播感染,包括艾滋病毒和生殖支原体，被检测到。通过对23SrRNA进行Sanger测序，检测大环内酯类和氟喹诺酮类的抗性相关突变（RAM）。parC和gyrA基因。
结果：通过从Blued和微信应用程序中识别10个初始“种子”来注册GSWs。从2017年6月至2021年7月，对349名GSW进行了面对面采访。生殖支原体和HIV阳性的患病率为92/349（26.4%，95%置信区间[CI]21.7-31.0)和71/349(20.3%，95%CI16.3-24.4），分别。尿道拭子中仅有生殖器支原体感染的GSWs比例为16，有症状的比例为2/16（12.5％）。肛门直肠拭子中单独存在生殖器支原体感染的GSWs比例为36，有症状的比例为3/36（8.3％）。多因素回归分析显示，过去3个月使用新型药物和过去30天与客户使用安全套不一致与生殖支原体感染有关。在73/88（83.0％）的生殖分枝杆菌阳性GSWs中检测到23SrRNA基因内的大环内酯抗性。此外，79.8％（71/89）的parC和21.1％（19/90）的gyrA基因存在导致氟喹诺酮耐药的突变。三个病例的三个基因中的任何一个都没有突变，11例3个基因都有突变,5例有gyrA和parC基因突变，23SrRNA基因无突变，42例有23SrRNA和parC基因突变，gyrA基因无突变。
结论：M.在我们的研究中，生殖器感染在中国的GSWs中表现出很高的患病率和非常高水平的大环内酯和氟喹诺酮耐药性。无症状的生殖支原体感染在GSW中相当常见。生殖器分枝杆菌阳性标本的常规耐药性检测和耐药性监测至关重要。
方法：这项研究是在349名GSWs中进行的，这些GSWs通过基于互联网的抽样收集进行了为期四年的随访。参与者被要求使用移动应用程序完成在线问卷，训练有素的面试官接受了尿道，肛门直肠,和唾液拭子标本.性传播感染,包括艾滋病毒和生殖支原体，被检测到。通过对23SrRNA进行Sanger测序，检测大环内酯类和氟喹诺酮类的抗性相关突变（RAM）。parC和gyrA基因。
结果：通过从Blued和微信应用程序中识别10个初始“种子”来注册GSWs。从2017年6月至2021年7月，对349名GSW进行了面对面采访。生殖支原体和HIV阳性的患病率为92/349（26.4%，95%置信区间[CI]21.7-31.0)和71/349(20.3%，95%CI16.3-24.4），分别。尿道拭子中仅有生殖器支原体感染的GSWs比例为16，有症状的比例为2/16（12.5％）。肛门直肠拭子中单独存在生殖器支原体感染的GSWs比例为36，有症状的比例为3/36（8.3％）。多因素回归分析显示，过去3个月使用新型药物和过去30天与客户使用安全套不一致与生殖支原体感染有关。在73/88（83.0％）的生殖分枝杆菌阳性GSWs中检测到23SrRNA基因内的大环内酯抗性。此外，79.8％（71/89）的parC和21.1％（19/90）的gyrA基因存在导致氟喹诺酮耐药的突变。三个病例的三个基因中的任何一个都没有突变，11例3个基因都有突变,5例有gyrA和parC基因突变，23SrRNA基因无突变，42例有23SrRNA和parC基因突变，gyrA基因无突变。
结论：M.在我们的研究中，生殖器感染在中国的GSWs中表现出很高的患病率和非常高水平的大环内酯和氟喹诺酮耐药性。无症状的生殖支原体感染在GSW中相当常见。生殖器分枝杆菌阳性标本的常规耐药性检测和耐药性监测至关重要。
