From the Guidelines
Mycoplasma is a genus of small bacteria that lack a cell wall, making them naturally resistant to many common antibiotics like penicillins that target cell wall synthesis. The most clinically significant species is Mycoplasma pneumoniae, which causes atypical pneumonia (often called "walking pneumonia") 1. Mycoplasma infections typically present with gradual onset of symptoms including persistent cough, fatigue, sore throat, and low-grade fever. These bacteria are transmitted through respiratory droplets and are particularly common in crowded settings like schools and military barracks. For treatment, macrolide antibiotics (azithromycin 500mg on day 1, then 250mg daily for 4 more days) are typically first-line, with fluoroquinolones or tetracyclines as alternatives for adults 1. However, increased macrolide resistance is reported in some areas, especially in Asia, with up to 95% of M. pneumoniae isolates from adult patients with respiratory tract infections being resistant to macrolides in one study 1. Mycoplasma's unique biology - being among the smallest free-living organisms with minimal genomes - allows them to evade detection by standard culture methods, so diagnosis often relies on PCR testing or serology 1. Infections are generally self-limiting but can occasionally cause extrapulmonary complications including skin rashes, hemolytic anemia, and neurological symptoms. Some key points to consider in the management of Mycoplasma infections include:
- The importance of antimicrobial therapy in reducing morbidity and shortening the duration of symptoms 1
- The need for epidemiological monitoring of macrolide resistance in M. pneumoniae isolates 1
- The potential for extrapulmonary complications and the need for careful diagnosis and management 1
From the FDA Drug Label
Mycoplasma pneumoniae The FDA drug label does not directly answer the question of what a mycoplasma is. However, based on the provided information, Mycoplasma is mentioned as a type of bacteria, specifically Mycoplasma pneumoniae, which is a microorganism against which azithromycin and doxycycline have been shown to be active 2, 2, and 3.
- Key points:
- Mycoplasma pneumoniae is a type of bacteria
- Azithromycin and doxycycline are effective against Mycoplasma pneumoniae
- Mycoplasma is not fully described in the provided drug labels
From the Research
Definition of Mycoplasma
- Mycoplasmas are the smallest free-living microorganisms, being about 300 nm in diameter 4
- They are bounded by a triple-layered membrane and, unlike conventional bacteria, do not have a rigid cell wall 4, 5, 6
- Mycoplasmas belong to the class named Mollicutes, and their small size and absence of a cell wall contribute to distinguish them from other bacteria 7
Characteristics of Mycoplasma
- Mycoplasmas are intrinsically resistant to antimicrobials targeting the cell wall and to sulfonamides, first-generation quinolones, trimethoprim, polymixins, and rifampicin 6
- They are susceptible to macrolides and related antibiotics, tetracyclines, and fluoroquinolones 4, 5, 8
- Mycoplasmas can develop resistance to antibiotics, either by gene mutation or by acquisition of a resistance gene 4, 5, 6, 8
Types of Mycoplasma
- Mycoplasma pneumoniae is a pathogenic mycoplasma responsible for respiratory tract infections in humans 5, 8
- Mycoplasma genitalium is a species of mycoplasma that is similar to Mycoplasma pneumoniae in terms of antibiotic susceptibility profile 4
- Other species of mycoplasma, such as M. gallisepticum, M. synoviae, M. hyopneumoniae, M. hyorhinis, and M. bovis, are found in animals and can cause various diseases 6
Host-Mycoplasma Interaction
- Mycoplasmas can interact with host cells and trigger inflammation, altering critical cellular pathways 7
- Some Mycoplasma species can suppress the transcriptional activity of p53, resulting in reduced apoptosis of damaged cells 7
- Mycoplasmas have been reported to have oncogenic potential, demonstrating accumulation of abnormalities and phenotypic changes of the cells 7