PDF(Pubmed)
Abstract：
UNASSIGNED: Mycoplasma genitalium (MG) infection is a public health concern due to antimicrobial resistance (AMR). Data are limited on repeat MG infection and AMR among US Air Force service members with HIV.
UNASSIGNED: US Air Force service members seeking HIV care were screened for MG infection during the surveillance period (16 May 2016-16 March 2020). Baseline and repeat MG prevalence rates were estimated. An extended Cox proportional hazards regression model evaluated characteristics associated with repeat MG infection. MG-positive rectal samples were tested for macrolide or fluoroquinolone resistance.
UNASSIGNED: Among 299 male patients from a total of 308 patients followed during the surveillance period, baseline prevalence of MG infection was 19.7% (n = 59); among the 101 patients who screened positive for MG at any time during the surveillance period, repeat MG was 35% (n = 36). Characteristics independently associated with increased risk of repeat infection were sexually transmitted infection history vs none (adjusted hazard ratio [aHR], 2.33; 95% CI, 1.26-4.31), a sexually transmitted infection coinfection vs no positive test result in the medical records (aHR, 5.13; 95% CI, 2.78-9.49), and a new HIV diagnosis (<1 vs ≥1 year; aHR, 2.63; 95% CI, 1.45-3.73). AMR in MG-positive rectal specimens was 88% (43/49) indicating macrolide resistance, 18% (10/56) quinolone resistance, and 18% (10/56) both.
UNASSIGNED: Macrolide and fluoroquinolone resistance mutations were common. Testing for co-occurring MG infection and AMR mutations may be warranted in guiding treatment for sexually transmitted infections such as chlamydia or gonorrhea detected at HIV diagnosis.
UNASSIGNED: US Air Force service members seeking HIV care were screened for MG infection during the surveillance period (16 May 2016-16 March 2020). Baseline and repeat MG prevalence rates were estimated. An extended Cox proportional hazards regression model evaluated characteristics associated with repeat MG infection. MG-positive rectal samples were tested for macrolide or fluoroquinolone resistance.
UNASSIGNED: Among 299 male patients from a total of 308 patients followed during the surveillance period, baseline prevalence of MG infection was 19.7% (n = 59); among the 101 patients who screened positive for MG at any time during the surveillance period, repeat MG was 35% (n = 36). Characteristics independently associated with increased risk of repeat infection were sexually transmitted infection history vs none (adjusted hazard ratio [aHR], 2.33; 95% CI, 1.26-4.31), a sexually transmitted infection coinfection vs no positive test result in the medical records (aHR, 5.13; 95% CI, 2.78-9.49), and a new HIV diagnosis (<1 vs ≥1 year; aHR, 2.63; 95% CI, 1.45-3.73). AMR in MG-positive rectal specimens was 88% (43/49) indicating macrolide resistance, 18% (10/56) quinolone resistance, and 18% (10/56) both.
UNASSIGNED: Macrolide and fluoroquinolone resistance mutations were common. Testing for co-occurring MG infection and AMR mutations may be warranted in guiding treatment for sexually transmitted infections such as chlamydia or gonorrhea detected at HIV diagnosis.
摘要：
■由于抗菌素耐药性（AMR），生殖支原体（MG）感染是公共卫生问题。美国空军服役人员感染艾滋病毒的重复MG感染和AMR数据有限。
■在监测期间（2016年5月16日至2020年3月16日），对寻求HIV护理的美国空军服役人员进行了MG感染筛查。估计基线和重复MG患病率。扩展的Cox比例风险回归模型评估了与重复MG感染相关的特征。对MG阳性直肠样品进行了大环内酯或氟喹诺酮耐药性测试。
■在监测期间，共有308名患者中的299名男性患者被随访，MG感染的基线患病率为19.7%(n=59);在监测期内任何时间筛查MG阳性的101例患者中,重复MG为35%(n=36)。与重复感染风险增加独立相关的特征是性传播感染史与无感染史(调整后的风险比[aHR]，2.33；95%CI，1.26-4.31），性传播感染合并感染与医疗记录中无阳性检测结果(AHR，5.13；95%CI，2.78-9.49)，和新的艾滋病毒诊断(<1vs≥1年；aHR，2.63；95%CI，1.45-3.73）。MG阳性直肠标本中的AMR为88%(43/49),表明大环内酯耐药,18%（10/56）喹诺酮耐药，和18%（10/56）。
■大环内酯和氟喹诺酮耐药突变是常见的。在指导HIV诊断时检测到的性传播感染如衣原体或淋病的治疗时，可能需要检测同时发生的MG感染和AMR突变。
■在监测期间（2016年5月16日至2020年3月16日），对寻求HIV护理的美国空军服役人员进行了MG感染筛查。估计基线和重复MG患病率。扩展的Cox比例风险回归模型评估了与重复MG感染相关的特征。对MG阳性直肠样品进行了大环内酯或氟喹诺酮耐药性测试。
■在监测期间，共有308名患者中的299名男性患者被随访，MG感染的基线患病率为19.7%(n=59);在监测期内任何时间筛查MG阳性的101例患者中,重复MG为35%(n=36)。与重复感染风险增加独立相关的特征是性传播感染史与无感染史(调整后的风险比[aHR]，2.33；95%CI，1.26-4.31），性传播感染合并感染与医疗记录中无阳性检测结果(AHR，5.13；95%CI，2.78-9.49)，和新的艾滋病毒诊断(<1vs≥1年；aHR，2.63；95%CI，1.45-3.73）。MG阳性直肠标本中的AMR为88%(43/49),表明大环内酯耐药,18%（10/56）喹诺酮耐药，和18%（10/56）。
■大环内酯和氟喹诺酮耐药突变是常见的。在指导HIV诊断时检测到的性传播感染如衣原体或淋病的治疗时，可能需要检测同时发生的MG感染和AMR突变。
