Falha no manejo sindrômico devido a Mycoplasma genitalium resistente em Florianópolis, Sul do Brasil

Autores

  • Fernando Hartmann Barazzetti Universidade Federal de Santa Catarina, Health Sciences Center, Molecular Biology, Microbiology, and Serology Laboratory (Reference Laboratory for Brazilian Gonococcal Antimicrobial Surveillance Program) – Florianópolis (SC), Brazil. https://orcid.org/0000-0001-6409-3021
  • Marcos André Schörner Universidade Federal de Santa Catarina, Health Sciences Center, Molecular Biology, Microbiology, and Serology Laboratory (Reference Laboratory for Brazilian Gonococcal Antimicrobial Surveillance Program) – Florianópolis (SC), Brazil. https://orcid.org/0000-0002-7303-6050
  • Jhonatan Augusto Ribeiro Universidade Federal de Santa Catarina, Health Sciences Center, Molecular Biology, Microbiology, and Serology Laboratory (Reference Laboratory for Brazilian Gonococcal Antimicrobial Surveillance Program) – Florianópolis (SC), Brazil. https://orcid.org/0000-0002-9222-7530
  • Henrique Borges da Silva Grisard Universidade Federal de Santa Catarina, Health Sciences Center, Molecular Biology, Microbiology, and Serology Laboratory (Reference Laboratory for Brazilian Gonococcal Antimicrobial Surveillance Program) – Florianópolis (SC), Brazil. https://orcid.org/0000-0002-7902-9548
  • Jéssica Motta Martins Universidade Federal de Santa Catarina, Health Sciences Center, Molecular Biology, Microbiology, and Serology Laboratory (Reference Laboratory for Brazilian Gonococcal Antimicrobial Surveillance Program) – Florianópolis (SC), Brazil. https://orcid.org/0000-0002-8852-7813
  • Julia Kinetz Wachter Universidade Federal de Santa Catarina, Health Sciences Center, Molecular Biology, Microbiology, and Serology Laboratory (Reference Laboratory for Brazilian Gonococcal Antimicrobial Surveillance Program) – Florianópolis (SC), Brazil. https://orcid.org/0000-0003-1681-7712
  • Patrícia de Almeida Vanny Universidade Federal de Santa Catarina, Professor Polydoro Ernani de São Thiago Universitary Hospital – Florianópolis (SC), Brazil.
  • Maria Luiza Bazzo Universidade Federal de Santa Catarina, Health Sciences Center, Molecular Biology, Microbiology, and Serology Laboratory (Reference Laboratory for Brazilian Gonococcal Antimicrobial Surveillance Program) – Florianópolis (SC), Brazil. https://orcid.org/0000-0003-1292-0974

DOI:

https://doi.org/10.5327/DST-2177-8264-2024361423

Palavras-chave:

Infecções sexualmente transmissíveis, Macrolídeos, Quinolonas, Polimorfismo de nucleotídeo único, Uretrite

Resumo

Introdução: Mycoplasma genitalium é uma bactéria associada a infecções sexualmente transmissíveis, que pode causar uretrite em homens e complicações
em mulheres, incluindo nascimento prematuro. O aumento da resistência aos macrolídeos em M. genitalium coloca desafios à eficácia do tratamento.
Objetivo: Apresentar um caso de falha terapêutica de uretrite causada por M. genitalium resistente aos macrolídeos. Relato de caso: Este relato de caso
descreve um homem de 20 anos com sintomas uretrais persistentes, apesar do tratamento com azitromicina, em que M. genitalium possuía a mutação A2058G no rRNA 23S. O tratamento subsequente com moxifloxacino resolveu os sintomas e eliminou M. genitalium. Conclusão: O estudo destacou a importância dos testes de resistência para orientar a terapia antimicrobiana e enfatizou a necessidade de atualizar as diretrizes de tratamento no Brasil.

Downloads

Não há dados estatísticos.

Referências

Tully JG, Cole RM, David DTR, Rose L. A Newly Discovered Mycoplasma

in the Human Urogenital Tract. The Lancet. 1981;317(8233):1288-91.

https://doi.org/10.1016/S0140-6736(81)92461-2

Taylor-Robinson D, Jensen JS. Mycoplasma genitalium: From chrysalis to

multicolored butterfly. Clin Microbiol Rev. 2011;24(3):498-514. https://

doi.org/10.1128/CMR.00006-11

Lis R, Rowhani-Rahbar A, Manhart LE. Mycoplasma genitalium Infection

and Female Reproductive Tract Disease: A Meta-analysis. Clin Infect Dis.

;61(3):418-26. https://doi.org/10.1093/cid/civ312

Jensen JS, Cusini M, Gomberg M, Moi H, Wilson J, Unemo M. 2021

European guideline on the management of Mycoplasma genitalium

infections. J Eur Acad Dermatol Venereol. 2022;36(5):641-50. https://doi.

org/10.1111/jdv.17972

Brasil. Protocolo Clínico e Diretrizes Terapêuticas Para Atenção Integral às

Pessoas com Infecções Sexualmente Transmissíveis (IST) [Internet]. Brazil:

Ministério da Saúde; 2022 [cited on Jun 5, 2024]. 211 p. Available from: http://

bvsms.saude.gov.br/bvs/publicacoes/protocolo_clinico_atecao_integral_ist.pdf

Machalek DA, Tao Y, Shilling H, Jensen JS, Unemo M, Murray G,

et al. Prevalence of mutations associated with resistance to macrolides

and fluoroquinolones in Mycoplasma genitalium: a systematic review

and meta-analysis. Lancet Infect Dis. 2020;20(11):1302-14. https://doi.

org/10.1016/S1473-3099(20)30154-7

Jensen JS, Bradshaw CS, Tabrizi SN, Fairley CK, Hamasuna R. Azithromycin

treatment failure in Mycoplasma genitalium-positive patients with

nongonococcal urethritis is associated with induced macrolide resistance.

Clin Infect Dis. 2008;47(12):1546-53. https://doi.org/10.1086/593188

Unemo M, Jensen JS. Antimicrobial-resistant sexually transmitted

infections: Gonorrhoea and Mycoplasma genitalium. Nat Rev Urol.

;14:139-52. https://doi.org/10.1038/nrurol.2016.268

Workowski KA, Bachmann LH, Chan PA, Johnston CM, Muzny CA, Park

I, et al. Sexually Transmitted Infections Treatment Guidelines. Atlanta:

Center for Surveillance, Epidemiology, and Laboratory Services, Centers

for Disease Control and Prevention (CDC), U.S. Department of Health

and Human Services; 2021.

Australian Society for HIV, Vira Hepatitis and Sexual Health Medicine.

Australian STI Management Guidelines for use in Primary Care [Internet].

Australian Society for HIV, Vira Hepatitis and Sexual Health Medicine;

[cited on Apr. 23, 2024]. Available from: https://sti.guidelines.org.

au/sexually-transmissible-infections/mycoplasma-genitalium/

Zheng BJ, Yin YP, Han Y, Shi MQ, Jiang N, Xiang Z, et al. The prevalence

of urethral and rectal Mycoplasma genitalium among men who have

sex with men in China, a cross-sectional study. BMC Public Health.

;14(1):195. https://doi.org/10.1186/1471-2458-14-195

Slifirski JB, Vodstrcil LA, Fairley CK, Ong JJ, Chow EPF, Chen MY,

et al. Mycoplasma genitalium Infection in adults reporting sexual

contact with infected partners, Australia, 2008-2016. Emerg Infect Dis.

;23(11):1826-33. https://doi.org/10.3201/eid2311.170998

Riera-Monroig J, Fuertes I, Alsina M, Blanco JL. Importance of the treatment of

rectal Mycoplasma genitalium in men who have sex with men. Enferm Infecc

Microbiol Clin. 2019;37(8):544-5. https://doi.org/10.1016/j.eimc.2018.07.003

Tuddenham S, Hamill MM, Ghanem KG. Sexually Transmitted Infections:

Updates From the 2021 CDC Guidelines. JAMA. 2022;327(2):161-72.

https://doi.org/10.1001/jama.2021.23487

Detels R, Green AM, Klausner JD, Katzenstein D, Gaydos C, Handsfield

HH, et al. The Incidence and Correlates of Symptomatic and Asymptomatic

Chlamydia trachomatis and Neisseria gonorrhoeae Infections in Selected

Populations in Five Countries. Sex Transm Dis. 2011;38(6):503-9.

Chan PA, Robinette A, Montgomery M, Almonte A, Cu-Uvin S, Lonks

JR, et al. Extragenital Infections Caused by Chlamydia trachomatis and

Neisseria gonorrhoeae: A Review of the Literature. Infect

Downloads

Publicado

2024-09-16

Como Citar

1.
Hartmann Barazzetti F, Schörner MA, Ribeiro JA, Grisard HB da S, Martins JM, Wachter JK, et al. Falha no manejo sindrômico devido a Mycoplasma genitalium resistente em Florianópolis, Sul do Brasil. DST [Internet]. 16º de setembro de 2024 [citado 16º de novembro de 2024];36. Disponível em: https://bdst.emnuvens.com.br/revista/article/view/1423

Edição

v. 36 (2024)

Seção

Relato de caso

Licença

Copyright (c) 2024 Brazilian Journal of Sexually Transmitted Diseases

Creative Commons License
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.