LITERATURE UPDATE
Mycoplasma pneumoniae: an often overlooked but clinically significant respiratory pathogen
Mycoplasma pneumoniae was one of the topics on the scientific programme of the recent BSMT Annual Microbiology Conference, a report on which appears in this issue. Here, Pathology in Practice Science Editor Brian Nation looks at other recent published work on this microorganism that lacks a cell wall.
Resurgence of Mycoplasma pneumoniae infections in children: emerging challenges and opportunities de Groot RCA, Streng BMM, Bont LJ, Meyer Sauteur PM, van Rossum AMC. Curr Opin Infect Dis. 2025 Oct 1;38(5):468–476. doi: 10.1097/QCO.0000000000001126.
This review aims to summarise recent advances in Mycoplasma pneumoniae epidemiology, pathophysiology, diagnostics, and treatment, since the 2023–2024 global resurgence of M. pneumoniae following the COVID-19 pandemic has provided new insights. The remarkably prolonged
reduction of M. pneumoniae infections during COVID-19- related non-pharmaceutical interventions has shed new light on M. pneumoniae transmission, both on an individual and a global level. M. pneumoniae epidemiology showed striking differences in comparison with other respiratory pathogens, including RSV and pneumococcus. The authors discuss the possible mechanisms behind the delayed resurgence, including waning immunity and the persistence of M. pneumoniae reservoirs. There have been contrasting reports on disease severity with notable differences in severity between children and adults, with young adults showing marked vulnerability. The inability of M. pneumoniae
diagnostic tests to differentiate between infection and carriage poses a continuing challenge: in daily clinical practice as well as in the interpretation of study results. Furthermore, several studies report safety and utility for tetracyclines and fluoroquinolones as treatment alternatives to macrolide antibiotics.
M. pneumoniae has an organelle that helps it atach to a host cell (transmission electron micrograph [TEM]).
the authors briefly focus on the recent developments that have enhanced the understanding of M. pneumoniae, one of the smallest pathogenic bacteria of great clinical importance in children. M. pneumoniae infections may
involve either upper or lower respiratory tract or both of them. Extrapulmonary manifestations have been reported in almost every organ, including the skin and the haematologic, cardiovascular, musculoskeletal, and nervous system due to direct local effects, after dissemination of bacteria or indirect effects. The correct identification of M. pneumoniae infections is vital for prescription of the appropriate therapy. There are scarce specific
In summary, the global resurgence
of M. pneumoniae following COVID-19 pandemic restrictions has provided a unique opportunity to study its epidemiology and pathophysiology, which has advanced the understanding of M. pneumoniae infections in children.
Mycoplasma pneumoniae: Among the smallest bacterial pathogens with great clinical significance in children Kumar S, Kumar S. Indian J Med Microbiol. 2023 Nov-Dec;46:100480. doi: 10.1016/j.ijmmb.2023.100480.
Mycoplasmas are the smallest prokaryotic microorganisms found in nature. Mycoplasma pneumoniae is the most commonly studied among human mycoplasmas. In this review,
findings of clinical laboratory results for the diagnosis of M. pneumoniae infection. Detection of M. pneumoniae infections can be achieved using culture, serology, or molecular-based methods. Culture is time-consuming, laborious, and expensive. The major types of serological tests for M. pneumoniae include the microtitre plate enzyme immunoassay (EIA), the membrane EIA, indirect immunofluorescence, and particle agglutination. Nucleic acid amplification tests (NAATs) include traditional PCR, nested PCR, real-time quantitative PCR, nucleic acid sequence- based amplification (NASBA), loop- mediated isothermal amplification (LAMP) technology, and RNA simultaneous amplification and testing (SAT). Macrolides have been the drug of choice for treating M. pneumoniae
August 2026
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J. L. Jordan and D. C. Krause
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