Prevalence of Antimicrobial Resistant Mycoplasma genitalium among Men Who Have Sex with Men: a Systematic Review and Meta-analysis
Michael Sciaudone, Elika Hashemi, Elena Cyrus, Arlene C. SeñaBackground:
Methods:
We searched PubMed, Embase, and Scopus from database inception to January 31, 2026 for studies that reported the prevalence of macrolide, fluoroquinolone, or tetracycline-resistant MG among MSM, included studies according to pre-determined eligibility criteria, and conducted a random effects meta-analysis to summarize findings and assess for trends over time and differences across geographic regions. Study quality was assessed using a 10-item critical appraisal tool developed by the Joanna Briggs Institute specifically for prevalence studies.
Results:
Fifty-one studies (N = 5,247) were included that conducted MG resistance testing, with sample sizes ranging from 7 to 1557 (median 56). The pooled prevalence of macrolide resistance was 75.7% (95% CI 69.5%-81.5%) and that of fluoroquinolone resistance was 23.5% (95% CI 17.8%-29.7%). Studies were highly heterogeneous (
Conclusions:
This systematic review revealed a high prevalence of macrolide resistant MG among MSM, and a lower, but significant prevalence of fluoroquinolone resistance. Larger, more rigorous studies that focus exclusively on MSM are needed to better estimate the global burden of antimicrobial resistant MG among MSM.