Retrospective analysis of infection and antimicrobial resistance patterns of among pregnant women in the southwestern USA.

Background: is a sexually transmitted infection (STI) pathogen. There have been no published studies concerning symptomatology, prevalence data, antibiotic resistance profiling or reports of co-infection with other STI in pregnant women.

Objective: To describe these characteristics among pregnant women attending prenatal clinics in a large tertiary care centre.

Design: Remnant genital samples collected from pregnant women between August 2018 and November 2019 were tested for and by the transcription-mediated amplification technique. Specimens with detectable RNA were sequenced for 23S rRNA mutations associated with azithromycin resistance and and mutations associated with resistance to moxifloxacin. Demographic, obstetric and STI co-infection data were recorded.

Results: Of the 719 samples, 41 (5.7 %) were positive for infection was associated with black race, Hispanic ethnicity and young age (p=0.003, p=0.008 and p=0.004, respectively). infection was also associated with co-infection and (group B ) colonisation (p≤0.001 and p=0.002, respectively). Of the 41 positive samples, 26 (63.4%) underwent successful sequencing. Eight (30.8%) had 23S rRNA mutations related to azithromycin resistance. One of 26 (3.8%) positive samples with sequencing results had the gyrA gene mutation and 1 of 18 sequenced samples (5.6%) had the parC gene mutation associated with moxifloxacin resistance.

Conclusions: Prevalence rates of in pregnant women was 5.7%. infection disproportionately affects young black women co-infected with . Pregnant women remain at risk for persistent infection with due to decreased azithromycin susceptibility.