Advances in Mycoplasma pneumoniae Infections

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Infectious Diseases".

Deadline for manuscript submissions: closed (31 January 2022) | Viewed by 17146

Special Issue Editors

Department of Pediatrics, Kawasaki Medical School, Okayama 701-0192, Japan
Interests: pediatric infectious diseases; clinical microbiology (especially Mycoplasma, Chlamydia, and Yersinia); vaccinology
1. Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
2. Infection Control and Education Center, Nagasaki University Hospital, Nagasaki, Japan
Interests: mycoplasmology; mycology; drug-resistance; infection control

Special Issue Information

Dear Colleagues,

Mycoplasma pneumoniae is the smallest prokaryotic microbe in nature that lacks a cell wall. M. pneumoniae causes various respiratory infections in humans and is a major cause of community‑acquired pneumonia in children as well as adults. The typical clinical presentation is primary atypical pneumonia. In addition, M. pneumoniae can also induce various complications in the blood, cardiovascular system, gastrointestinal tract, and skin, as well as pericarditis, myocarditis, nephritis, and meningitis. Acquired immunity against Mycoplasma pneumoniae does not have lifelong persistence and repeated infection is common. The pathogenic mechanism of M. pneumoniae infection is thought to be mainly due to the immunological involvement of the host; however, the pathogenesis of M. pneumoniae infection is complex and remains to be fully elucidated. Although the first choice of treatment for M. pneumoniae infection is macrolide antibacterial agents, clinically significant acquired macrolide resistance has emerged worldwide and is now complicating treatment. In this Special Issue, I would like to focus on the many new developments over the past few years that have enhanced our understanding of this microbe.

Prof. Dr. Kazunobu Ouchi
Prof. Dr. Koichi Izumikawa
Guest Editor

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Keywords

  • Mycoplasma pneumoniae
  • pathogenesis
  • immunity
  • epidemiology
  • diagnosis
  • treatment
  • macrolide resistance

Published Papers (7 papers)

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Research

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9 pages, 1352 KiB  
Article
Combined Radiographic Features and Age Can Distinguish Mycoplasma pneumoniae Pneumonia from Other Bacterial Pneumonias: Analysis Using the 16S rRNA Gene Sequencing Data
by Yuto Iwanaga, Kei Yamasaki, Kazuki Nemoto, Kentaro Akata, Hiroaki Ikegami, Keigo Uchimura, Shingo Noguchi, Chinatsu Nishida, Toshinori Kawanami, Kazumasa Fukuda, Hiroshi Mukae and Kazuhiro Yatera
J. Clin. Med. 2022, 11(8), 2201; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11082201 - 14 Apr 2022
Cited by 2 | Viewed by 1486
Abstract
The study objective was to evaluate chest radiographic features that distinguish Mycoplasma pneumoniae pneumonia (MPP) from other bacterial pneumonias diagnosed based on the bacterial floral analysis with 16S rRNA gene sequencing, using bronchoalveolar lavage fluid samples directly obtained from pneumonia lesions. Patients were [...] Read more.
The study objective was to evaluate chest radiographic features that distinguish Mycoplasma pneumoniae pneumonia (MPP) from other bacterial pneumonias diagnosed based on the bacterial floral analysis with 16S rRNA gene sequencing, using bronchoalveolar lavage fluid samples directly obtained from pneumonia lesions. Patients were grouped according to the dominant bacterial phenotype; among 120 enrolled patients with CAP, chest CT findings were evaluated in 55 patients diagnosed with a mono-bacterial infection (one bacterial phylotype occupies more than 80% of all phylotypes in a sample) by three authorized respiratory physicians. Among this relatively small sample size of 55 patients with CAP, 10 had MPP, and 45 had other bacterial pneumonia and were categorized into four groups according to their predominant bacterial phylotypes. We created a new scoring system to discriminate MPP from other pneumonias, using a combination of significant CT findings that were observed in the M. pneumoniae group, and age (<60 years) (MPP–CTA scoring system). When the cutoff value was set to 1, this scoring system had a sensitivity of 80%, a specificity of 93%, a positive predictive value of 73%, and a negative predictive value of 95%. Among the CT findings, centrilobular nodules were characteristic findings in patients with MPP, and a combination of chest CT findings and age might distinguish MPP from other bacterial pneumonias. Full article
(This article belongs to the Special Issue Advances in Mycoplasma pneumoniae Infections)
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8 pages, 1786 KiB  
Article
Recombinase Polymerase Amplification Combined with Real-Time Fluorescent Probe for Mycoplasma pneumoniae Detection
by Tingting Jiang, Yacui Wang, Weiwei Jiao, Yiqin Song, Qing Zhao, Tianyi Wang, Jing Bi and Adong Shen
J. Clin. Med. 2022, 11(7), 1780; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11071780 - 23 Mar 2022
Cited by 7 | Viewed by 1878
Abstract
Mycoplasma pneumoniae (M. pneumoniae) is one of the major causes of community-acquired pneumonia, accounting for 20–40% of total cases. Rapid and accurate detection of M. pneumoniae is crucial for the diagnosis and rational selection of antibiotics. In this study, we set [...] Read more.
Mycoplasma pneumoniae (M. pneumoniae) is one of the major causes of community-acquired pneumonia, accounting for 20–40% of total cases. Rapid and accurate detection of M. pneumoniae is crucial for the diagnosis and rational selection of antibiotics. In this study, we set up a real-time recombinase polymerase amplification (RPA) assay to detect the conserved gene CARDS of M. pneumoniae. The amplification can be finished in 20 min at a wide temperature range from 37–41 °C. The limit of detection of RPA assay was 10 fg per microliter. Cross-reaction with commonly detected respiratory pathogens was not observed using RPA assay. Among clinical sputum samples, the detection rate of RPA assay and real-time PCR assay was 48.4% (92/190) and 46.3% (88/190), respectively (p = 0.68). Therefore, the RPA assay for M. pneumoniae detection is rapid and easy to use and may serve as a promising test for early diagnosis of M. pneumoniae infection. Full article
(This article belongs to the Special Issue Advances in Mycoplasma pneumoniae Infections)
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7 pages, 406 KiB  
Communication
Clinical Differences between Community-Acquired Mycoplasma pneumoniae Pneumonia and COVID-19 Pneumonia
by Naoyuki Miyashita, Yasushi Nakamori, Makoto Ogata, Naoki Fukuda, Akihisa Yamura, Yoshihisa Ishiura and Shosaku Nomura
J. Clin. Med. 2022, 11(4), 964; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11040964 - 12 Feb 2022
Cited by 6 | Viewed by 2447
Abstract
Mycoplasmapneumoniae is one of the major causative pathogens of community-acquired pneumonia (CAP). M. pneumoniae CAP is clinically and radiologically distinct from bacterial CAPs. One feature of the Japanese Respiratory Society (JRS) guidelines is a trial to be carried out to differentiate between [...] Read more.
Mycoplasmapneumoniae is one of the major causative pathogens of community-acquired pneumonia (CAP). M. pneumoniae CAP is clinically and radiologically distinct from bacterial CAPs. One feature of the Japanese Respiratory Society (JRS) guidelines is a trial to be carried out to differentiate between M. pneumoniae pneumonia and bacterial pneumonia for the selection of antibiotics. The purpose of the present study was to clarify the clinical and radiological differences of the M. pneumoniae CAP and coronavirus disease 2019 (COVID-19) CAP. This study was conducted at 5 institutions and assessed a total of 210 patients with M. pneumoniae CAP and 956 patients with COVID-19 CAP. The median age was significantly younger in patients with M. pneumoniae CAP than COVID-19 CAP. Among the clinical symptoms, cough and sputum were observed more frequently in patients with M. pneumoniae CAP than those with COVID-19 CAP. However, the diagnostic specificity of these findings was low. In contrast, loss of taste and anosmia were observed in patients with COVID-19 CAP but not observed in those with M. pneumoniae CAP. Bronchial wall thickening and nodules (tree-in-bud and centrilobular), which are chest computed tomography (CT) features of M. pneumoniae CAP, were rarely observed in patients with COVID-19 CAP. Our results demonstrated that there were two specific differences between M. pneumoniae CAP and COVID-19 CAP: (1) the presence of loss of taste and/or anosmia and (2) chest CT findings. Full article
(This article belongs to the Special Issue Advances in Mycoplasma pneumoniae Infections)
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13 pages, 1944 KiB  
Article
Association of Tandem Repeat Number Variabilities in Subunit S of the Type I Restriction-Modification System with Macrolide Resistance in Mycoplasma pneumoniae
by Joon-Kee Lee, Moon-Woo Seong, Ki-Wook Yun and Eun-Hwa Choi
J. Clin. Med. 2022, 11(3), 715; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11030715 - 28 Jan 2022
Cited by 3 | Viewed by 2055
Abstract
Mycoplasma pneumoniae is one of the major pathogens responsible for pneumonia in children. Modern molecular genetics has advanced both the management and the epidemiologic study of this disease. Despite these advancements, macrolide resistance remains a global threat in the management of M. pneumoniae [...] Read more.
Mycoplasma pneumoniae is one of the major pathogens responsible for pneumonia in children. Modern molecular genetics has advanced both the management and the epidemiologic study of this disease. Despite these advancements, macrolide resistance remains a global threat in the management of M. pneumoniae infection, for which the genetic background remains unrevealed. In this study, the result of whole genome analysis of 20 sequence type 3 (ST3) M. pneumoniae strains were examined to investigate the gene(s) associated with macrolide resistance. Overall, genetic similarities within M. pneumoniae, and especially ST3, were very high (over 99.99 %). Macrolide resistant ST3 strains shared 20 single nucleotide polymorphisms, of which one gene (mpn085) was found to be associated with resistance. BLAST comparison of M. pneumoniae revealed regular tandem repeat number variabilities between macrolide-susceptible and resistant strains for genes coding the Type I restriction-modification (R-M) system of subunit S (HsdS). Of the ten known HsdS genes, macrolide resistance was determined by the unique tandem repeat of mpn085 and mpn285. In conclusion, the use of whole genome sequencing (WGS) to target macrolide resistance in M. pneumoniae indicates that the determinant of macrolide resistance is variabilities in the tandem repeat numbers of the type I R-M system in subunit S. Full article
(This article belongs to the Special Issue Advances in Mycoplasma pneumoniae Infections)
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7 pages, 887 KiB  
Article
Efficacy of Empiric Antibiotic Coverage in Community-Acquired Pneumonia Associated with Each Atypical Bacteria: A Meta-Analysis
by Khalid Eljaaly, Ahmed Aljabri, Ali A. Rabaan, Ohoud Aljuhani, Abrar K. Thabit, Mohannad Alshibani and Thamer A. Almangour
J. Clin. Med. 2021, 10(19), 4321; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm10194321 - 23 Sep 2021
Cited by 6 | Viewed by 2800
Abstract
The benefit of empiric coverage for community-acquired pneumonia (CAP) for atypical bacteria is controversial. This meta-analysis purpose was to compare the clinical failure rate between adults who empirically received atypical coverage versus those who did not. We searched PubMed and EMBASE for randomized [...] Read more.
The benefit of empiric coverage for community-acquired pneumonia (CAP) for atypical bacteria is controversial. This meta-analysis purpose was to compare the clinical failure rate between adults who empirically received atypical coverage versus those who did not. We searched PubMed and EMBASE for randomized controlled trials (RCTs), comparing the clinical failure rate of CAP associated with individual atypical bacteria between adults who received empiric atypical coverage versus those who did not. Risk differences (RDs) with 95% confidence intervals (CIs) were calculated using random-effects models. Eight double-blind RCTs (65 patients with Legionella spp., 176 patients with M. pneumoniae, and 78 patients with C. pneumoniae) were included in the meta-analysis. The rate of clinical failure was significantly lower with empiric atypical coverage in CAP associated with Legionella spp. (RD, −42.6%; 95% CI, −69.8% to −15.4%; p-value = 0.002; I2 = 0%) and Mycoplasma pneumoniae (RD, −9.5%; 95% CI, −18.9% to −0.1%; p-value = 0.048; I2 = 0%), but not with Chlamydia pneumoniae (RD, 7.1%; 95% CI, −9.0% to 23.1%; p-value = 0.390; I2 = 0%). This meta-analysis of RCTs found that empiric atypical coverage decreased the clinical failure rate of CAP associated with Legionella spp. and M. pneumoniae, but not with C. pneumoniae. Full article
(This article belongs to the Special Issue Advances in Mycoplasma pneumoniae Infections)
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Review

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8 pages, 265 KiB  
Review
Recent Trends in the Epidemiology, Diagnosis, and Treatment of Macrolide-Resistant Mycoplasma pneumoniae
by Tomohiro Oishi and Kazunobu Ouchi
J. Clin. Med. 2022, 11(7), 1782; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11071782 - 24 Mar 2022
Cited by 6 | Viewed by 2925
Abstract
Among Mycoplasma pneumoniae (MP) is one of the major pathogens causing lower respiratory tract infection. Macrolide-resistant Mycoplasma pneumoniae (MRMP) isolates have been increasing and has become a global concern, especially in East Asian countries. This affects the treatment of MP infection; that is, [...] Read more.
Among Mycoplasma pneumoniae (MP) is one of the major pathogens causing lower respiratory tract infection. Macrolide-resistant Mycoplasma pneumoniae (MRMP) isolates have been increasing and has become a global concern, especially in East Asian countries. This affects the treatment of MP infection; that is, some patients with MRMP infections fever cannot be controlled despite macrolide therapy. Therefore, alternative therapies, including secondary antimicrobials, including tetracyclines, fluoroquinolones, or systemic corticosteroids, were introduced. However, there are insufficient data on these alternative therapies. Thus, this article provides reviews of the recent trends in the epidemiology, diagnosis, and treatment of MRMP. Full article
(This article belongs to the Special Issue Advances in Mycoplasma pneumoniae Infections)
9 pages, 680 KiB  
Review
Mycoplasma pneumoniae Pleural Effusion in Adults
by Chang Ho Kim and Jaehee Lee
J. Clin. Med. 2022, 11(5), 1281; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11051281 - 26 Feb 2022
Cited by 2 | Viewed by 2489
Abstract
Parapneumonic effusions often complicate Mycoplasma pneumoniae (MP) pneumonia, contrary to the notion that they are a rare feature of MP infection. Increased research and evidence on MP parapneumonic effusions (MPPE) can help elucidate its clinical significance as one of the variable manifestations of [...] Read more.
Parapneumonic effusions often complicate Mycoplasma pneumoniae (MP) pneumonia, contrary to the notion that they are a rare feature of MP infection. Increased research and evidence on MP parapneumonic effusions (MPPE) can help elucidate its clinical significance as one of the variable manifestations of MP infection. This article aims to summarize the existing literature about the clinical characteristics of MPPE in adults and discuss its diagnostic implications from the perspective of pleural fluid analysis. Approximately 20–25% of adult patients with MP pneumonia develop MPPE, and its frequency in children and adults seems to be similar. Although the pathogenesis of MPPE remains to be elucidated, MP-induced cell-mediated immune mechanisms might be partially associated with the development of MPPE. MPPE usually shows mononuclear leukocyte predominance with elevated adenosine deaminase (ADA) activity, similar to tuberculous pleural effusion (TPE). The degree of increase in pleural fluid ADA levels and serum inflammatory biomarkers may help differentiate between MPPE and TPE. During the acute phase, a single positive IgM and positive polymerase chain reaction results allow for a precise and reliable MP infection diagnosis. The mainstay of treatment is the selection of adequate anti-mycoplasma antibiotics with or without corticosteroid, based on the local epidemiologic data on macrolide resistance. Full article
(This article belongs to the Special Issue Advances in Mycoplasma pneumoniae Infections)
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