Resumen de Epidemiologia i resistència antibiòtica en mycoplasma genitalium
This thesis provides the first antibiotic resistance estimates in Mycoplasma genitalium in Spain and suggests the implementation of novel treatment strategies against infections caused by this sexually transmitted pathogen. This study offers, through a comprehensive analysis of the infection in our settings, global insights regarding M. genitalium infection and its antimicrobial resistance mechanisms. Chapter 1 updates and summarizes the clinical and epidemiological evidence regarding the infection, highlighting also some basic aspects of the physiology and pathogenesis of the bacterium. Chapter 2 “Antibiotic resistance: where are we now?” provides estimates regarding macrolide and fluoroquinolone resistance in M. genitalium in Barcelona, Spain, through a cohort study performed between 2016 and 2017. Additionally, the chapter reviews and describes the regional and European evolution of antibiotic resistance in M. genitalium in the last decade. On the other hand, chapter 3 “Mycoplasma genitalium: should we screen and how?” and chapter 4 “Transmission dynamics in Mycoplasma genitalium” are focused on asymptomatic infections, addressing the prevalence of M. genitalium and antimicrobial resistance among asymptomatic individuals, and revealing the transmission dynamics of the infection. Finally, chapter 5 summarizes the main conclusions of this thesis work, culminating with the proposal of a novel treatment algorithm based on the results and the evidence obtained along this manuscript.
