Mycoplasma pneumoniae: an elusive pathogen
• Mycoplasmas are the smallest self-replicating organisms that are capable of cell-free existence
• Due to the lack of a cell wall, mycoplasmas do not respond to penicillins and other beta-lactams used
for the treatment of bacterial pneumonia
• Differential diagnosis of M. pneumoniae is crucial for effective patient management
• Transmission of M. pneumoniae is primarily through aerosols from person to person, and cyclic
epidemics of the bacterium are observed every 3-7 years, usually in the early autumn
• The infection is most common in children aged 2-12, with 80% of adults being seropositive for IgG
• M. pneumoniae is responsible for 10-30% of cases of Community Acquired Pneumonia (CAP)
• CAP however only represents 10% of M. pneumoniae infections – other complications have been
reported such as tracheobronchitis, upper respiratory tract disease, asthma and a significant rate of
hospitalisation, especially in the elderly
• IgM is a reliable marker of acute infection in children, but can present several limitations in adults:
– IgM can persist for up to a year, therefore is not always indicative of acute infection
– Approximately 20% of adults, especially the elderly, do not mount an IgM response, particularly in
the case of re-infection
• Due to the late elevation of IgG and the high seroprevalence in adults due to past infection, it is
advisable, where possible, to test simultaneously for both IgG and IgM
• A significant increase in IgG titre from paired specimens collected 2-3 weeks apart indicates current
or recent infection
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