Clinical Information

Mycoplasma (Mycoplasmoides) pneumoniae is a small bacterium transmitted via organism-containing droplets. It is a cause of upper respiratory infection, pharyngitis, and tracheobronchitis, particularly in children, and has been associated with approximately 20% of cases of community acquired pneumonia.(1) Central nervous system and cardiac manifestations are some of the extrapulmonary complications of infections due to M pneumoniae. The disease is usually self-limited although severe disease may occur, including in patients who are immunocompromised.(2)

Identification of M pneumoniae by culture-based methods is time consuming and insensitive. Serologic assays have drawbacks; the development of IgM antibodies takes approximately 1 week, and the IgM response in adults may be variable or may be decreased in immunosuppressed individuals.(3,4) Confirmation of the disease may be dependent on the observation of a 4-fold rise in IgG antibody titers between acute and convalescent specimens, only after several weeks following the initial onset of illness, only providing clinical application for retrospective testing and not individual patient care.(4) Real-time polymerase chain reaction (PCR) testing offers a rapid and sensitive option for detection of M pneumoniae DNA from clinical specimens.(5)

Macrolide resistance in M pneumoniae is increasingly reported. In a study performed at Mayo Clinic, 10% of M pneumoniae detections were associated with macrolide resistance.(6) Real-time PCR testing can be used to assess for common mutations associated with macrolide resistance in M pneumoniae.