Mycoplasma and Ureaplasma

Ken B. Waites; David Taylor-Robinson

doi:10.1128/9781555816728.ch59

Chapter 59 : Mycoplasma and Ureaplasma

Authors: Ken B. Waites, David Taylor-Robinson

Content Type: Reference

Publication Year: 2011

Category: Clinical Microbiology

Book DOI: 10.1128/9781555816728

Chapter DOI: 10.1128/9781555816728.ch59

MyBook is a cheap paperback edition of the original book and will be sold at uniform, low price.

Preview this chapter:

Mycoplasma and Ureaplasma, Page 1 of 2

< Previous page | Next page > /docserver/preview/fulltext/10.1128/9781555816728/9781555814632_Chap59-1.gif /docserver/preview/fulltext/10.1128/9781555816728/9781555814632_Chap59-2.gif

Abstract:

Mollicutes are believed to have evolved from clostridium-like gram-positive cells by gene deletion. In humans, mycoplasmas and ureaplasmas are associated with the mucosa, residing predominantly in the respiratory or urogenital tract, rarely penetrating the submucosa, except in cases of immunosuppression or instrumentation, when they may invade the bloodstream and disseminate to various organs and tissues. In humans, mycoplasmas and ureaplasmas may be transmitted by direct contact between hosts, i.e., venereally through genital-genital or oral-genital contact, vertically from mother to offspring either at birth or in utero, by respiratory aerosols or fomites in the case of M. pneumoniae, or even by nosocomial acquisition through transplanted tissues. Polymerase chain reaction (PCR) systems have been developed for all of the clinically important Mycoplasma and Ureaplasma species that infect humans. Typing of human mycoplasmas or ureaplasmas for diagnostic or epidemiological purposes is not recommended at the present time, and the methods are unavailable except in specialized research or reference laboratories. Fluoroquinolones such as levofloxacin and moxifloxacin are usually active against all human mycoplasmal and ureaplasmal species. Eradication of infection under these circumstances can be extremely difficult, requiring prolonged therapy, even when the organisms are susceptible to the expected agents. This difficulty highlights the facts that mollicutes are inhibited but not killed by most commonly used bacteriostatic antimicrobial agents in concentrations achievable in vivo and that a functioning immune system plays an integral part in their eradication.

Citation: Waites K, Taylor-Robinson D. 2011. Mycoplasma and Ureaplasma, p 970-985. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch59

Key Concept Ranking

Antimicrobial Susceptibility Testing: 0.4907194
Multiple-Locus Variable-Number Tandem-Repeat Analysis: 0.45030144
Lower Respiratory Tract Infections: 0.44325337
Restriction Fragment Length Polymorphism: 0.43003705

0.4907194

Highlighted Text: Show | Hide

Full text loading...

Figures

Mycoplasma and Ureaplasma

[com.pub2web.rdf.cci.facet.ContentItem[id=http://asm.metastore.ingenta.com/content/author/10.1128/9781555816728.chap59-1,webId=/content/author/10.1128/9781555816728.chap59-1,properties={foaf_givenname=Ken B., foaf_name=Ken B. Waites, foaf_surname=Waites}], com.pub2web.rdf.cci.facet.ContentItem[id=http://asm.metastore.ingenta.com/content/author/10.1128/9781555816728.chap59-2,webId=/content/author/10.1128/9781555816728.chap59-2,properties={foaf_givenname=David, foaf_name=David Taylor-Robinson, foaf_surname=Taylor-Robinson}]]

/content/10.1128/9781555816728.chap59.fig59-1

FIGURE 1

Fried-egg-type colonies of Mycoplasma hominis of up to 110 µm in diameter growing on A8 agar. Magnification, ×132.

10.1128/9781555816728/fig59-1_thmb.gif

10.1128/9781555816728/fig59-1.gif

FIGURE 1

Fried-egg-type colonies of Mycoplasma hominis of up to 110 µm in diameter growing on A8 agar. Magnification, ×132.

/content/10.1128/9781555816728.chap59.fig59-2

FIGURE 2

Spherical colonies of Mycoplasma pneumoniae of up to 100 µm in diameter growing on SP4 agar. Magnification, ×126.

10.1128/9781555816728/fig59-2_thmb.gif

10.1128/9781555816728/fig59-2.gif

FIGURE 2

Spherical colonies of Mycoplasma pneumoniae of up to 100 µm in diameter growing on SP4 agar. Magnification, ×126.

/content/10.1128/9781555816728.chap59.fig59-3

FIGURE 3

Granular, brown, urease-positive colonies of Ureaplasma species, 15 to 60 µm in diameter, from a vaginal specimen growing on A8 agar. Magnification, ×100.

10.1128/9781555816728/fig59-3_thmb.gif

10.1128/9781555816728/fig59-3.gif

FIGURE 3

Granular, brown, urease-positive colonies of Ureaplasma species, 15 to 60 µm in diameter, from a vaginal specimen growing on A8 agar. Magnification, ×100.

References

/content/book/10.1128/9781555816728.chap59

1. Abele-Horn, M.,, C. Blendinger,, C. Becher,, P. Emmerling,, and G. Ruckdeschel. 1996. Evaluation of commercial kits for quantitative identification and tests on antibiotic susceptibility of genital mycoplasmas. Zentralbl. Bakteriol. 284:540–549.

2. Abele-Horn, M.,, C. Wolff,, P. Dressel,, F. Pfaff,, and A. Zimmermann. 1997. Association of Ureaplasma urealyticum biovars with clinical outcome for neonates, obstetric patients, and gynecological patients with pelvic inflammatory disease. J. Clin. Microbiol. 35:1199–2202.

3. Ainsworth, J. G.,, J. Clarke,, R. Goldin,, and D. Taylor-Robinson. 2000. Disseminated Mycoplasma fermentans in AIDS patients: several case reports. Int. J. STD AIDS 11:751–755.

4. Ainsworth, J. G.,, J. Clarke,, M. Lipman,, D. Mitchell,, and D. Taylor-Robinson. 2000. Detection of Mycoplasma fermentans in broncho-alveolar lavage fluid specimens from AIDS patients with lower respiratory tract infection. HIV Med. 1:219–223.

5. Alexander, T. S.,, L. D. Gray,, J. A. Kraft,, D. S. Leland,, M. T. Nikaido,, and D. H. Willis. 1996. Performance of Meridian ImmunoCard Mycoplasma test in a multicenter clinical trial. J. Clin. Microbiol. 34:1180–1183.

6. Aubert, G.,, B. Pozzetto,, O. G. Gaudin,, J. Hafid,, A. D. Mbida,, and A. Ros. 1992. Evaluation of five commercial tests: complement fixation, microparticle agglutination, indirect immunofluorescence, enzyme-linked immunosorbent assay and latex agglutination, in comparison to immunoblotting for Mycoplasma pneumoniae serology. Ann. Biol. Clin. (Paris) 50:593–597.

7. Baczynska, A.,, H. Friis Svenstrup,, J. Fedder,, S. Birkelund,, and G. Christiansen. 2005. The use of enzyme-linked immunosorbent assay for detection of Mycoplasma hominis antibodies in infertile women serum samples. Hum. Reprod. 20:1277–1285.

8. Baczynska, A.,, H. F. Svenstrup,, J. Fedder,, S. Birkelund,, and G. Christiansen. 2004. Development of real-time PCR for detection of Mycoplasma hominis. BMC Microbiol. 4:35.

9. Barker, C. E.,, M. Sillis,, and T. G. Wreghitt. 1990. Evaluation of Serodia Myco II particle agglutination test for detecting Mycoplasma pneumoniae antibody: comparison with mu-capture ELISA and indirect immunofluorescence. J. Clin. Pathol. 43:163–165.

10. Baseman, J. B.,, M. Cagle,, J. E. Korte,, C. Herrera,, W. G. Rasmussen,, J. G. Baseman,, R. Shain,, and J. M. Piper. 2004. Diagnostic assessment of Mycoplasma genitalium in culturepositive women. J. Clin. Microbiol. 42:203–211.

11. Baseman, J. B.,, and J. G. Tully. 1997. Mycoplasmas: sophisticated, reemerging, and burdened by their notoriety. Emerg. Infect. Dis. 3:21–32.

12. Bebear, C. M.,, H. Renaudin,, A. Charron,, M. Clerc,, S. Pereyre,, and C. Bebear. 2003. DNA gyrase and topoisomerase IV mutations in clinical isolates of Ureaplasma spp. and Mycoplasma hominis resistant to fluoroquinolones. Antimicrob. Agents Chemother. 47:3323–3325.

13. Beersma, M. F.,, K. Dirven,, A. P. van Dam,, K. E. Templeton,, E. C. Claas,, and H. Goossens. 2005. Evaluation of 12 commercial tests and the complement fixation test for Mycoplasma pneumoniae-specific immunoglobulin G (IgG) and IgM antibodies, with PCR used as the “gold standard.” J. Clin. Microbiol. 43:2277–2285.

14. Beeton, M. L.,, V. J. Chalker,, N. C. Maxwell,, S. Kotecha,, and O. B. Spiller. 2009. Concurrent titration and determination of antibiotic resistance in Ureaplasma species with identification of novel point mutations in genes associated with resistance. Antimicrob. Agents Chemother. 53:2020–2027.

15. Bernet, C.,, M. Garret,, B. de Barbeyrac,, C. Bebear,, and J. Bonnet. 1989. Detection of Mycoplasma pneumoniae by using the polymerase chain reaction. J. Clin. Microbiol. 27:2492–2496.

16. Bjornelius, E.,, J. S. Jensen,, and P. Lidbrink. 2004. Conjunctivitis associated with Mycoplasma genitalium infection. Clin. Infect. Dis. 39:e67–e69.

17. Blanchard, A.,, J. Hentschel,, L. Duffy,, K. Baldus,, and G. H. Cassell. 1993. Detection of Ureaplasma urealyticum by polymerase chain reaction in the urogenital tract of adults, in amniotic fluid, and in the respiratory tract of newborns. Clin. Infect. Dis. 17(Suppl. 1):S148–S153.

18. Blaylock, M. W.,, O. Musatovova,, J. G. Baseman,, and J. B. Baseman. 2004. Determination of infectious load of Mycoplasma genitalium in clinical samples of human vaginal cells. J. Clin. Microbiol. 42:746–752.

19. Bradshaw, C. S.,, S. N. Tabrizi,, T. R. Read,, S. M. Garland,, C. A. Hopkins,, L. M. Moss,, and C. K. Fairley. 2006. Etiologies of nongonococcal urethritis: bacteria, viruses, and the association with orogenital exposure. J. Infect. Dis. 193:336–345.

20. Broitman, N. L.,, C. M. Floyd,, C. A. Johnson,, L. M. de la Maza,, and E. M. Peterson. 1992. Comparison of commercially available media for detection and isolation of Ureaplasma urealyticum and Mycoplasma hominis. J. Clin. Microbiol. 30:1335–1337.

21. Brown, M. B.,, G. H. Cassell,, W. M. McCormack,, and J. K. Davis. 1987. Measurement of antibody to Mycoplasma hominis by an enzyme-linked immunoassay and detection of class-specific antibody responses in women with postpartum fever. Am. J. Obstet. Gynecol. 156:701–708.

22. Brown, M. B.,, G. H. Cassell,, D. Taylor-Robinson,, and M. C. Shepard. 1983. Measurement of antibody to Ureaplasma urealyticum by an enzyme-linked immunosorbent assay and detection of antibody responses in patients with nongonococcal urethritis. J. Clin. Microbiol. 17:288–295.

23. Cassell, G. H.,, R. O. Davis,, K. B. Waites,, M. B. Brown,, P. A. Marriott,, S. Stagno,, and J. K. Davis. 1983. Isolation of Mycoplasma hominis and Ureaplasma urealyticum from amniotic fluid at 16-20 weeks of gestation: potential effect on outcome of pregnancy. Sex. Transm. Dis. 10:294–302.

24. Cassell, G. H.,, G. Gambill,, and L. B. Duffy,. 1996. ELISA in respiratory infections of humans, p. 123–136. In J. G. Tully, and S. Razin (ed.), Molecular and Diagnostic Procedures in Diagnostic Mycoplasmology. Academic Press, New York, NY.

25. Cassell, G. H.,, K. B. Waites,, and D. T. Crouse,. 2001. Mycoplasmal infections, p. 733–767. In J. S. Remington, and J. O. Klein (ed.), Infectious Diseases of the Fetus and Newborn Infant, 5th ed. W.B. Saunders Co., Inc., Philadelphia, PA.

26. Chaim, W.,, S. Horowitz,, J. B. David,, F. Ingel,, B. Evinson,, and M. Mazor. 2003. Ureaplasma urealyticum in the development of postpartum endometritis. Eur. J. Obstet. Gynecol. Reprod. Biol. 109:145–148.

27. Cheah, F. C.,, T. P. Anderson,, B. A. Darlow,, and D. R. Murdoch. 2005. Comparison of the Mycoplasma Duo test with PCR for detection of Ureaplasma species in endotracheal aspirates from premature infants. J. Clin. Microbiol. 43:509–510.

28. Clausen, H. F.,, J. Fedder,, M. Drasbek,, P. K. Nielsen,, B. Toft,, H. J. Ingerslev,, S. Birkelund,, and G. Christiansen. 2001. Serological investigation of Mycoplasma genitalium in infertile women. Hum. Reprod. 16:1866–1874.

29. Clegg, A.,, M. Passey,, M. Yoannes,, and A. Michael. 1997. High rates of genital mycoplasma infection in the highlands of Papua New Guinea determined both by culture and by a commercial detection kit. J. Clin. Microbiol. 35:197–200.

30. Cohen, C. R.,, L. E. Manhart,, E. A. Bukusi,, S. Astete,, R. C. Brunham,, K. K. Holmes,, S. K. Sinei,, J. J. Bwayo,, and P. A. Totten. 2002. Association between Mycoplasma genitalium and acute endometritis. Lancet 359:765–766.

31. Cousin-Allery, A.,, A. Charron,, B. de Barbeyrac,, G. Fremy,, J. Skov Jensen,, H. Renaudin,, and C. Bebear. 2000. Molecular typing of Mycoplasma pneumoniae strains by PCR-based methods and pulsed-field gel electrophoresis. Application to French and Danish isolates. Epidemiol. Infect. 124:103–111.

32. Csango, P. A.,, J. E. Pedersen,, and R. D. Hess. 2004. Comparison of four Mycoplasma pneumoniae IgM-, IgG- and IgA-specific enzyme immunoassays in blood donors and patients. Clin. Microbiol. Infect. 10:1094–1098.

33. Dallo, S. F.,, and J. B. Baseman. 2000. Intracellular DNA replication and long-term survival of pathogenic mycoplasmas. Microb. Pathog. 29:301–309.

34. de Barbeyrac, B.,, C. Bernet-Poggi,, F. Febrer,, H. Renaudin,, M. Dupon,, and C. Bebear. 1993. Detection of Mycoplasma pneumoniae and Mycoplasma genitalium in clinical samples by polymerase chain reaction. Clin. Infect. Dis. 17(Suppl. 1):S83–S89.

35. Degrange, S.,, C. Cazanave,, A. Charron,, H. Renaudin,, C. Bebear,, and C. M. Bebear. 2009. Development of multiple-locus variable-number tandem-repeat analysis for molecular typing of Mycoplasma pneumoniae. J. Clin. Microbiol. 47:914–923.

36. Deguchi, T.,, C. B. Gilroy,, and D. Taylor-Robinson. 1996. Failure to detect Mycoplasma fermentans, Mycoplasma penetrans, or Mycoplasma pirum in the urethra of patients with acute nongonococcal urethritis. Eur. J. Clin. Microbiol. Infect. Dis. 15: 169–171.

37. Deguchi, T.,, S. Maeda,, M. Tamaki,, T. Yoshida,, H. Ishiko,, M. Ito,, S. Yokoi,, Y. Takahashi,, and S. Ishihara. 2001. Analysis of the gyrA and parC genes of Mycoplasma genitalium detected in first-pass urine of men with non-gonococcal urethritis before and after fluoroquinolone treatment. J. Antimicrob. Chemother. 48:742–744.

38. Deguchi, T.,, T. Yoshida,, T. Miyazawa,, M. Yasuda,, M. Tamaki,, H. Ishiko,, and S. Maeda. 2004. Association of Ureaplasma urealyticum (biovar 2) with nongonococcal urethritis. Sex. Transm. Dis. 31:192–195.

39. Doble, A.,, B. J. Thomas,, P. M. Furr,, M. M. Walker,, J. R. W. Harris,, R. O. Witherow,, and D. Taylor-Robinson. 1989. A search for infectious agents in chronic abacterial prostatitis using ultrasound guided biopsy. Br. J. Urol. 64:297–301.

40. Domingues, D.,, L. T. Tavira,, A. Duarte,, A. Sanca,, E. Prieto,, and F. Exposto. 2002. Ureaplasma urealyticum biovar determination in women attending a family planning clinic in Guine-Bissau, using polymerase chain reaction of the multiple-banded antigen gene. J. Clin. Lab. Anal. 16:71–75.

41. Dorigo-Zetsma, J. W.,, J. Dankert,, and S. A. Zaat. 2000. Genotyping of Mycoplasma pneumoniae clinical isolates reveals eight P1 subtypes within two genomic groups. J. Clin. Microbiol. 38:965–970.

42. Dorigo-Zetsma, J. W.,, R. P. Verkooyen,, H. P. van Helden,, H. van der Nat,, and J. M. van den Bosch. 2001. Molecular detection of Mycoplasma pneumoniae in adults with community- acquired pneumonia requiring hospitalization. J. Clin. Microbiol. 39:1184–1186.

43. Dosa, E.,, E. Nagy,, W. Falk,, I. Szoke,, and U. Ballies. 1999. Evaluation of the Etest for susceptibility testing of Mycoplasma hominis and Ureaplasma urealyticum. J. Antimicrob. Chemother. 43:575–578.

44. Duffy, L.,, J. Glass,, G. Hall,, R. Avery,, R. Rackley,, S. Peterson,, and K. Waites. 2006. Fluoroquinolone resistance in Ureaplasma parvum in the United States. J. Clin. Microbiol. 44:1590–1591.

45. Dumke, R.,, I. Catrein,, E. Pirkil,, R. Herrmann,, and E. Jacobs. 2003. Subtyping of Mycoplasma pneumoniae isolates based on extended genome sequencing and on expression profiles. Int. J. Med. Microbiol. 292:513–525.

46. Dumke, R.,, and E. Jacobs. 2009. Comparison of commercial and in-house real-time PCR assays used for detection of Mycoplasma pneumoniae. J. Clin. Microbiol. 47:441–444.

47. Dumke, R.,, N. Schurwanz,, M. Lenz,, M. Schuppler,, C. Luck,, and E. Jacobs. 2007. Sensitive detection of Mycoplasma pneumoniae in human respiratory tract samples by optimized real-time PCR approach. J. Clin. Microbiol. 45:2726–2730.

48. Dutro, S. M.,, J. K. Hebb,, C. A. Garin,, J. P. Hughes,, G. E. Kenny,, and P. A. Totten. 2003. Development and performance of a microwell-plate-based polymerase chain reaction assay for Mycoplasma genitalium. Sex. Transm. Dis. 30:756–763.

49. Echahidi, F.,, G. Muyldermans,, S. Lauwers,, and A. Naessens. 2000. Development of monoclonal antibodies against Ureaplasma urealyticum serotypes and their use for serotyping clinical isolates. Clin. Diagn. Lab. Immunol. 7:563–567.

50. Echevarria, J. M.,, P. Leon,, P. Balfagon,, J. A. Lopez,, and M. V. Fernandez. 1990. Diagnosis of Mycoplasma pneumoniae infection by microparticle agglutination and antibody-capture enzyme-immunoassay. Eur. J. Clin. Microbiol. Infect. Dis. 9: 217–220.

51. Eschenbach, D. A. 1993. Ureaplasma urealyticum and premature birth. Clin. Infect. Dis. 17(Suppl. 1):S100–S106.

52. Falk, L.,, H. Fredlund,, and J. S. Jensen. 2005. Signs and symptoms of urethritis and cervicitis among women with or without Mycoplasma genitalium or Chlamydia trachomatis infection. Sex. Transm. Infect. 81:73–78.

53. Falk, L.,, H. Fredlund,, and J. S. Jensen. 2004. Symptomatic urethritis is more prevalent in men infected with Mycoplasma genitalium than with Chlamydia trachomatis. Sex. Transm. Infect. 80:289–293.

54. Furr, P. M.,, and D. Taylor-Robinson. 1984. Microimmunofluorescence technique for detection of antibody to Mycoplasma genitalium. J. Clin. Pathol. 37:1072–1074.

55. Grenabo, L.,, H. Hedelin,, and S. Pettersson. 1988. Urinary infection stones caused by Ureaplasma urealyticum: a review. Scand. J. Infect. Dis. Suppl. 53:46–49.

56. Hahn, D. L. 2009. Macrolide therapy in asthma: limited treatment, long-term improvement. Eur. Respir. J. 33:1239.

57. Hatchel, J. M.,, R. S. Balish,, M. L. Duley,, and M. F. Balish. 2006. Ultrastructure and gliding motility of Mycoplasma amphoriforme, a possible human respiratory pathogen. Microbiology 152:2181–2189.

58. Henrich, B.,, R. C. Feldmann,, and U. Hadding. 1993. Cytoadhesins of Mycoplasma hominis. Infect. Immun. 61:2945–2951.

59. Hilliard, N. J.,, L. B. Duffy,, D. M. Crabb,, and K. B. Waites. 2005. In vitro comparison of agar and microbroth dilution methods for determination of MICs for Mycoplasma hominis. J. Microbiol. Methods 60:285–288.

60. Hu, P. C.,, U. Schaper,, A. M. Collier,, W. A. Clyde, Jr.,, M. Horikawa,, Y. S. Huang,, and M. F. Barile. 1987. A Mycoplasma genitalium protein resembling the Mycoplasma pneumoniae attachment protein. Infect. Immun. 55:1126–1131.

61. Jacobs, E.,, A. Pilatschek,, B. Gerstenecker,, K. Oberle,, and W. Bredt. 1990. Immunodominant epitopes of the adhesin of Mycoplasma pneumoniae. J. Clin. Microbiol. 28:1194–1197.

62. Jalil, N.,, A. Doble,, C. Gilchrist,, and D. Taylor-Robinson. 1988. Infection of the epididymis by Ureaplasma urealyticum. Genitourin. Med. 64:367–368.

63. Jensen, J. S. 1994. Mycoplasma genitalium: a cause of nongonococcal urethritis? Genitourin. Med. 70:363.

64. Jensen, J. S. 2004. Mycoplasma genitalium: the aetiological agent of urethritis and other sexually transmitted diseases. J. Eur. Acad. Dermatol. Venereol. 18:1–11.

65. Jensen, J. S.,, E. Bjornelius,, B. Dohn,, and P. Lidbrink. 2004. Comparison of first void urine and urogenital swab specimens for detection of Mycoplasma genitalium and Chlamydia trachomatis by polymerase chain reaction in patients attending a sexually transmitted disease clinic. Sex. Transm. Dis. 31:499–507.

66. Jensen, J. S.,, E. Bjornelius,, B. Dohn,, and P. Lidbrink. 2004. Use of TaqMan 5;pr nuclease real-time PCR for quantitative detection of Mycoplasma genitalium DNA in males with and without urethritis who were attendees at a sexually transmitted disease clinic. J. Clin. Microbiol. 42:683–692.

67. Jensen, J. S.,, C. S. Bradshaw,, S. N. Tabrizi,, C. K. Fairley,, and R. Hamasuna. 2008. Azithromycin treatment failure in Mycoplasma genitalium-positive patients with nongonococcal urethritis is associated with induced macrolide resistance. Clin. Infect. Dis. 47:1546–1553.

68. Jensen, J. S.,, H. T. Hansen,, and K. Lind. 1996. Isolation of Mycoplasma genitalium strains from the male urethra. J. Clin. Microbiol. 34:286–291.

69. Jensen, J. S.,, J. Sondergard-Andersen,, S. A. Uldum,, and K. Lind. 1989. Detection of Mycoplasma pneumoniae in simulated clinical samples by polymerase chain reaction. APMIS 97: 1046–1048.

70. Jensen, J. S.,, S. A. Uldum,, J. Sondergard-Andersen,, J. Vuust,, and K. Lind. 1991. Polymerase chain reaction for detection of Mycoplasma genitalium in clinical samples. J. Clin. Microbiol. 29:46–50.

71. Johnson, S.,, D. Sidebottom,, F. Bruckner,, and D. Collins. 2000. Identification of Mycoplasma fermentans in synovial fluid samples from arthritis patients with inflammatory disease. J. Clin. Microbiol. 38:90–93.

72. Johnston, S. L.,, F. Blasi,, P. N. Black,, R. J. Martin,, D. J. Farrell,, and R. B. Nieman. 2006. The effect of telithromycin in acute exacerbations of asthma. N. Engl. J. Med. 354:1589–1600.

73. Jurstrand, M.,, J. S. Jensen,, H. Fredlund,, L. Falk,, and P. Molling. 2005. Detection of Mycoplasma genitalium in urogenital specimens by real-time PCR and by conventional PCR assay. J. Med. Microbiol. 54:23–29.

74. Kannan, T. R.,, D. Provenzano,, J. R. Wright,, and J. B. Baseman. 2005. Identification and characterization of human surfactant protein A binding protein of Mycoplasma pneumoniae. Infect. Immun. 73:2828–2834.

75. Katz, B.,, P. Patel,, L. Duffy,, R. L. Schelonka,, R. A. Dimmitt,, and K. B. Waites. 2005. Characterization of ureaplasmas isolated from preterm infants with and without bronchopulmonary dysplasia. J. Clin. Microbiol. 43:4852–4854.

76. Kenny, G. E.,, and F. D. Cartwright. 1993. Effect of pH, inoculum size, and incubation time on the susceptibility of Ureaplasma urealyticum to erythromycin in vitro. Clin. Infect. Dis. 17(Suppl. 1):S215–S218.

77. Kenny, G. E.,, F. D. Cartwright,, and M. C. Roberts. 1986. Agar dilution method for determination of antibiotic susceptibility of Ureaplasma urealyticum. Pediatr. Infect. Dis. J. 5:S332–S334.

78. Knox, C. L.,, and P. Timms. 1998. Comparison of PCR, nested PCR, and random amplified polymorphic DNA PCR for detection and typing of Ureaplasma urealyticum in specimens from pregnant women. J. Clin. Microbiol. 36:3032–3039.

79. Kong, F.,, Z. Ma,, G. James,, S. Gordon,, and G. L. Gilbert. 2000. Molecular genotyping of human Ureaplasma species based on multiple-banded antigen (MBA) gene sequences. Int. J. Syst. Evol. Microbiol. 50(Pt. 5):1921–1929.

80. Krieger, J. N.,, D. E. Riley,, M. C. Roberts,, and R. E. Berger. 1996. Prokaryotic DNA sequences in patients with chronic idiopathic prostatitis. J. Clin. Microbiol. 34:3120–3128.

81. Lieberman, D.,, S. Horowitz,, O. Horovitz,, F. Schlaeffer,, and A. Porath. 1995. Microparticle agglutination versus antibody-capture enzyme immunoassay for diagnosis of community-acquired Mycoplasma pneumoniae pneumonia. Eur. J. Clin. Microbiol. Infect. Dis. 14:577–1584.

82. Lind, K. 1982. Serological cross-reactions between “Mycoplasma genitalium” and M. pneumoniae. Lancet ii:1158–1159.

83. Liu, Y.,, X. Ye,, H. Zhang,, X. Xu,, W. Li,, D. Zhu,, and M. Wang. 2009. Antimicrobial susceptibility of Mycoplasma pneumoniae isolates and molecular analysis of macrolide-resistant strains from Shanghai, China. Antimicrob. Agents Chemother. 53:2160–2162.

84. Lo, S. C.,, M. M. Hayes,, R. Y. Wang,, P. F. Pierce,, H. Kotani,, and J. W. Shih. 1991. Newly discovered mycoplasma isolated from patients infected with HIV. Lancet 338:1415–1418.

85. Lo, S. C.,, R. Y. Wang,, T. Grandinetti,, N. Zou,, C. L. Haley,, M. M. Hayes,, D. J. Wear,, and J. W. Shih. 2003. Mycoplasma hominis lipid-associated membrane protein antigens for effective detection of M. hominis-specific antibodies in humans. Clin. Infect. Dis. 36:1246–1253.

86. Lo, S. C.,, D. J. Wear,, S. L. Green,, P. G. Jones,, and J. F. Legier. 1993. Adult respiratory distress syndrome with or without systemic disease associated with infections due to Mycoplasma fermentans. Clin. Infect. Dis. 17(Suppl. 1):S259–S263.

87. Lu, G. C.,, J. R. Schwebke,, L. B. Duffy,, G. H. Cassell,, J. C. Hauth,, W. W. Andrews,, and R. L. Goldenberg. 2001. Midtrimester vaginal Mycoplasma genitalium in women with subsequent spontaneous preterm birth. Am. J. Obstet. Gynecol. 185:163–165.

88. Luki, N.,, P. Lebel,, M. Boucher,, B. Doray,, J. Turgeon,, and R. Brousseau. 1998. Comparison of polymerase chain reaction assay with culture for detection of genital mycoplasmas in perinatal infections. Eur. J. Clin. Microbiol. Infect. Dis. 17:255–263.

89. Luneberg, E.,, J. S. Jensen,, and M. Frosch. 1993. Detection of Mycoplasma pneumoniae by polymerase chain reaction and nonradioactive hybridization in microtiter plates. J. Clin. Microbiol. 31:1088–1094.

90. Maeda, S.,, T. Deguchi,, H. Ishiko,, T. Matsumoto,, S. Naito,, H. Kumon,, T. Tsukamoto,, S. Onodera,, and S. Kamidono. 2004. Detection of Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma parvum (biovar 1) and Ureaplasma urealyticum (biovar 2) in patients with non-gonococcal urethritis using polymerase chain reaction-microtiter plate hybridization. Int. J. Urol. 11:750–754.

91. Mahony, J. B.,, D. Jang,, S. Chong,, K. Luinstra,, J. Sellors,, M. Tyndall,, and M. Chernesky. 1997. Detection of Chlamydia trachomatis, Neisseria gonorrhoeae, Ureaplasma urealyticum, and Mycoplasma genitalium in first-void urine specimens by multiplex polymerase chain reaction. Mol. Diagn. 2:161–168.

92. Mallard, K.,, K. Schopfer,, and T. Bodmer. 2005. Development of real-time PCR for the differential detection and quantification of Ureaplasma urealyticum and Ureaplasma parvum. J. Microbiol. Methods 60:13–19.

93. Maltezou, H. C.,, B. La-Scola,, H. Astra,, I. Constantopoulou,, V. Vlahou,, D. A. Kafetzis,, A. G. Constantopoulos,, and D. Raoult. 2004. Mycoplasma pneumoniae and Legionella pneumophila in community-acquired lower respiratory tract infections among hospitalized children: diagnosis by real time PCR. Scand. J. Infect. Dis. 36:639–642.

94. Martin, R. J.,, M. Kraft,, H. W. Chu,, E. A. Berns,, and G. H. Cassell. 2001. A link between chronic asthma and chronic infection. J. Allergy. Clin. Immunol. 107:595–601.

95. Meyer, R. D.,, and W. Clough. 1993. Extragenital Mycoplasma hominis infections in adults: emphasis on immunosuppression. Clin. Infect. Dis. 17(Suppl. 1):S243–S249.

96. Moller, B. R.,, D. Taylor-Robinson,, and P. M. Furr. 1984. Serological evidence implicating Mycoplasma genitalium in pelvic inflammatory disease. Lancet i:1102–1103.

97. Moser, S. A.,, C. A. Mayfield,, L. B. Duffy,, and K. B. Waites. 2006. Genotypic characterization of Ureaplasma species by pulsed field gel electrophoresis. J. Microbiol. Methods 67:606–610.

98. Naessens, A.,, W. Foulon,, J. Breynaert,, and S. Lauwers. 1988. Serotypes of Ureaplasma urealyticum isolated from normal pregnant women and patients with pregnancy complications. J. Clin. Microbiol. 26:319–322.

99. Neimark, H. C.,, and C. S. Lange. 1990. Pulse-field electrophoresis indicates full-length mycoplasma chromosomes range widely in size. Nucleic Acids Res. 18:5443–5448.

100. Novy, M. J.,, L. Duffy,, M. K. Axthelm,, D. W. Sadowsky,, S. S. Witkin,, M. G. Gravett,, G. H. Cassell,, and K. B. Waites. 2009. Ureaplasma parvum or Mycoplasma hominis as sole pathogens cause chorioamnionitis, preterm delivery, and fetal pneumonia in rhesus macaques. Reprod. Sci. 16:56–70.

101. Oakeshott, P.,, P. Hay,, D. Taylor-Robinson,, S. Hay,, B. Dohn,, S. Kerry,, and J. S. Jensen. 2004. Prevalence of Mycoplasma genitalium in early pregnancy and relationship between its presence and pregnancy outcome. Br. J. Obstet. Gynecol. 111:1464–1467.

102. Ovyn, C.,, D. van Strijp,, M. Ieven,, D. Ursi,, B. van Gemen,, and H. Goossens. 1996. Typing of Mycoplasma pneumoniae by nucleic acid sequence-based amplification, NASBA. Mol. Cell. Probes 10:319–324.

103. Ozaki, T.,, N. Nishimura,, J. Ahn,, N. Watanabe,, T. Muto,, A. Saito,, N. Koyama,, K. Nakane,, and K. Funahashi. 2007. Utility of a rapid diagnosis kit for Mycoplasma pneumoniae pneumonia in children, and the antimicrobial susceptibility of the isolates. J. Infect. Chemother. 13:204–207.

104. Perni, S. C.,, S. Vardhana,, I. Korneeva,, S. L. Tuttle,, L. R. Paraskevas,, S. T. Chasen,, R. B. Kalish,, and S. S. Witkin. 2004. Mycoplasma hominis and Ureaplasma urealyticum in midtrimester amniotic fluid: association with amniotic fluid cytokine levels and pregnancy outcome. Am. J. Obstet. Gynecol. 191:1382–1386.

105. Peuchant, O.,, A. Menard,, H. Renaudin,, M. Morozumi,, K. Ubukata,, C. M. Bebear,, and S. Pereyre. 2009. Increased macrolide resistance of Mycoplasma pneumoniae in France directly detected in clinical specimens by real-time PCR and melting curve analysis. J. Antimicrob. Chemother. 64:52–58.

106. Phillips, L. E.,, K. H. Goodrich,, R. M. Turner,, and S. Faro. 1986. Isolation of Mycoplasma species and Ureaplasma urealyticum from obstetrical and gynecological patients by using commercially available medium formulations. J. Clin. Microbiol. 37:377–379.

107. Pitcher, D.,, M. Sillis,, and J. A. Robertson. 2001. Simple method for determining biovar and serovar types of Ureaplasma urealyticum clinical isolates using PCR-single-strand conformation polymorphism analysis. J. Clin. Microbiol. 39:1840–1844.

108. Pratt, B. C. 1991. Recovery of Mycoplasma hominis from blood culture media. Med. Lab. Sci. 48:350.

109. Quinn, P. A.,, L. U. Arshoff,, and H. C. Li. 1981. Serotyping of Ureaplasma urealyticum by immunoperoxidase assay. J. Clin. Microbiol. 13:670–676.

110. Ramirez, J. A.,, S. Ahkee,, A. Tolentino,, R. D. Miller,, and J. T. Summersgill. 1996. Diagnosis of Legionella pneumophila, Mycoplasma pneumoniae, or Chlamydia pneumoniae lower respiratory infection using the polymerase chain reaction on a single throat swab specimen. Diagn. Microbiol. Infect. Dis. 24:7–14.

111. Reznikov, M.,, T. K. Blackmore,, J. J. Finlay-Jones,, and D. L. Gordon. 1995. Comparison of nasopharyngeal aspirates and throat swab specimens in a polymerase chain reaction-based test for Mycoplasma pneumoniae. Eur. J. Clin. Microbiol. Infect. Dis. 14:58–61.

112. Robertson, J. A.,, M. Alfa,, and E. S. Boatman. 1983. Morphology of the cells and colonies of Mycoplasma hominis. Sex. Transm. Dis. 10:232–239.

113. Robertson, J. A.,, L. E. Pyle,, G. W. Stemke,, and L. R. Finch. 1990. Human ureaplasmas show diverse genome sizes by pulsed-field electrophoresis. Nucleic Acids Res. 18:1451–1455.

114. Rohner, P.,, I. Schnyder,, B. Ninet,, J. Schrenzel,, D. Lew,, T. Ramla,, J. Garbino,, and V. Jacomo. 2004. Severe Mycoplasma hominis infections in two renal transplant patients. Eur. J. Clin. Microbiol. Infect. Dis. 23:203–204.

115. Sasaki, T.,, T. Kenri,, N. Okazaki,, M. Iseki,, R. Yamashita,, M. Shintani,, Y. Sasaki,, and M. Yayoshi. 1996. Epidemiological study of Mycoplasma pneumoniae infections in Japan based on PCR-restriction fragment length polymorphism of the P1 cytadhesin gene. J. Clin. Microbiol. 34:447–449.

116. Schaeverbeke, T.,, C. B. Gilroy,, C. Bebear,, J. Dehais,, and D. Taylor-Robinson. 1996. Mycoplasma fermentans, but not M. penetrans, detected by PCR assays in synovium from patients with rheumatoid arthritis and other rheumatic disorders. J. Clin. Pathol. 49:824–828.

117. Schaeverbeke, T.,, H. Renaudin,, M. Clerc,, L. Lequen,, J. P. Vernhes,, B. De Barbeyrac,, B. Bannwarth,, C. Bebear,, and J. Dehais. 1997. Systematic detection of mycoplasmas by culture and polymerase chain reaction (PCR) procedures in 209 synovial fluid samples. Br. J. Rheumatol. 36:310–314.

118. Schelonka, R. L.,, B. Katz,, K. B. Waites,, and D. K. Benjamin, Jr. 2005. Critical appraisal of the role of Ureaplasma in the development of bronchopulmonary dysplasia with metaanalytic techniques. Pediatr. Infect. Dis J. 24:1033–1039.

119. Sillis, M. 1993. Genital mycoplasmas revisited—an evaluation of a new culture medium. Br. J. Biomed. Sci. 50:89–91.

120. Simms, I.,, K. Eastick,, H. Mallinson,, K. Thomas,, R. Gokhale,, P. Hay,, A. Herring,, and P. A. Rogers. 2003. Associations between Mycoplasma genitalium, Chlamydia trachomatis and pelvic inflammatory disease. J. Clin. Pathol. 56:616–618.

121. Stamm, W. E.,, K. Running,, J. Hale,, and K. K. Holmes. 1983. Etiologic role of Mycoplasma hominis and Ureaplasma urealyticum in women with the acute urethral syndrome. Sex. Transm. Dis. 10:318–322.

122. Talkington, D. F.,, S. Shott,, M. T. Fallon,, S. B. Schwartz,, and W. L. Thacker. 2004. Analysis of eight commercial enzyme immunoassay tests for detection of antibodies to Mycoplasma pneumoniae in human serum. Clin. Diagn. Lab. Immunol. 11:862–867.

123. Talkington, D. F.,, K. B. Waites,, S. B. Schwartz,, and R. E. Besser,. 2001. Emerging from obscurity: understanding pulmonary and extrapulmonary syndromes, pathogenesis, and epidemiology of human Mycoplasma pneumoniae infections, p. 57–84. In W. M. Scheld,, W. A. Craig,, and J. M. Hughes (ed.), Emerging Infections 5. ASM Press, Washington, DC.

124. Taylor-Robinson, D. 1989. Genital mycoplasma infections. Clin. Lab. Med. 9:501–523.

125. Taylor-Robinson, D., 1983. Metabolism inhibition test, p. 411–417. In J. G. Tully, and S. Razin (ed.), Methods in Mycoplasmology, vol. 1. Academic Press, New York, NY.

126. Taylor-Robinson, D. 1986. Evaluation of the role of Ureaplasma urealyticum in infertility. Pediatr. Infect. Dis. J. 5:S262–S265.

127. Taylor-Robinson, D. 2002. Mycoplasma genitalium—an update. Int. J. STD AIDS 13:145–151.

128. Taylor-Robinson, D. 1996. Infections due to species of Mycoplasma and Ureaplasma: an update. Clin. Infect. Dis. 23:671–682.

129. Taylor-Robinson, D. 2007. The role of mycoplasmas in pregnancy outcome. Best Pract. Res. Clin. Obstet. Gynaecol. 21:425–438.

130. Taylor-Robinson, D.,, and C. W. Csonka,. 1981. Laboratory and clinical aspects of mycoplasmal infections of the human genitourinary tract, p. 151–186. In J. W. Harris (ed.), Recent Advances in Sexually Transmitted Diseases, vol. 2. Churchill Livingstone, Ltd., Edinburgh, United Kingdom.

131. Thacker, W. L.,, and D. F. Talkington. 2000. Analysis of complement fixation and commercial enzyme immunoassays for detection of antibodies to Mycoplasma pneumoniae in human serum. Clin. Diagn. Lab. Immunol. 7:778–780.

132. Thacker, W. L.,, and D. F. Talkington. 1995. Comparison of two rapid commercial tests with complement fixation for serologic diagnosis of Mycoplasma pneumoniae infections. J. Clin. Microbiol. 33:1212–1214.

133. Thomsen, A. C. 1978. Mycoplasmas in human pyelonephritis: demonstration of antibodies in serum and urine. J. Clin. Microbiol. 8:197–202.

134. Touati, A.,, A. Benard,, A. Ben Hassen,, C. M. Bebear,, and S. Pereyre. 2009. Evaluation of five commercial real-time PCR assays for the detection of Mycoplasma pneumoniae in respiratory tract specimens. J. Clin. Microbiol. 47:2269–2271.

135. Tully, J. G.,, D. Taylor-Robinson,, D. L. Rose,, R. M. Cole,, and J. M. Bove. 1983. Mycoplasma genitalium, a new species from the human urogenital tract. Int. J. Syst. Bacteriol. 33:387–396.

136. Uno, M.,, T. Deguchi,, H. Komeda,, M. Hayasaki,, M. Iida,, M. Nagatani,, and Y. Kawada. 1997. Mycoplasma genitalium in the cervices of Japanese women. Sex. Transm. Dis. 24:284–286.

137. Waites, K.,, and D. Talkington,. 2005. New developments in human diseases due to mycoplasmas, p. 289–354. In A. Blanchard, and G. Browning (ed.), Mycoplasmas: Pathogenesis, Molecular Biology, and Emerging Strategies for Control. Horizon Scientific Press, Norwich, United Kingdom.

138. Waites, K. B., 2008. Mycoplasma, p. 1145–1156. In D. Schlossberg (ed.), Clinical Infectious Disease. Cambridge University Press, Cambridge, United Kingdom.

139. Waites, K. B.,, M. F. Balish,, and T. P. Atkinson. 2008. New insights into the pathogenesis and detection of Mycoplasma pneumoniae infections. Future Microbiol. 3:635–648.

140. Waites, K. B.,, C. M. Bebear,, J. A. Robertson,, D. F. Talkington,, and G. E. Kenny (ed.). 2001. Cumitech 34, Laboratory Diagnosis of Mycoplasmal Infections, ASM Press, Washington, DC.

141. Waites, K. B.,, and K. C. Canupp. 2001. Evaluation of BacT/ALERT system for detection of Mycoplasma hominis in simulated blood cultures. J. Clin. Microbiol. 39:4328–4331.

142. Waites, K. B.,, K. C. Canupp,, and G. E. Kenny. 1999. In vitro susceptibilities of Mycoplasma hominis to six fluoroquinolones as determined by E test. Antimicrob. Agents Chemother. 43:2571–2573.

143. Waites, K. B.,, D. M. Crabb,, L. B. Duffy,, and G. H. Cassell. 1997. Evaluation of the Etest for detection of tetracycline resistance in Mycoplasma hominis. Diagn. Microbiol. Infect. Dis. 27:117–122.

144. Waites, K. B.,, L. B. Duffy,, S. Schwartz,, and D. F. Talkington,. 2004. Mycoplasma and Ureaplasma, p. 3.15.1–3.15.17. In H. Isenberg (ed.), Clinical Microbiology Procedures Handbook, 2nd ed. ASM Press, Washington, DC.

145. Waites, K. B.,, T. A. Figarola,, T. Schmid,, D. M. Crabb,, L. B. Duffy,, and J. W. Simecka. 1991. Comparison of agar versus broth dilution techniques for determining antibiotic susceptibilities of Ureaplasma urealyticum. Diagn. Microbiol. Infect. Dis. 14:265–271.

146. Waites, K. B.,, B. Katz,, and R. L. Schelonka. 2005. Mycoplasmas and ureaplasmas as neonatal pathogens. Clin. Microbiol. Rev. 18:757–789.

147. Waites, K. B.,, and D. F. Talkington. 2004. Mycoplasma pneumoniae and its role as a human pathogen. Clin. Microbiol. Rev. 17:697–728.

148. Waites, K. B.,, D. F. Talkington,, and C. M. Bebear,. 2002. Mycoplasmas, p. 201–224. In A. L. Truant (ed.), Manual of Commercial Methods in Clinical Microbiology. ASM Press, Washington, DC.

149. Wang, R. Y.,, T. Grandinetti,, J. W. Shih,, S. H. Weiss,, C. L. Haley,, M. M. Hayes,, and S. C. Lo. 1997. Mycoplasma genitalium infection and host antibody immune response in patients infected by HIV, patients attending STD clinics and in healthy blood donors. FEMS Immunol. Med. Microbiol. 19: 237–245.

150. Wang, R. Y.,, W. S. Hu,, M. S. Dawson,, J. W. Shih,, and S. C. Lo. 1992. Selective detection of Mycoplasma fermentans by polymerase chain reaction and by using a nucleotide sequence within the insertion sequence-like element. J. Clin. Microbiol. 30:245–248.

151. Webster, D.,, H. Windsor,, C. Ling,, D. Windsor,, and D. Pitcher. 2003. Chronic bronchitis in immunocompromised patients: association with a novel Mycoplasma species. Eur. J. Clin. Microbiol. Infect. Dis. 22:530–534.

152. Wilson, M. H.,, and A. M. Collier. 1976. Ultrastructural study of Mycoplasma pneumoniae in organ culture. J. Bacteriol. 125:332–339.

153. Wolff, B. J.,, W. L. Thacker,, S. B. Schwartz,, and J. M. Winchell. 2008. Detection of macrolide resistance in Mycoplasma pneumoniae by real-time PCR and high-resolution melt analysis. Antimicrob. Agents Chemother. 52:3542–3549.

154. Wood, J. C.,, R. M. Lu,, E. M. Peterson,, and L. M. de la Maza. 1985. Evaluation of Mycotrim-GU for isolation of Mycoplasma species and Ureaplasma urealyticum. J. Clin. Microbiol. 22:789–792.

155. Xiao, L.,, T. P. Atkinson,, J. Hagood,, C. Makris,, L. B. Duffy,, and K. B. Waites. 2009. Emerging macrolide resistance in Mycoplasma pneumoniae in children: detection and characterization of resistant isolates. Pediatr. Infect. Dis. 28:693–698.

156. Xin, D.,, Z. Mi,, X. Han,, L. Qin,, J. Li,, T. Wei,, X. Chen,, S. Ma,, A. Hou,, G. Li,, and D. Shi. 2009. Molecular mechanisms of macrolide resistance in clinical isolates of Mycoplasma pneumoniae from China. Antimicrob. Agents Chemother. 53:2158–2159.

157. Yoon, B. H.,, R. Romero,, J. H. Lim,, S. S. Shim,, J. S. Hong,, J. Y. Shim,, and J. K. Jun. 2003. The clinical significance of detecting Ureaplasma urealyticum by the polymerase chain reaction in the amniotic fluid of patients with preterm labor. Am. J. Obstet. Gynecol. 189:919–924.

158. Yoshida, T.,, S. Maeda,, T. Deguchi,, T. Miyazawa,, and H. Ishiko. 2003. Rapid detection of Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma parvum, and Ureaplasma urealyticum organisms in genitourinary samples by PCR-microtiter plate hybridization assay. J. Clin. Microbiol. 41:1850–1855.

159. Zheng, X.,, L. J. Teng,, H. L. Watson,, J. I. Glass,, A. Blanchard,, and G. H. Cassell. 1995. Small repeating units within the Ureaplasma urealyticum MB antigen gene encode serovar specificity and are associated with antigen size variation. Infect. Immun. 63:891–898.

Tables

Mycoplasma and Ureaplasma

/content/10.1128/9781555816728.chap59.tab59-1

TABLE 1

Classification and some distinguishing features of mollicutes

a The total number includes subspecies. The genus Mycoplasma also includes four species not validly published and nine “Candidatus” species of cell wall-less uncultivated parasitic bacteria, eight of which attach to the surface of erythrocytes and may also occur free in the plasma, plus one pneumotrophic “Candidatus” species. Some were previously classified in the genera Haemobartonella and Eperythrozoon. Their G+C contents and sterol requirements are unknown.

b U. urealyticum and U. parvum, formerly considered biovars of U. urealyticum, are now classified as two separate species and are the only ureaplasmas of human origin.

c Phytoplasmas are “Candidatus” species of uncultivable mollicutes of plants and insects genetically related to the Acholeplasmatales.

10.1128/9781555816728/tab59-1_thmb.gif

10.1128/9781555816728/tab59-1.gif

TABLE 1

Classification and some distinguishing features of mollicutes

b U. urealyticum and U. parvum, formerly considered biovars of U. urealyticum, are now classified as two separate species and are the only ureaplasmas of human origin.

c Phytoplasmas are “Candidatus” species of uncultivable mollicutes of plants and insects genetically related to the Acholeplasmatales.

/content/10.1128/9781555816728.chap59.tab59-2

TABLE 2

Primary sites of colonization, metabolism, and pathogenicity of mollicutes of human origin a

a Symbols: +, positive for trait; –, negative for trait; ?, unknown.

b All isolates reported to date have been from the lower respiratory tract, but no other sites have been sampled.

c The organism has been found in the oropharynx, but it seems unlikely that this is a common or primary location.

d These species metabolize urea.

10.1128/9781555816728/tab59-2_thmb.gif

10.1128/9781555816728/tab59-2.gif

TABLE 2

Primary sites of colonization, metabolism, and pathogenicity of mollicutes of human origin a

a Symbols: +, positive for trait; –, negative for trait; ?, unknown.

b All isolates reported to date have been from the lower respiratory tract, but no other sites have been sampled.

c The organism has been found in the oropharynx, but it seems unlikely that this is a common or primary location.

d These species metabolize urea.

/content/10.1128/9781555816728.chap59.tab59-3

TABLE 3

Examples of test kits sold in the United States for detection of serum antibodies to M. pneumoniae a

a This table does not include all commercially available test kits for serological diagnosis of M. pneumoniae infections sold in the United States. It provides descriptions of tests representing various formats and is limited to those products which have been evaluated in independent studies.

10.1128/9781555816728/tab59-3_thmb.gif

10.1128/9781555816728/tab59-3.gif

TABLE 3

Examples of test kits sold in the United States for detection of serum antibodies to M. pneumoniae a

/content/10.1128/9781555816728.chap59.tab59-4

TABLE 4

Ranges of MIC of various antimicrobials for M. pneumoniae, M. hominis, M. fermentans, M. genitalium, and Ureaplasma spp.a

a Data were compiled from multiple published studies in which different methodologies, and often different antimicrobial concentrations, were used. Elevated MICs (≥8 µg/ml) for the occasionally encountered fluoroquinolone-resistant M. hominis and Ureaplasma spp. have not been included in the MIC ranges. ND, no data available.

b Macrolide-susceptible strains only. MICs for M. pneumoniae isolates containing mutations in domain V of rRNA usually exceed 32 µg/ml.

c Tetracycline-susceptible strains only. MICs for isolates containing tet(M) are generally 2–>64 µg/ml.

d Macrolide-susceptible strains only. MICs for Ureaplasma spp. containing mutations in rRNA usually exceed 32 µg/ml.

10.1128/9781555816728/tab59-4_thmb.gif

10.1128/9781555816728/tab59-4.gif

TABLE 4

Ranges of MIC of various antimicrobials for M. pneumoniae, M. hominis, M. fermentans, M. genitalium, and Ureaplasma spp.a

b Macrolide-susceptible strains only. MICs for M. pneumoniae isolates containing mutations in domain V of rRNA usually exceed 32 µg/ml.

c Tetracycline-susceptible strains only. MICs for isolates containing tet(M) are generally 2–>64 µg/ml.

d Macrolide-susceptible strains only. MICs for Ureaplasma spp. containing mutations in rRNA usually exceed 32 µg/ml.