Automated Mycoplasma genitalium Molecular Macrolide Resistance Detection and Nucleic Acid Target Semi-Quantitation: Patient Demographic Considerations

Authors

• Josephine Moore, Marquette University
• Trinity Krueger, Marquette University
• Amanda Zapp, Marquette University
• Stephen C. Lavey, Loyola University Chicago
• Kimber L. Munson, Marquette University
• Irene A. Stafford, McGovern Medical School
• Michael E. Newcomb, Northwestern University
• Brian Mustanski, Northwestern University
• Erik Munson, Marquette UniversityFollow

Document Type

Article

Publication Date

7-2025

Publisher

American Society for Microbiology

Source Publication

Microbiology Spectrum

Source ISSN

2165-0497

Original Item ID

DOI: 10.1128/spectrum.00738-25

Abstract

Recent work has optimized parameters of a real-time reverse transcriptase PCR-based laboratory-developed test on the Panther Fusion system which detects Mycoplasma genitalium-specific macrolide resistance-associated mutations LDT (MRM-LDT) from primary swab and urine specimens. In this study, MRM-LDT was applied to a large multi-demographic study set to further characterize M. genitalium resistance in the United States. A total of 2,145 primary clinical specimens testing positive for M. genitalium 16S rRNA by transcription-mediated amplification (TMA) were initially titered by the same assay using serial 10-fold dilutions to determine relative target nucleic acid burden. Specimens were then processed for MRM-LDT. Findings were stratified by men who have sex with men (MSM; n = 3 settings), community care (n = 2), and university student (n = 3) populations. The mean log10 target nucleic acid titer of a TMA-positive specimen was 3.46 (median 3; range 0–10). A 43.2% MRM-LDT detection rate was found in specimens derived from community care settings. Analogous assessments of university student and MSM demographics revealed 60.8% and 62.0% detection, respectively (P ≤ 0.0004 versus community care). Within the university student demographic, differences existed in target nucleic acid titer for two settings (P = 0.01); similar differences were encountered between a local MSM cohort and two that were nationally based (P ≤ 0.01). Within the university cohort, MRM-LDT detection rate was increased in symptomatic patients (P = 0.005). M. genitalium macrolide resistance rates among multiple demographics, as determined by MRM-LDT, are high in the United States and are consistent with target nucleic acid burden within the primary specimen. However, caveats experienced within subgroupings of these demographics support reflex MRM-LDT on M. genitalium-positive specimens.

Comments

Microbiology Spectrum, Vol. 13, No. 7 (July 2025): e0073825. DOI.

Recommended Citation

Moore, Josephine; Krueger, Trinity; Zapp, Amanda; Lavey, Stephen C.; Munson, Kimber L.; Stafford, Irene A.; Newcomb, Michael E.; Mustanski, Brian; and Munson, Erik, "Automated Mycoplasma genitalium Molecular Macrolide Resistance Detection and Nucleic Acid Target Semi-Quantitation: Patient Demographic Considerations" (2025). Clinical Lab Sciences Faculty Research and Publications. 83.
https://epublications.marquette.edu/clinical_lab_fac/83