ABSTRACT
OBJECTIVE: To estimate the prevalence of Mycoplasma genitalium in Toronto, Ont; detect mutations associated with macrolide and fluoroquinolone resistance; and describe treatment outcomes. DESIGN: Prospective, cross-sectional study. SETTING: A sexual health clinic in Toronto. PARTICIPANTS: A consecutive sample of men and women attending the sexual health clinic between September 1, 2013, and December 20, 2013. INTERVENTIONS: Participants underwent testing for M genitalium, along with standard sexually transmitted infection screening. All samples that had positive results for M genitalium were tested for mutations associated with resistance to macrolides and fluoroquinolones. Mycoplasma genitalium treatment was based on resistance profile and verified with a test of cure. MAIN OUTCOME MEASURES: Positive results for M genitalium and antibiotic resistance.
Subject(s)
Anti-Bacterial Agents/administration & dosage , Drug Resistance, Bacterial/genetics , Mycoplasma Infections/drug therapy , Mycoplasma Infections/epidemiology , Adult , Azithromycin/administration & dosage , Cross-Sectional Studies , Doxycycline/administration & dosage , Female , Fluoroquinolones/administration & dosage , Fluoroquinolones/adverse effects , Humans , Macrolides/adverse effects , Male , Middle Aged , Moxifloxacin , Mycoplasma genitalium/drug effects , Mycoplasma genitalium/genetics , Ontario/epidemiology , Prospective Studies , Sex Factors , Treatment Outcome , Young AdultABSTRACT
The Merlin Immediate HIV-1 and -2 Test (Merlin point-of-care [POC] test; Merlin Biomedical & Pharmaceutical) is a nitrocellulose membrane flow immunoassay performed at the POC with the use of blood obtained from a fingerprick. The results of this test were compared with those of enzyme immunoassay (EIA) performed on venous blood samples in the laboratory. Positive results of both tests were confirmed by a Western blot (WB). The study included 553 adults with known HIV (human immunodeficiency virus) seropositivity (all of whom had positive Merlin POC test results) and 2659 adults with unknown HIV serostatus (20 of whom had positive EIA/WB results; 19 of the 20 also had positive Merlin-POC test results). The sensitivity of the Merlin POC test was 95.0% for patients with an unknown HIV serostatus and 99.83% for those with a positive serostatus. For previously untested subjects, the test's specificity and positive predictive value were 100%, its negative predictive value was 99.96%, and its overall accuracy was 99.96%. The Merlin POC test is highly accurate for the detection of HIV antibodies.
