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{{Infobox_Disease |
{{Mycoplasma pneumonia}}
  Name          = {{PAGENAME}} |
{{Taxobox
  Image          = |
| color = lightgrey
  Caption        = |
| name = ''Mycoplasma pneumoniae''
  DiseasesDB    = |
| regnum = [[Bacteria]]
  ICD10          = |
| divisio = [[Tenericutes]]
  ICD9          = |
| classis = [[Mollicutes]]
  ICDO          = |
| ordo = [[Mycoplasmatales]]
  OMIM          = |
| familia = [[Mycoplasmataceae]]
  MedlinePlus    = |
| genus = ''[[Mycoplasma]]''
  eMedicineSubj  = |
| genitalia
  eMedicineTopic = |
| binomial = ''Mycoplasma pneumoniae''
  MeshID        = |
| binomial_authority = Somerson et al., 1963
}}
}}
{{SI}}
__NOTOC__
{{About0|Mycoplasma pneumonia}}
{{CMG}}
{{CMG}}


{{EH}}
==Overview==
''Mycoplasma'' pneumonia is caused by ''Mycoplasma pneumoniae'', a very small bacterium that lacks cell wall and periplasmic space. On Gram-stain, ''Mycoplasma'' stains pink, i.e. it is Gram-negative by staining. However, it is structurally different from other Gram-negative organisms because it lacks a cell wall.


== Epidemiology and Demographics ==
==Clinical Significance==
''M. pneumoniae'' is the bacterium responsible for ''Mycoplasma'' pneumonia, an atypical pneumonia common in children and young adults.


Each year an estimated 2 million cases and 100,000 pneumonia-related hospitalizations occur in the United States.
==Taxonomy==
*Bacteria; Firmicutes; Mollicutes; Mycoplasmatales; Mycoplasmataceae; ''Mycoplasma pneumoniae''
*The term ''Mycoplasma'' (“mykes”, meaning fungus and “plasma”, meaning formed) is derived from the fungal-like growth of some mycoplasma species.<ref name=Waites/>


'''Trends'''  
==Cell Biology==
*''Mycoplasma'' is the smallest [[self-replicating]] organism. They are bacteria that lack a cell wall and [[periplasmic space]], have reduced [[genome]]s, and limited [[metabolic]] activity.<ref name=Romero-Arroyo>{{cite journal | last1 = Romero-Arroyo | first1 = C. E. | last2 = Jordan | first2 = J. | last3 = Peacock | first3 = S. J. | last4 = Willby | first4 = M. J. | last5 = Farmer | first5 = M. A. | last6 = Krause | first6 = D. C. | year = 1994 | title = ''Mycoplasma pneumoniae'' protein P30 is required for cytadherence and associated with proper cell development | url = | journal = J. Bacteriol | volume = 181 | issue = | pages = 1079–1087 | doi = 10.1128/CMR.17.4.697-728.2004 }}</ref><ref name=Dallo>S. Dallo, and J. Baseman "Intracellular DNA replication and long-term survival of pathogenic mycoplasmas" ''Microb. Pathog.'' 2000; 29, 301–309. {{10.1006/mpat.2000.0395}}</ref>
*''Mycoplasma pneumoniae'' cells have an elongated shape that is approximately 1-2&nbsp;µm in length and 0.1–0.2&nbsp;µm in width.
*The extremely small cell size means they are incapable of being examined by [[light microscopy]]; a [[stereomicroscope]] is required for viewing the [[Morphology (biology)|morphology]] of ''M. pneumoniae'' [[Colony (biology)|colonies]], which are usually less than 100&nbsp;µm in length. The inability to synthesize a [[peptidoglycan cell wall]] is due to the absence of [[gene]]s encoding its formation and results in an increased importance in maintenance of [[osmotic]] stability to avoid [[desiccation]]. The lack of a cell wall also calls for increased support of the [[cell membrane]], which includes a rigid [[cytoskeleton]] composed of an intricate [[protein]] network and, potentially, an [[extracellular]] [[Capsule (microbiology)|capsule]] to facilitate [[adhesion (medicine)|adherence]] to the [[host cell]].<ref name=Waites>{{cite journal | last1 = Ken | first1 =  | last2 = Waites | first2 = B | last3 = Deborah | first3 = F. Talkington | year = 2004 | title = ''Mycoplasma pneumoniae'' and Its Role as a Human Pathogen | url = | journal = Clin. Microbiol. Rev | volume = 17 | issue = 4| pages = 697–728 | doi = 10.1128/CMR.17.4.697-728.2004 }}</ref>
*''M. pneumoniae'' are the only [[bacteria]]l cells that possess [[cholesterol]] in their cell membrane (obtained from the host) and possess more genes that encode for membrane [[lipoprotein]] variations than other mycoplasmas, which are thought to be associated with its parasitic lifestyle. ''M. pneumoniae'' cells also possess an attachment [[organelle]], which is used in the [[Bacterial gliding|gliding motility]] of the organism by an unknown mechanism.<ref name=Romero-Arroyo>{{cite journal | last1 = Romero-Arroyo | first1 = C. E. | last2 = Jordan | first2 = J. | last3 = Peacock | first3 = S. J. | last4 = Willby | first4 = M. J. | last5 = Farmer | first5 = M. A. | last6 = Krause | first6 = D. C. | year = 1994 | title = ''Mycoplasma pneumoniae'' protein P30 is required for cytadherence and associated with proper cell development | url = | journal = J. Bacteriol | volume = 181 | issue = | pages = 1079–1087 | doi = 10.1128/CMR.17.4.697-728.2004 }}</ref>
*The absence of a [[peptidoglycan cell wall]] results in resistance to many [[Antibacterial|antibacterial agents]]. The persistence of ''M. pneumoniae'' infections even after treatment is associated with its ability to mimic [[host cell]] surface composition.
*On Gram-stain, ''Mycoplasma'' stains pink, i.e. it is Gram-negative by staining. However, it is structurally different from other Gram-negative organisms because it lacks a cell wall.


Unknown. However, with improved diagnostic testing, more cases may be identified.
== Genomics==
 
*[[Sequencing]] of the ''M. pneumoniae'' genome in 1996 revealed it is 816,394 bp (approximately 800 kb) in size. The genome contains 687 genes that encode for proteins, of which about 56.6% code for essential metabolic [[enzymes]]; notably those involved in [[glycolysis]] and [[organic acid]] [[fermentation]].<ref name="Romero-Arroyo">{{cite journal | last1 = Romero-Arroyo | first1 = C. E. | last2 = Jordan | first2 = J. | last3 = Peacock | first3 = S. J. | last4 = Willby | first4 = M. J. | last5 = Farmer | first5 = M. A. | last6 = Krause | first6 = D. C. | year = 1994 | title = ''Mycoplasma pneumoniae'' protein P30 is required for cytadherence and associated with proper cell development | url = | journal = J. Bacteriol | volume = 181 | issue = | pages = 1079–1087 | doi = 10.1128/CMR.17.4.697-728.2004 }}</ref><ref name="Wodke">{{cite journal | last1 = Wodke | first1 = J. A. H. | last2 = Puchałka | first2 = J. | last3 = Lluch-Senar | first3 = M. | last4 = Marcos | first4 = J. | last5 = Yus | first5 = E. | last6 = Godinho | first6 = M. | last7 = Gutiérrez-Gallego | first7 = R. | last8 = Serrano | first8 = L. | last9 = Klipp | first9 = E. | last10 = Maier | first10 = T. | title = Dissecting the energy metabolism in ''Mycoplasma pneumoniae'' through genome-scale metabolic modeling | url = | journal = Mol. Syst. Biol | volume = 2010 | issue = | page = 9 | doi = 10.1038/msb.2013.6 }}</ref>
== Risk Factors ==
*''M. pneumoniae'' is consequently very susceptible to loss of [[Enzymatic activity|enzymatic function]] by [[gene mutation]]s, as the only buffering systems against functional loss by point mutations are for maintenance of the [[pentose phosphate pathway]] and [[nucleotide]] metabolism.<ref name="Wodke">{{cite journal | last1 = Wodke | first1 = J. A. H. | last2 = Puchałka | first2 = J. | last3 = Lluch-Senar | first3 = M. | last4 = Marcos | first4 = J. | last5 = Yus | first5 = E. | last6 = Godinho | first6 = M. | last7 = Gutiérrez-Gallego | first7 = R. | last8 = Serrano | first8 = L. | last9 = Klipp | first9 = E. | last10 = Maier | first10 = T. | title = Dissecting the energy metabolism in ''Mycoplasma pneumoniae'' through genome-scale metabolic modeling | url = | journal = Mol. Syst. Biol | volume = 2010 | issue = | page = 9 | doi = 10.1038/msb.2013.6 }}</ref>
 
*Loss of function in other pathways is suggested to be compensated by host cell metabolism.<ref name="Wodke">{{cite journal | last1 = Wodke | first1 = J. A. H. | last2 = Puchałka | first2 = J. | last3 = Lluch-Senar | first3 = M. | last4 = Marcos | first4 = J. | last5 = Yus | first5 = E. | last6 = Godinho | first6 = M. | last7 = Gutiérrez-Gallego | first7 = R. | last8 = Serrano | first8 = L. | last9 = Klipp | first9 = E. | last10 = Maier | first10 = T. | title = Dissecting the energy metabolism in ''Mycoplasma pneumoniae'' through genome-scale metabolic modeling | url = | journal = Mol. Syst. Biol | volume = 2010 | issue = | page = 9 | doi = 10.1038/msb.2013.6 }}</ref>
Persons of all ages are at risk but rarely children less than 5 years old. It is the leading cause of pneumonia in school-age children and young adults. Outbreaks can occur especially in crowded military and institutional (e.g., college) settings. Outbreaks in these settings can last several months.
*In addition to the potential for loss of pathway function, the reduced genome of ''M. pneumoniae'' outright lacks a number of pathways, including the [[TCA cycle]], [[Electron transport chain|respiratory electron transport chain]], and [[biosynthesis]] pathways for [[amino acids]], [[fatty acids]], [[cholesterol]] and [[purines]] and [[pyrimidines]].<ref name="Romero-Arroyo">{{cite journal | last1 = Romero-Arroyo | first1 = C. E. | last2 = Jordan | first2 = J. | last3 = Peacock | first3 = S. J. | last4 = Willby | first4 = M. J. | last5 = Farmer | first5 = M. A. | last6 = Krause | first6 = D. C. | year = 1994 | title = ''Mycoplasma pneumoniae'' protein P30 is required for cytadherence and associated with proper cell development | url = | journal = J. Bacteriol | volume = 181 | issue = | pages = 1079–1087 | doi = 10.1128/CMR.17.4.697-728.2004 }}</ref><ref name="Wodke">{{cite journal | last1 = Wodke | first1 = J. A. H. | last2 = Puchałka | first2 = J. | last3 = Lluch-Senar | first3 = M. | last4 = Marcos | first4 = J. | last5 = Yus | first5 = E. | last6 = Godinho | first6 = M. | last7 = Gutiérrez-Gallego | first7 = R. | last8 = Serrano | first8 = L. | last9 = Klipp | first9 = E. | last10 = Maier | first10 = T. | title = Dissecting the energy metabolism in ''Mycoplasma pneumoniae'' through genome-scale metabolic modeling | url = | journal = Mol. Syst. Biol | volume = 2010 | issue = | page = 9 | doi = 10.1038/msb.2013.6 }}</ref>
 
*These limitations make ''M. pneumoniae'' dependent upon import systems to acquire essential building blocks from their host or the environment that cannot be obtained through [[Glycolytic Pathways|glycolytic pathways]].<ref name="Romero-Arroyo">{{cite journal | last1 = Romero-Arroyo | first1 = C. E. | last2 = Jordan | first2 = J. | last3 = Peacock | first3 = S. J. | last4 = Willby | first4 = M. J. | last5 = Farmer | first5 = M. A. | last6 = Krause | first6 = D. C. | year = 1994 | title = ''Mycoplasma pneumoniae'' protein P30 is required for cytadherence and associated with proper cell development | url = | journal = J. Bacteriol | volume = 181 | issue = | pages = 1079–1087 | doi = 10.1128/CMR.17.4.697-728.2004 }}</ref><ref name="Wodke">{{cite journal | last1 = Wodke | first1 = J. A. H. | last2 = Puchałka | first2 = J. | last3 = Lluch-Senar | first3 = M. | last4 = Marcos | first4 = J. | last5 = Yus | first5 = E. | last6 = Godinho | first6 = M. | last7 = Gutiérrez-Gallego | first7 = R. | last8 = Serrano | first8 = L. | last9 = Klipp | first9 = E. | last10 = Maier | first10 = T. | title = Dissecting the energy metabolism in ''Mycoplasma pneumoniae'' through genome-scale metabolic modeling | url = | journal = Mol. Syst. Biol | volume = 2010 | issue = | page = 9 | doi = 10.1038/msb.2013.6 }}</ref>
== Pathophysiology & Etiology==
*Along with energy costly protein and [[RNA]] production, a large portion of energy metabolism is exerted to maintain [[proton gradient]]s (up to 80%) due to the high [[Surface-area-to-volume ratio|surface area to volume ratio]] of ''M. pneumoniae'' cells. Only 12 – 29% of energy metabolism is directed at [[cell growth]], which is unusually low for bacterial cells, and is thought to be an [[adaptation]] of its parasitic lifestyle.<ref name="Wodke" />  Unlike other bacteria, ''M. pneumoniae'' uses the [[codon]] UGA to code for [[tryptophan]] rather than using it as a stop codon.
 
'''Etiologic Agent:'''  
 
Mycoplasma pneumoniae, a small bacterium. This class of organisms lack a peptidoglycan cell wall present on all other firmicute bacteria. Instead, it has a cell membrane which incorporates sterol compounds, similar to eukaryotic cells. It obtains these sterols from the host serum, allowing it to retain a simple structure. Lacking a cell wall, these organisms are resistant to the effects of penicillins and other beta-lactam antibiotics, which act by disrupting the bacterial cell wall.
 
M. pneumoniae has one of the smallest genomes known, with 816 kilobase pairs (kbs). Its genome and proteome has been fully characterized. It uses some unique genetic code, making its code more similar to mitochondria than to other bacteria. Thus it is said that Mycoplasma pneumoniae has a degenerate genome. It lacks the cellular machinery for making many essential compounds, including new purines and pyrimidines. It also has no tri-carboxylic acid cycle and an incomplete electron transport chain. Because of this, it is an obligate parasite.  
 
'''Transmission:'''
 
Person-to-person transmission by contact with respiratory secretions. Once attached to the mucosa of a host organism, M. pneumonia extracts nutrients, grows and reproduces by binary fission. Attachment sites include the upper and lower respiratory tract, causing pharyngitis, bronchitis and pneumonia. The infection caused by this bacterium is called atypical pneumonia because of its protracted course and lack of sputum production and wealth of extra-pulmonary symptoms. Chronic mycoplasma infections have been implicated in the pathogenesis of rheumatoid arthritis and other rheumatological diseases.
 
== Diagnosis ==  
M. pneumoniae infections can be differentiated from other types of pneumonia by the relatively slow progression of symptoms, a positive blood test for cold-hemagglutinins in 50-70% of patients after 10 days of infection, lack of bacteria in a gram stained sputum sample, and a lack of growth on blood agar.
 
=== History and Symptoms ===
Majority with upper respiratory tract infections with [[fever]], [[cough]], malaise, and [[headache]]. May lead to tracheobronchitis with [[fever]] and nonproductive [[cough]]: radiologically confirmed pneumonia develops in 5-10% of cases; rare extrapulmonary syndromes, including cardiologic, neurologic, and dermatologic findings.
 
== Risk Stratification and Prognosis==
Persistent cough is common during convalescence; other sequelae are rare. Fatal cases are reported occasionally, primarily among the elderly and persons with sickle-cell disease.


==References==
==References==
* http://www.cdc.gov/ncidod/dbmd/diseaseinfo/mycoplasmapneum_t.htm
{{reflist|2}}
 
== Acknowledgements ==
The content on this page was first contributed by: C. Michael Gibson, M.S., M.D.
{{SIB}}
 
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Latest revision as of 01:25, 8 February 2016

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Mycoplasma pneumoniae
Scientific classification
Kingdom: Bacteria
Division: Tenericutes
Class: Mollicutes
Order: Mycoplasmatales
Family: Mycoplasmataceae
Genus: Mycoplasma
Binomial name
Mycoplasma pneumoniae
Somerson et al., 1963
This page is about microbiologic aspects of the organism(s).  For clinical aspects of the disease, see Mycoplasma pneumonia.

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Mycoplasma pneumonia is caused by Mycoplasma pneumoniae, a very small bacterium that lacks cell wall and periplasmic space. On Gram-stain, Mycoplasma stains pink, i.e. it is Gram-negative by staining. However, it is structurally different from other Gram-negative organisms because it lacks a cell wall.

Clinical Significance

M. pneumoniae is the bacterium responsible for Mycoplasma pneumonia, an atypical pneumonia common in children and young adults.

Taxonomy

  • Bacteria; Firmicutes; Mollicutes; Mycoplasmatales; Mycoplasmataceae; Mycoplasma pneumoniae
  • The term Mycoplasma (“mykes”, meaning fungus and “plasma”, meaning formed) is derived from the fungal-like growth of some mycoplasma species.[1]

Cell Biology

  • Mycoplasma is the smallest self-replicating organism. They are bacteria that lack a cell wall and periplasmic space, have reduced genomes, and limited metabolic activity.[2][3]
  • Mycoplasma pneumoniae cells have an elongated shape that is approximately 1-2 µm in length and 0.1–0.2 µm in width.
  • The extremely small cell size means they are incapable of being examined by light microscopy; a stereomicroscope is required for viewing the morphology of M. pneumoniae colonies, which are usually less than 100 µm in length. The inability to synthesize a peptidoglycan cell wall is due to the absence of genes encoding its formation and results in an increased importance in maintenance of osmotic stability to avoid desiccation. The lack of a cell wall also calls for increased support of the cell membrane, which includes a rigid cytoskeleton composed of an intricate protein network and, potentially, an extracellular capsule to facilitate adherence to the host cell.[1]
  • M. pneumoniae are the only bacterial cells that possess cholesterol in their cell membrane (obtained from the host) and possess more genes that encode for membrane lipoprotein variations than other mycoplasmas, which are thought to be associated with its parasitic lifestyle. M. pneumoniae cells also possess an attachment organelle, which is used in the gliding motility of the organism by an unknown mechanism.[2]
  • The absence of a peptidoglycan cell wall results in resistance to many antibacterial agents. The persistence of M. pneumoniae infections even after treatment is associated with its ability to mimic host cell surface composition.
  • On Gram-stain, Mycoplasma stains pink, i.e. it is Gram-negative by staining. However, it is structurally different from other Gram-negative organisms because it lacks a cell wall.

Genomics

References

  1. 1.0 1.1 Ken; Waites, B; Deborah, F. Talkington (2004). "Mycoplasma pneumoniae and Its Role as a Human Pathogen". Clin. Microbiol. Rev. 17 (4): 697–728. doi:10.1128/CMR.17.4.697-728.2004.
  2. 2.0 2.1 2.2 2.3 2.4 Romero-Arroyo, C. E.; Jordan, J.; Peacock, S. J.; Willby, M. J.; Farmer, M. A.; Krause, D. C. (1994). "Mycoplasma pneumoniae protein P30 is required for cytadherence and associated with proper cell development". J. Bacteriol. 181: 1079–1087. doi:10.1128/CMR.17.4.697-728.2004.
  3. S. Dallo, and J. Baseman "Intracellular DNA replication and long-term survival of pathogenic mycoplasmas" Microb. Pathog. 2000; 29, 301–309. Template:10.1006/mpat.2000.0395
  4. 4.0 4.1 4.2 4.3 4.4 4.5 Wodke, J. A. H.; Puchałka, J.; Lluch-Senar, M.; Marcos, J.; Yus, E.; Godinho, M.; Gutiérrez-Gallego, R.; Serrano, L.; Klipp, E.; Maier, T. "Dissecting the energy metabolism in Mycoplasma pneumoniae through genome-scale metabolic modeling". Mol. Syst. Biol. 2010: 9. doi:10.1038/msb.2013.6.