Initial failure of pristinamycin treatment in a case of multidrug-resistant Mycoplasma genitalium urethritis eventually treated by sequential therapy

We present a case of persistent Mycoplasma genitalium (MG) urethritis with documented macrolide and fluoroquinolone resistance, and we describe the A2062T mutation in the 23S rRNA gene, possibly associated with pristinamycin resistance. After several treatment failures and loss of the A2062T mutation, MG urethritis was finally cured by a sequential antibiotic treatment including minocycline.