Macrolide Resistance in Treponema pallidum in the United States and Ireland
Open accessAbstract
An HIV-infected patient in San Francisco with primary syphilis was treated with azithromycin, but the lesion did not resolve. The authors of this case report confirmed resistance to azithromycin and identified a mutation in the 23S rRNA genes of T. pallidum. The mutation was also found in samples collected in Baltimore, Seattle, and Dublin.
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T. pallidum chromosomal mutations are associated with azithromycin and other macrolide resistance.
“because of T. pallidum chromosomal mutations associated with azithromycin and other macrolide resistance”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [606]
Documented treatment failures with azithromycin for syphilis have occurred in multiple U.S. geographic areas.
“documented treatment failures in multiple U.S. geographic areas”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [606]
Azithromycin resistance appears to be linked to intrinsic macrolide resistance in some strains of T. pallidum.
“which appears to be linked to intrinsic macrolide resistance in some strains of T. pallidium.102,103”
From BASHH UK guidelines for the management of syphilis 2024 (2024) · cites this paper as [102]
Rapid emergence of resistance to azithromycin with clinical failure has been described in several studies.
“However, rapid emergence of resistance to azithromycin with clinical failure has been described in several studies”
From BASHH UK guidelines for the management of syphilis 2024 (2024) · cites this paper as [102]
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- Authors
- Lukehart, S. A., Godornes, C., Molini, B. J., Sonnett, P., Hopkins, S., Mulcahy, F., Engelman, J., Mitchell, S. J., Rompalo, A. M., Marra, C. M., & Klausner, J. D.
- Affiliations
- University of Washington (US)
- St. James's Hospital (IE)
- San Francisco Department of Public Health (US)
- Centers for Disease Control and Prevention (US)
- Johns Hopkins University (US)
- ORCID
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2004-07-08
- Volume
- 351
- Issue
- 2
- Pages
- 154-158
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2148572979
- Cited by
- 378
- References
- 19
- Citations by year
- 2026: 6 · 2025: 8 · 2024: 15 · 2023: 12 · 2022: 10 · 2021: 9 · 2020: 13 · 2019: 12 · 2018: 19 · 2017: 13 · 2016: 16 · 2015: 25 · 2014: 16 · 2013: 13 · 2012: 26
- FWCI
- 15.66
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- National Institutes of Health (5r01ns038663-05)
- National Institute of Allergy and Infectious Diseases (R01AI042143, AI-42143, R01AI045724, P01AI034616, AI 34616, AI 45724)
- National Institute of Neurological Disorders and Stroke (NS 34235, R01NS034235, NS 38663)
- Topics
- Health Sciences › Medicine › Physiology › Syphilis Diagnosis and Treatment
- Life Sciences › Immunology and Microbiology › Parasitology › Vector-borne infectious diseases
- Life Sciences › Immunology and Microbiology › Microbiology › Reproductive tract infections research
- Keywords
- Treponema pallidum, macrolide resistance, azithromycin resistance, 23S rRNA mutations, primary syphilis, HIV coinfection, antimicrobial resistance, United States, Ireland
- MeSH terms
- Adult, Animals, Anti-Bacterial Agents, Genes, Bacterial, Humans, Ireland, Male, Mutation, Penicillin G Benzathine, Rabbits, Syphilis, Treponema pallidum, United States, HIV Infections, Treatment Failure, Azithromycin, Macrolides, Genes, rRNA, Drug Resistance, Bacterial
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