Mycoplasma pneumoniae

Paul Auwaerter, M.D.
Mycoplasma pneumoniae is a topic covered in the Johns Hopkins ABX Guide.

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MICROBIOLOGY

  • Aerobic, fastidious organism.
  • Organism lacks a cell wall. Member of Mollicutes class, among the smallest known free-living bacteria.
    • Lack of cell wall means that beta-lactam antibiotics have no effect.
  • Historically termed the "Eaton agent," prior to successful cultivation in 1962.
  • Believed to be a frequent cause of atypical pneumonia but historically a difficult diagnosis and serology inaccurate often.
    • Not a part of normal human oropharyngeal flora.
    • The organism produces community-acquired respiratory distress syndrome (CARDS) toxin implicated in the colonization of upper airways and pathogenesis as intracellular pathogen → assists with the invasion of cells.
    • M. pneumoniae culture is difficult. Growth often requires 7-21 days, successful in 40-90% of cases.
      • Culture media requires heart infusion, peptone, yeast extract, salts, glucose or arginine + fetal calf serum (5-20%).
      • Bacterial overgrowth a common problem.
  • Macrolide resistance growing issue worldwide and especially common in China (90% of isolates).
    • Outbreak investigations in the U.S. have found macrolide resistance rates of 8-27%.

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MICROBIOLOGY

  • Aerobic, fastidious organism.
  • Organism lacks a cell wall. Member of Mollicutes class, among the smallest known free-living bacteria.
    • Lack of cell wall means that beta-lactam antibiotics have no effect.
  • Historically termed the "Eaton agent," prior to successful cultivation in 1962.
  • Believed to be a frequent cause of atypical pneumonia but historically a difficult diagnosis and serology inaccurate often.
    • Not a part of normal human oropharyngeal flora.
    • The organism produces community-acquired respiratory distress syndrome (CARDS) toxin implicated in the colonization of upper airways and pathogenesis as intracellular pathogen → assists with the invasion of cells.
    • M. pneumoniae culture is difficult. Growth often requires 7-21 days, successful in 40-90% of cases.
      • Culture media requires heart infusion, peptone, yeast extract, salts, glucose or arginine + fetal calf serum (5-20%).
      • Bacterial overgrowth a common problem.
  • Macrolide resistance growing issue worldwide and especially common in China (90% of isolates).
    • Outbreak investigations in the U.S. have found macrolide resistance rates of 8-27%.

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Last updated: February 13, 2021