Possible Transmission of mcr-1–Harboring Escherichia coli between Companion Animals and Human

described in France in 2012 (14%). We found 35 A→G substitutions at position 2058 or 2059, two A2062T mutations and one A2059C mutation (Table) (1,9). Notably, in patients 15 and 33, who were infected with strains with macrolide resistance–associated mutations, M. genitalium infection was unsuccessfully treated with azithromycin, with treatment failures after azithromycin (1 g) and extended azithromycin (1.5 g for 5 d), but moxifloxacin treatment was effective. Patient 15 had been treated 1 year earlier with azithromycin (1 g) for nongonococcal urethritis. Among the 168 patients whose isolates were examined for the 23S rRNA, gyrA, and parC genes, strains from 2 patients (patients 3 and 6) had both macrolideand fluoroquinolone-associated mutations (1.2%; 95% CI 0.33%–4.24%). Both patients received azithromycin (1 g), and patient 6 received additional azithromycin (1.5 g) after failure of azithromycin (1 g). Patient 6 experienced azithromycin failure again after the extended regimen. M. genitalium multidrug resistance is described in France at a prevalence of 1.2%, lower than prevalence described in Australia (7.5%) (7) and Japan (30.8%) (10). In conclusion, M. genitalium fluoroquinolone resistance is emerging in France, with a prevalence of 6% in 2013– 2014. Further, macrolide resistance also increased during this period, to a rate of 17.2%. Patients infected with M. genitalium strains containing both macrolide and fluoroquinolone resistance mutations associated with therapeutic failure raise concerns about untreatable M. genitalium infections.