Skip to main content
SpringerLink
Log in

Mycoplasma and Ureaplasma Infections in Transplantation: A Big Impact Despite the Lack of a Cell Wall

  • Living reference work entry
  • First Online:
Emerging Transplant Infections

  • 193 Accesses

Abstract

In the general population, Mycoplasma spp. and Ureaplasma spp. are considered as pathogens with low virulence. Asymptomatic urogenital colonization with genital mycoplasmas is common. M. pneumoniae infections most frequently present as tracheobronchitis. In immunosuppressed individuals, a broad spectrum of invasive diseases has been attributed to these pathogens. After kidney transplantation and hematopoietic stem cell transplantation, Mycoplasma spp. and Ureaplasma spp. have been detected as causative pathogens in urogenital infections. Surgical site infections following solid organ transplantation are rarely caused by Mycoplasma spp. and Ureaplasma spp.. Recently, an association between hyperammonemia syndrome and genital mycoplasmas has been described after lung, kidney, and hematopoietic stem cell transplantation. Hyperammonemia syndrome, characterized by a combination of progressive elevations in plasma ammonium levels and worsening neurological symptoms, is a rare but potentially fatal disorder. Routine cultural approaches are poorly sensitive, and nucleic acid amplification tests should be applied for diagnosis. Commonly used broad-spectrum antibiotics are frequently not active against these cell wall-lacking bacteria. Mycoplasma spp. or Ureaplasma spp. should be considered as etiologic agents if routine diagnostics do not identify relevant pathogens or if response to empiric antibiotic therapy is insufficient.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Institutional subscriptions

References

  1. Horner P, Donders G, Cusini M, Gomberg M, Jensen JS, Unemo M. Should we be testing for urogenital Mycoplasma hominis, Ureaplasma parvum and Ureaplasma urealyticum in men and women? – a position statement from the European STI Guidelines Editorial Board. J Eur Acad Dermatol Venereol. 2018;32(11):1845–51.

    Article  CAS  PubMed  Google Scholar 

  2. Gerber S, Vial Y, Hohlfeld P, Witkin SS. Detection of Ureaplasma urealyticum in second-trimester amniotic fluid by polymerase chain reaction correlates with subsequent preterm labor and delivery. J Infect Dis. 2003;187(3):518–21.

    Article  PubMed  Google Scholar 

  3. Capoccia R, Greub G, Baud D. Ureaplasma urealyticum, Mycoplasma hominis and adverse pregnancy outcomes. Curr Opin Infect Dis. 2013;26(3):231–40.

    Article  PubMed  Google Scholar 

  4. Kasper DC, Mechtler TP, Bohm J, Petricevic L, Gleiss A, Spergser J, et al. In utero exposure to Ureaplasma spp. is associated with increased rate of bronchopulmonary dysplasia and intraventricular hemorrhage in preterm infants. J Perinat Med. 2011;39(3):331–6.

    Article  PubMed  Google Scholar 

  5. Abele-Horn M, Genzel-Boroviczeny O, Uhlig T, Zimmermann A, Peters J, Scholz M. Ureaplasma urealyticum colonization and bronchopulmonary dysplasia: a comparative prospective multicentre study. Eur J Pediatr. 1998;157(12):1004–11.

    Article  CAS  PubMed  Google Scholar 

  6. Abele-Horn M, Peters J, Genzel-Boroviczeny O, Wolff C, Zimmermann A, Gottschling W. Vaginal Ureaplasma urealyticum colonization: influence on pregnancy outcome and neonatal morbidity. Infection. 1997;25(5):286–91.

    Article  CAS  PubMed  Google Scholar 

  7. Meyer RD, Clough W. Extragenital Mycoplasma hominis infections in adults: emphasis on immunosuppression. Clin Infect Dis. 1993;17(Suppl 1):S243–9.

    Article  PubMed  Google Scholar 

  8. Taylor-Robinson D, Furr PM, Webster AD. Ureaplasma urealyticum in the immunocompromised host. Pediatr Infect Dis. 1986;5(6 Suppl):S236–8.

    Article  CAS  PubMed  Google Scholar 

  9. Waites KB, Talkington DF. Mycoplasma pneumoniae and its role as a human pathogen. Clin Microbiol Rev. 2004;17(4):697–728, table of contents.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Foy HM, Grayston JT, Kenny GE, Alexander ER, McMahan R. Epidemiology of Mycoplasma pneumoniae infection in families. JAMA. 1966;197(11):859–66.

    Article  CAS  PubMed  Google Scholar 

  11. Schalock PC, Dinulos JG. Mycoplasma pneumoniae-induced cutaneous disease. Int J Dermatol. 2009;48(7):673–80; quiz 80–1.

    Article  PubMed  Google Scholar 

  12. Alexander ER, Foy HM, Kenny GE, Kronmal RA, McMahan R, Clarke ER, et al. Pneumonia due to Mycoplasma pneumoniae. Its incidence in the membership of a co-operative medical group. N Engl J Med. 1966;275(3):131–6.

    Article  CAS  PubMed  Google Scholar 

  13. Gdalevich M, Haas EJ, Dukhan L, Katz M, Zelenski V, Moran-Gilad J. Control of a Mycoplasma pneumoniae outbreak in an institutional setting using azithromycin prophylaxis. Front Public Health. 2017;5:366.

    Article  PubMed  Google Scholar 

  14. Shields RK, Clancy CJ, Minces LR, Shigemura N, Kwak EJ, Silveira FP, et al. Epidemiology and outcomes of deep surgical site infections following lung transplantation. Am J Transplant. 2013;13(8):2137–45.

    Article  CAS  PubMed  Google Scholar 

  15. Smibert OC, Wilson HL, Sohail A, Narayanasamy S, Schultz MB, Ballard SA, et al. Donor-derived Mycoplasma hominis and an apparent cluster of M. hominis cases in solid organ transplant recipients. Clin Infect Dis. 2017;65(9):1504–8.

    Article  CAS  PubMed  Google Scholar 

  16. Sampath R, Patel R, Cunningham SA, Arif S, Daly RC, Badley AD, et al. Cardiothoracic transplant recipient Mycoplasma hominis: an uncommon infection with probable donor transmission. EBioMedicine. 2017;19:84–90.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Mitsani D, Nguyen MH, Silveira FP, Bermudez C, Toyoda Y, Pasculle AW, et al. Mycoplasma hominis pericarditis in a lung transplant recipient: review of the literature about an uncommon but important cardiothoracic pathogen. Transpl Infect Dis. 2010;12(2):146–50.

    Article  CAS  PubMed  Google Scholar 

  18. Hagiya H, Yoshida H, Yamamoto N, Kimura K, Ueda A, Nishi I, et al. Mycoplasma hominis periaortic abscess following heart-lung transplantation. Transpl Infect Dis. 2017;19(3). https://doi.org/10.1111/tid.12697. Epub 2017 May 3.

    Article  Google Scholar 

  19. Dixit A, Alexandrescu S, Boyer D, Graf EH, Vargas SO, Silverman M. Mycoplasma hominis empyema in an 18-year-old stem cell and lung transplant recipient: case report and review of the literature. J Pediatric Infect Dis Soc. 2017;6(4):e173–e6.

    Article  PubMed  Google Scholar 

  20. Hopkins PM, Winlaw DS, Chhajed PN, Harkness JL, Horton MD, Keogh AM, et al. Mycoplasma hominis infection in heart and lung transplantation. J Heart Lung Transplant. 2002;21(11):1225–9.

    Article  PubMed  Google Scholar 

  21. Bharat A, Cunningham SA, Scott Budinger GR, Kreisel D, DeWet CJ, Gelman AE, et al. Disseminated Ureaplasma infection as a cause of fatal hyperammonemia in humans. Sci Transl Med. 2015;7(284):284re3.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Vogel U, Luneberg E, Kuse ER, Neulinger AL, Frosch M. Extragenital Mycoplasma hominis infection in two liver transplant recipients. Clin Infect Dis. 1997;24(3):512–3.

    Article  CAS  PubMed  Google Scholar 

  23. Jacobs F, Van de Stadt J, Gelin M, Nonhoff C, Gay F, Adler M, et al. Mycoplasma hominis infection of perihepatic hematomas in a liver transplant recipient. Surgery. 1992;111(1):98–100.

    CAS  PubMed  Google Scholar 

  24. Losada I, Canle D, Moure R, Villanueva R, Bueno J, Sanchez-Galindo A, et al. Mycoplasma hominis infection after liver transplantation in a child. Transplantation. 2004;77(10):1624–5.

    Article  PubMed  Google Scholar 

  25. Haller M, Forst H, Ruckdeschel G, Denecke H, Peter K. Peritonitis due to Mycoplasma hominis and Ureaplasma urealyticum in a liver transplant recipient. Eur J Clin Microbiol Infect Dis. 1991;10(3):172.

    Article  CAS  PubMed  Google Scholar 

  26. Gerber L, Gaspert A, Braghetti A, Zwahlen H, Wuthrich R, Zbinden R, et al. Ureaplasma and Mycoplasma in kidney allograft recipients-A case series and review of the literature. Transpl Infect Dis. 2018;20(5):e12937.

    Article  PubMed  Google Scholar 

  27. Loupy A, Join-Lambert OF, Bebear CM, Legendre C, Anglicheau D. Urogenital mycoplasma: an emerging cause of deep wound infection after kidney transplantation? NDT Plus. 2008;1(4):239–40.

    PubMed  PubMed Central  Google Scholar 

  28. Pastural M, Audard V, Bralet MP, Remy P, Salomon L, Tankovic J, et al. Mycoplasma hominis infection in renal transplantation. Nephrol Dial Transplant. 2002;17(3):495–6.

    Article  PubMed  Google Scholar 

  29. Miranda C, Carazo C, Banon R, Mendoza J, Montes A, de la Rosa M. Mycoplasma hominis infection in three renal transplant patients. Diagn Microbiol Infect Dis. 1990;13(4):329–31.

    Article  CAS  PubMed  Google Scholar 

  30. Nowbakht C, Edwards AR, Rodriguez-Buritica DF, Luce AM, Doshi PB, De Golovine A, et al. Two cases of fatal hyperammonemia syndrome due to Mycoplasma hominis and Ureaplasma urealyticum in immunocompromised patients outside lung transplant recipients. Open Forum Infect Dis. 2019;6(3):ofz033.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Burdge DR, Reid GD, Reeve CE, Robertson JA, Stemke GW, Bowie WR. Septic arthritis due to dual infection with Mycoplasma hominis and Ureaplasma urealyticum. J Rheumatol. 1988;15(2):366–8.

    CAS  PubMed  Google Scholar 

  32. Geissdorfer W, Sandner G, John S, Gessner A, Schoerner C, Schroppel K. Ureaplasma urealyticum meningitis in an adult patient. J Clin Microbiol. 2008;46(3):1141–3.

    Article  PubMed  Google Scholar 

  33. Geissdorfer W, Schorner C, Lohoff M. Systemic Mycoplasma hominis infection in a patient immunocompromised due to combined transplantation of kidney and pancreas. Eur J Clin Microbiol Infect Dis. 2001;20(7):511–2.

    Article  CAS  PubMed  Google Scholar 

  34. Okumura Y, Kajihara T, Koba Y, Onodera M, Hara T, Tahara H, et al. Multiple intraabdominal abscesses caused by Mycoplasma hominis infection following simultaneous pancreas-kidney transplantation. Ann Lab Med. 2018;38(4):381–3.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Arber C, Buser A, Heim D, Weisser M, Tyndall A, Tichelli A, et al. Septic polyarthritis with Ureaplasma urealyticum in a patient with prolonged agammaglobulinemia and B-cell aplasia after allogeneic HSCT and rituximab pretreatment. Bone Marrow Transplant. 2007;40(6): 597–8.

    Article  CAS  PubMed  Google Scholar 

  36. Choi GJ, Kim SJ, Kang JM, Choi SR, Yoo KH, Kim YJ. Severe hematuria in a hematopoietic cell transplant recipient caused by Ureaplasma urealyticum not by BK virus or adenovirus infection. Transpl Infect Dis. 2018;20(4):e12921.

    Article  PubMed  Google Scholar 

  37. Graetz R, Meyer R, Shehab K, Katsanis E. Successful resolution of hyperammonemia following hematopoietic cell transplantation with directed treatment of Ureaplasma parvum infection. Transpl Infect Dis. 2018;20(2):e12839.

    Article  PubMed  Google Scholar 

  38. Faraci M, Giardino S, Lanino E, Morreale G, Ghibaudo E, Francesia Berta M, et al. Toxic epidermal necrolysis-like reaction after hematopoietic stem cell transplantation in children. J Pediatr Hematol Oncol. 2017;39(4):254–8.

    Article  PubMed  Google Scholar 

  39. Waites KB, Xiao L, Liu Y, Balish MF, Atkinson TP. Mycoplasma pneumoniae from the respiratory tract and beyond. Clin Microbiol Rev. 2017;30(3):747–809.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. Loens K, Ieven M. Mycoplasma pneumoniae: current knowledge on nucleic acid amplification techniques and serological diagnostics. Front Microbiol. 2016;7:448.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Loens K, Goossens H, Ieven M. Acute respiratory infection due to Mycoplasma pneumoniae: current status of diagnostic methods. Eur J Clin Microbiol Infect Dis. 2010;29(9):1055–69.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  42. Waites KB, Xiao L, Paralanov V, Viscardi RM, Glass JI. Molecular methods for the detection of Mycoplasma and Ureaplasma infections in humans: a paper from the 2011 William Beaumont Hospital Symposium on molecular pathology. J Mol Diagn. 2012;14(5):437–50.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  43. Dumke R, Jacobs E. Evaluation of five real-time PCR assays for detection of Mycoplasma pneumoniae. J Clin Microbiol. 2014;52(11):4078–81.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  44. Gaydos CA. Mycoplasma genitalium: accurate diagnosis is necessary for adequate treatment. J Infect Dis. 2017;216(suppl_2):S406–S11.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  45. US Department of Health & Human Services, US Food and Drug Administration. In: Nucleic acid detection system for non-viral microorganism(s) causing sexually transmitted infections. Medical Devices Databases. https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/denovo.cfm?ID=DEN180047. Accessed 3 june 2019.

  46. Hashim IA, Cuthbert JA. Elevated ammonia concentrations: potential for pre-analytical and analytical contributing factors. Clin Biochem. 2014;47(16–17):233–6.

    Article  CAS  PubMed  Google Scholar 

  47. Nikolac N, Omazic J, Simundic AM. The evidence based practice for optimal sample quality for ammonia measurement. Clin Biochem. 2014;47(12):991–5.

    Article  CAS  PubMed  Google Scholar 

  48. Schuff-Werner P, Steiner M. Preanalytical ammonia generation: a race with time but not with temperature. J Clin Pathol. 2015;68(9):757–8.

    Article  CAS  PubMed  Google Scholar 

  49. Taylor-Robinson D, Jensen JS. Mycoplasma genitalium: from Chrysalis to multicolored butterfly. Clin Microbiol Rev. 2011;24(3):498–514.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Wang QY, Li RH, Zheng LQ, Shang XH. Prevalence and antimicrobial susceptibility of Ureaplasma urealyticum and Mycoplasma hominis in female outpatients, 2009–2013. J Microbiol Immunol Infect. 2016;49(3):359–62.

    Article  CAS  PubMed  Google Scholar 

  51. Huang C, Long X, Jing S, Fan L, Xu K, Wang S, et al. Ureaplasma urealyticum and Mycoplasma hominis infections and semen quality in 19,098 infertile men in China. World J Urol. 2016;34(7):1039–44.

    Article  PubMed  Google Scholar 

  52. Beeton ML, Spiller OB. Antibiotic resistance among Ureaplasma spp. isolates: cause for concern? J Antimicrob Chemother. 2017;72(2):330–7.

    Article  CAS  PubMed  Google Scholar 

  53. Schneider SC, Tinguely R, Droz S, Hilty M, Dona V, Bodmer T, et al. Antibiotic susceptibility and sequence type distribution of Ureaplasma species isolated from genital samples in Switzerland. Antimicrob Agents Chemother. 2015;59(10):6026–31.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  54. Dionne-Odom J, Geisler WM, Aaron KJ, Waites KB, Westfall AO, Van Der Pol B, et al. High prevalence of multidrug-resistant Mycoplasma genitalium in human immunodeficiency virus-infected men who have sex with men in Alabama. Clin Infect Dis. 2018;66(5):796–8.

    Article  CAS  PubMed  Google Scholar 

  55. Braam JF, van Dommelen L, Henquet CJM, van de Bovenkamp JHB, Kusters JG. Multidrug-resistant Mycoplasma genitalium infections in Europe. Eur J Clin Microbiol Infect Dis. 2017;36(9):1565–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  56. Prevention CoDCa. Guideline for isolation precautions: preventing transmission of infectious agents in healthcare settings (2007) 09/2018.

    Google Scholar 

  57. Klausner JD, Passaro D, Rosenberg J, Thacker WL, Talkington DF, Werner SB, et al. Enhanced control of an outbreak of Mycoplasma pneumoniae pneumonia with azithromycin prophylaxis. J Infect Dis. 1998;177(1):161–6.

    Article  CAS  PubMed  Google Scholar 

  58. Jensen KJ, Senterfit LB, Scully WE, Conway TJ, West RF, Drummy WW. Mycoplasma pneumoniae infections in children. An epidemiologic appraisal in families treated with oxytetracycline. Am J Epidemiol. 1967;86(2):419–32.

    Article  CAS  PubMed  Google Scholar 

  59. Schillinger JA, Arnold K, Mokulis EC, et al. Prophylaxis against Mycoplasma pneumoniae; a double-blind placebo-controlled trial using doxycycline. In: Microbiology ASf, editor. 35th Interscience Conference on Antimicrobial Agents and Chemotherapy San Francisco: program and abstracts of the 35th Interscience Conference on Antimicrobial Agents and Chemotherapy 1995.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland

    Peter W. Schreiber & Nicolas Müller

Authors
  1. Peter W. Schreiber
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Nicolas Müller
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Peter W. Schreiber .

Editor information

Editors and Affiliations

  1. Miller School of Medicine, University of Miami, Miami, FL, USA

    Michele I. Morris

  2. Massachusetts General Hospital, Harvard University, Boston, MA, USA

    Camille Nelson Kotton

  3. Duke University, Durham, NC, USA

    Camille Wolfe

Section Editor information

  1. Infectious Diseases Division, Harvard University Medical School, Boston, MA, USA

    Camille Nelson Kotton

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Schreiber, P.W., Müller, N. (2020). Mycoplasma and Ureaplasma Infections in Transplantation: A Big Impact Despite the Lack of a Cell Wall. In: Morris, M., Kotton, C., Wolfe, C. (eds) Emerging Transplant Infections. Springer, Cham. https://doi.org/10.1007/978-3-030-01751-4_19-1

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-01751-4_19-1

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-01751-4

  • Online ISBN: 978-3-030-01751-4

  • eBook Packages: Springer Reference MedicineReference Module Medicine

Publish with us

Policies and ethics

Search

Navigation