Mycoplasma Urea Plasma - 06-07 Med

Cell Wall-Deficient Bacteria
Cell Wall-Deficient Bacteria
• Mycoplasma pneumoniae
• Urealpsama urealyticum
• Mycoplasma hominis
Objectives
• To know the general characteristics of Mycoplasma and how

they are differ from other bacterial species.
• To know the clinical diseases caused by Mycoplasma pneumoniae,
Mycoplasma hominis and Mycoplasma urealyticum
• To know the possible roles of Mycoplasma hominis and
Mycoplasma urealyticum in infections of low birth-weight and
high –risk neonates
• To know the diagnostic methods for Mycoplasma pneumoniae
infection
• Aware about selective media for detection of mycoplasma.
Pathogenic Mycoplasama and Ureaplasama Species of Human
Organism Site Prevalence Disease
M. pneumoniae Upper & common Primary typical

lower RT pneumoniae
M. hominis GUT common Postpartum fever,

PID
U. urealyticum GUT Very common Nongonococcal

urethritis
MYCOPLASMA
GENERAL CHARACTERISTICS
• The smallest free-living organism (0.3 u dia)
• Have no cell wall
o Insensitive to penicillins & cephalosporins
o NOT stained by Gram-staining
• Cytoplasmic membrane contains cholesterol
• Slow growth on specialized artificial culture
media like New York City (NYC) agar media
(a week)
• Typical “fried-egg” appearance of colonies
(seen by microscope)
MYCOPLASMA PNEUMONIAE
• Not part of the normal flora, therefore its isolation
is always significant and pathognomonic
MAIN DISEASE
• Primary atypical pneumonia
• Common in late summer and early autumn
PATHOGENESIS & EPIDEMIOLOGY

• Droplet infection
• Organism adhere to respiratory epithelium
o Inhibit ciliary motion
o Damage epithelium
• ~10% of infected individuals develop pneumonia
• 5-10% of community acquired pneumonia
• Common in children & young adults
PRIMARY ATYPICAL PNEUMONIA
CLINICAL FEATURES
• Infecting dose is very low with long incubation period 3-
15 days
• Age between 5-15 years
• Sore throat, Cough with small amount of whitish
• fever & headache
Non-purulent sputum
• Opacities on chest X-Rays
IMMUNITY
• Auto IgM Abs are produced against type O RBCs
• Agglutinate RBCs at 4oC but not at 37oC : are
called “cold agglutinins”
Treatment
Erythromycin, tetracycline
Mycoplasma hominis and
Ureaplasma urealyticum
• Differentiated from mycoplasma due to urease
enzyme production
• Opportunistic pathogens
• Both associated with infection in the urogenital
tract
• Frequently isolated from asymptomatic individuals,
making interpretation of positive cultures difficult.
• Produce “fried egg” colonies
• As M. pneumonia both M. hominin and U. plasama
grow on specialized medium New York city agar
Diseases
• Non-gonococcal, non-chlamydial uretheritis in men
• Post-partum fever in women
• Transmitted by sexual contact
MYCOPLASMA & UREPLASMA
LAB DIAGNOSIS
• Culture : “Fried egg” colonies on specialized medium
Diagnosis is usually serologic

• A fourfold rise of the serum titer in the acute and
convalescent sera indicate M. pneumoniae
• Using complement fixation, a titer of 1:128 or higher –
indicates recent infection
• Cold agglutinins are nonspecific but helpful
TREATMENT
• Tetracycline OR
• Spectinomycin or
• Quinolones
Case study
A 14 year old young male developed gradually
increasing fever and cough with small amount of
whitish sputum which was non-purulent. After 3 days,
fever was high grade with difficulty in breathing. On
chest X-rays the lung fields showed pneumonic
lesions. Gram-stained & ZN sputum smears were not
diagnostic. On routine culture of sputum there was no
growth. However after a week of incubation on
specialized media there were fried-egg colonies by
microscopic examination.
Questions
1. What is the likely diagnosis?
2. What is the identity of the organism?
3. What serological test will help for confirmation of

diagnosis?
4. What is the antibiotic of choice for this organism?

Case study
A premature infant in the neonatal intensive care unit,

who weighed 0.75 kg at birth, developed signs of
meningitis and lumber puncture (LP) is performed.
White blood cell count of the cerebrospinal fluid
(CSF) was negative. The Gram stain was reported as
no organisms seen, and routine culture at 3 days was
no growth. The infant was still symptomatic at this
time, and the pediatric physician after consultation
with the microbiology laboratory, ordered additional
cultures of the original CSF, which had been placed in
the 370C incubator. An organism was recovered by
the laboratory
Learning assessment questions
• From what source did the infant described in the case study
acquire the infection?
• Was the infant infected during passage through the birth canal
or in utero?
• Would routine prenatal culture of the mother have yielded this
organism?
• Why was the Gram stain negative?
• On what medium does this organism produce very tiny colonies?
• What special procedure must be observed on specimens
suspected of Mycoplasma? Why?
• What current seriological assays are available to demonstrate
M. pneumoniae antibodies?
• How are Mycoplasma infections treated?

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Cell Wall-Deficient Bacteria

Cell Wall-Deficient Bacteria

• To know the general characteristics of Mycoplasma and how

Organism Site Prevalence Disease

M. pneumoniae Upper & common Primary typical

M. hominis GUT common Postpartum fever,

U. urealyticum GUT Very common Nongonococcal

PATHOGENESIS & EPIDEMIOLOGY

Diagnosis is usually serologic

1. What is the likely diagnosis?

2. What is the identity of the organism?

3. What serological test will help for confirmation of

4. What is the antibiotic of choice for this organism?

A premature infant in the neonatal intensive care unit,

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