Estimation of antimicrobial resistance of Mycoplasma genitalium, Belgium, 2022.

Irith De Baetselier, Hilde Smet, Kaat Kehoe, Imelda Loosen, Marijke Reynders, Iqbal Mansoor, Lorenzo Filippin, Mathieu Cauchie, Ellen Van Even, Nadia Makki, Gilberte Schiettekatte, Wouter Vandewal, Bart Glibert, Veerle Matheeussen, Yolien Van der Beken, Reinoud Cartuyvels, Sophia Steyaert, Ann Lemmens, Maria-Grazia Garrino, Henry ParidaensElena Lazarova, Bénédicte Lissoir, Marine Deffontaine, Amélie Heinrichs, Veroniek Saegeman, Elizaveta Padalko, Amaryl Lecompte, Wim Vanden Berghe, Chris Kenyon, Dorien Van den Bossche

Research output: Contribution to journalArticlepeer-review


BackgroundAntimicrobial resistance (AMR) of Mycoplasma genitalium (MG) is a growing concern worldwide and surveillance is needed. In Belgium, samples are sent to the National Reference Centre of Sexually Transmitted Infections (NRC-STI) on a voluntary basis and representative or robust national AMR data are lacking.AimWe aimed to estimate the occurrence of resistant MG in Belgium.MethodsBetween July and November 2022, frozen remnants of MG-positive samples from 21 Belgian laboratories were analysed at the NRC-STI. Macrolide and fluoroquinolone resistance-associated mutations (RAMs) were assessed using Sanger sequencing of the 23SrRNA and parC gene. Differences in resistance patterns were correlated with surveillance methodology, socio-demographic and behavioural variables via Fisher's exact test and logistic regression analysis.ResultsOf the 244 MG-positive samples received, 232 could be sequenced for macrolide and fluoroquinolone RAMs. Over half of the sequenced samples (55.2%) were resistant to macrolides. All sequenced samples from men who have sex with men (MSM) (24/24) were macrolide-resistant. Fluoroquinolone RAMs were found in 25.9% of the samples and occurrence did not differ between socio-demographic and sexual behaviour characteristics.ConclusionAlthough limited in sample size, our data suggest no additional benefit of testing MG retrieved from MSM for macrolide resistance in Belgium, when making treatment decisions. The lower occurrence of macrolide resistance in other population groups, combined with emergence of fluoroquinolone RAMs support macrolide-resistance testing in these groups. Continued surveillance of resistance in MG in different population groups will be crucial to confirm our findings and to guide national testing and treatment strategies.

Original languageEnglish
Issue number7
Publication statusPublished - Feb-2024


  • Male
  • Humans
  • Anti-Bacterial Agents/pharmacology
  • Homosexuality, Male
  • Mycoplasma genitalium/genetics
  • Belgium/epidemiology
  • Macrolides/pharmacology
  • Drug Resistance, Bacterial/genetics
  • Mycoplasma Infections/drug therapy
  • Mutation
  • RNA, Ribosomal, 23S/genetics
  • Sexual and Gender Minorities
  • Fluoroquinolones/pharmacology
  • Sexually Transmitted Diseases


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