Mycoplasmas

Introduction
• Mycoplasmas are spherical to filamentous cells with no cell walls.
There is an attachment organelle at the tip of filamentous M
pneumoniae, M genitalium, and several other pathogenic
mycoplasmas
• The mycoplasmas are placed in a separate class Mollicutes(mollis,
soft; cutis, skin)
• Mycoplasmas are the smallest self-replicating organisms with the
smallest genomes (a total of about 500 to 1000 genes); they are low
in guanine and cytosine
 Structure

Members of mycoplasma contains cholesterol

containing cell membrane
Electron microscopy revels M. pneumoniae and other
some pathogenic mycoplasma contains terminal
structure which helps in attachment
Characteristics
• Fried-egg-shaped colonies are seen on agar.
• Mycoplasmas are nutritionally very exacting. Many require
cholesterol, a unique property among prokaryotes.
• Ureaplasmas require urea for growth, another unusual property.
• Mycoplasmas have surface antigens such as membrane proteins,
lipoproteins, glycolipids, and lipoglycans
• Mycoplasmas have been nicknamed the “crabgrass” of cell cultures
Colony morphology
Growth conditions
• A routine mycoplasma medium consists of heart infusion, peptone,
yeast extract, salts, glucose or arginine, and horse serum (5 to 20
percent). Fetal or newborn calf serum is preferable to horse serum
• Mycoplasma spp are facultative anaerobes but M. pneumoniae is
strict aerobe
• Optimum temperature requirement for growth is 35-37°
• They are fastidious and grow slowly in culture media
Shape and colony
• The coccus is the basic form of all mycoplasmas in culture. The
diameter of the smallest coccus capable of reproduction is about 300
nm. In most mycoplasma cultures, elongated or filamentous forms (up
to 100 μm long and about 0.4 μm thick) also occur.
• One of the most useful distinguishing features of mycoplasmas is their
peculiar fried-egg colony shape, consisting of a central zone of growth
embedded in the agar and a peripheral one on the agar surface
Microscopy
Species
• M. pneumoniae,
• M. genitalium,
• M. fermentans and
• M. penetrans ferment glucose while
• M. hominis is glucose non fermenter.
• M. hominis hydrolyses arginine
Epidemiology
• Ubiquitous in nature
• Plants, Insects and other animals serves as reservoir
• Mycoplasma pneumoniae infection occurs worldwide and is more
prevalent in colder months.
• It affects mainly children ages 5 to 9 years.
• It is spread by close personal contact and has a long incubation
period.
• Ureaplasma urealyticum is spread primarily through sexual contact.
Women may be asymptomatic reservoirs
Pathogenesis
• All mycoplasmas cultivated and identified thus far are parasites of
humans, animals, plants, or arthropods.
• Mycoplasmas are surface parasites of the human respiratory and
urogenital tracts.
• Mycoplasma pneumoniae attaches to sialoglycoproteins or
sialoglycolipid receptors on the tracheal epithelium via protein
adhesins on the attachment organelle.
• The major adhesin is a 170-kilodalton (kDa) protein, named P1.
Hydrogen peroxide and superoxide radicals (O2–) excreted by the
attached organisms cause oxidative tissue damage
Pathogenesis
Virulance factor and immunity
• Hydrogen peroxide (H2O2), the end product of respiration in
mycoplasmas, has been implicated as a major pathogenic factor ever
since it was shown to be responsible for the lysis of erythrocytes by
mycoplasmas in vitro
• IgM antibodies, followed by IgG and secretory IgA, are important in
host resistance
Symptoms
Coomb’s Test
• Coomb’s test is a direct agglutination reaction, more commonly known as antiglobulin
test.
• In the test, incomplete antibodies do not agglutinate erythrocytes. Incomplete
antibody antiglobulin coats the surface of erythrocytes but does not cause any
agglutination.
• When such erythrocytes are treated with antiglobulin or Coombs’ serum then the
cells are agglutinated.
• Coombs’ Serum or Coomb’s reagent is a special serum from a rabbit or other animal
previously immunized with purified human globulin to prepare antibodies directed
against IgG and complement (eg. rabbit antiserum against human globulin).
• It is used in the direct and indirect Coomb’s tests and also called antihuman globulin.
M.hominis
• Mycoplasma hominis, a common inhabitant of the vagina of healthy
women, becomes pathogenic once it invades the internal genital
organs, where it may cause pelvic inflammatory diseases such as
tubo-ovarian abscess or salpingitis.
• M. hominis is responsible for infections related to pregnancy. It has
been isolated from the amniotic fluid of women with
chorioamnionitis and there is strong evidence of involvement in post-
partum or post-abortum fever generally secondary to endometritis.
infections
• M. hominis has also been associated with extragenital infections
• Cases including septic arthritis, septicemia, osteitis, retroperitoneal
abscesses and peritonitis, hematoma infection, vascular and catheter-
related infections, sternal wound infections
• M. hominis is also suspected to be the cause of neonatal infections,
including conjunctivis, respiratory distress, fever, meningitis,
abscesses, and congenital pneumonia, which occurs a few hours after
birth
Ureaplasma urealyticum
• Ureaplasma urealyticum causes nongonococcal urethritis in men. The
wide occurrence of U urealyticum in sexually active,
• For Ureaplasma culture, the medium is supplemented with urea and
its pH is brought to 6.0.
• Colonies of ureaplasmas are usually
minute(less than
100 μm in diameter); because of
urea hydrolysis and ammonia liberation,
the medium becomes alkaline
Infection
• Ureaplasma spp. can be found in the mucosal surfaces of the cervix or
vagina of sexually mature asymptomatic women
• The vertical transmission rate varies from 18% to 88% according to
studies. This rate is higher in low birth weight. Babies can be infected
by intrauterine infection or intrapartum transmission
• Ureaplasmas can cause placental inflammation and may invade the
amniotic sac early in pregnancy in the presence of intact fetal
membranes, causing persistent infection and adverse pregnancy
outcome, including preterm labor, preterm premature rupture of
membranes, and chorioamnionitis
Urease test
Treatment
• The mycoplasmas are sensitive to tetracyclines, macrolides, and the
newer quinolones, but are resistant to antibiotics that specifically
inhibit bacterial cell wall synthesis
• U urealyticum is resistant to tetracycline
• M.hominis is resistant to erythromycin or sometimes tetracycline.
Clindamycins are used for such strains.