Mycoplasma genitalium and Antimicrobial Resistance Among a Cohort of West African Men Who Have Sex With Men Using Preexposure Prophylaxis (CohMSM-PrEP ANRS 12369-Expertise France Study)
Authors: De Baetselier Irith , Vuylsteke Bea , Cuylaerts Vicky , Cuer Benjamin , Yaya Issifou , Mensah Ephrem , Dah Elias , Anoma Camille , Koné Amadou , Diandé Souba , Dagnra Anoumou , Fayé-Ketté Hortense , Yeo Alain , Smet Hilde , Van den Bossche Dorien , Keita Bintou Dembélé , Spire Bruno , Laurent Christian , Crucitti Tania ,   CohMSM-PrEP Study Group, Laurent Christian , Yaya Issifou , Ouedraogo Sayouba , Granouillac Bruno , Cuer Benjamin , Serrano Laetitia , Peeters Martine , Spire Bruno , Sagaon-Teyssier Luis , Mora Marion , Maradan Gwenaëlle , Bourrelly Michel , Berenger Cyril , Boyer Sylvie , Castro Daniela Rojas , Riegel Lucas , Vuylsteke Bea , De Baetselier Irith , Reyniers Thijs , Crucitti Tania , Keita Bintou Dembélé , Diallo Fodié , Coulibaly Alou , Kader Maïga Alassane , Camara Drissa , Diarra Mahamadou , Ouologuem Aly , Sangaré Naboh , Keita Abdoul Aziz , Cissé Oumar , Traoré Fodé , Ouary Bréhima Abdrahamane , Kanta Ibrahima , Anoma Camille , Malan Jean-Baptiste , Kotchi Rachelle , Aka Niamkey Thomas , Lokrou Kpassou Julien , Coulibaly Noufo Hamed , Koffi Ekessi Jean Armel , N’guessan Dibi Frédéric , Yoro Stéphane-Alain Babo , Cissé Adama , Dah Ter Tiero Elias , Traoré Issa , Rajaonarivelo Camille , Ouedraogo Fayçal Rodrique , Ouedraogo Joseph , Coulibaly Christian , Ouedraogo Mamadou , Ilboudo Ousseni , Traoré Abdoulazziz , Comsiambo Honoré , Mensah Ephrem , Agboyibor Mawuényégan Kouamivi , Attisso Anani , Kokouba Anouwarsadat , Badjassim Aléda Mawuli , Agbomadji Kouakou Kokouvi Selom , Attiogbe Messan , Yaka Kossi Jeff , Ekon Agbégnigan Lorette , Bimba Julien , Dagnra Claver Anoumou , Tegueni Kokou Dominique 
Published: November 2022

Abstract

Background
Antimicrobial resistance to macrolides and fluoroquinolones in Mycoplasma genitalium (MG) among men who have sex with men (MSM) is worryingly high in high-resource countries. Data in Africa are lacking. We aimed to assess the burden of MG including the presence of resistance-associated mutations (RAMs) in MG among MSM using human immunodeficiency virus preexposure prophylaxis in Burkina Faso, Côte d’Ivoire, Mali, and Togo.

Methods
MSM were included in a prospective cohort study (2017–2021). Molecular detection of MG in urine, anorectal, and pharyngeal samples was performed at baseline and after 6 and 12 months. Detection of RAMs to macrolides and fluoroquinolones was performed by sequencing the 23S ribosomal RNA, parC, and gyrA genes. A sample was found to be possibly resistant to fluoroquinolones if alterations were found in ParC position 83/87.

Results
Of 598 participants, 173 (28.9%) were positive at least once for MG and global point-prevalence was 19.4%. Interestingly, 238 of 250 (95.2%) infections were asymptomatic and 72 of 138 MG infections with follow-up data (52.2%) cleared during the study. Only 1 macrolide RAM was found (0.6%). Prevalence of fluoroquinolones RAMs was 11.3% overall, ranging from 2.4% in Burkina Faso to 17.5% in Mali.

Conclusions
Although MG was highly prevalent in these MSM, macrolide resistance was almost nonexistent. Nevertheless, &gt;10% of the samples were possibly resistant to fluoroquinolones. Heterogeneity in the prevalence of fluoroquinolone RAMs between countries may be explained by different antimicrobial consumption in humans and animals.