Chronic Bronchitis in Immunocompromised Patients: Association with a Novel Mycoplasma Species
- 141 Downloads
Patients with primary antibody deficiency are prone to recurrent bronchitis, often caused by nonencapsulated Haemophilus influenzae and streptococcal infection. Productive cough often persists even after elimination of these organisms with antibiotics. During an investigation into the cause of unexplained chronic bronchitis in these patients, a novel Mycoplasma species (designated A39) was first isolated from the sputum of a man with X-linked agammaglobulinaemia. Screening of sputa from a further 45 patients with primary antibody deficiency showed that 10 were positive for a similar organism using culture and/or a polymerase chain reaction based on sequences within the 16S ribosomal RNA gene. A comparison of the sequence data showed that the organism was distinct from but similar to Mycoplasma pneumoniae and other closely related mycoplasmas found in humans and animals. Electron microscopy showed some unique morphological characteristics. Although respiratory symptoms improved after elimination of A39 from the sputum of the patient with X-linked agammaglobulinaemia, further work is needed to establish the organism as a pathogen.
KeywordsHaemophilus Influenzae Mycoplasma Pneumoniae Throat Swab Common Variable Immunodeficiency CVID Patient
We thank nurses Cilla Freud and Irene Wahlberg, along with Ms. J. Lewin and the staff of the Royal Free Hospital microbiology and electron microscopy department for help in managing and investigating the patients. All experiments described in this paper comply with the current laws of the country in which they were performed.
- 1.Samuelson A, Borrelli S, Gustafson R, Hammarstrom L, Smith CIE, Jonasson J et al. (1995) Characterisation of Haemophilus influenzae isolates from the respiratory tract of patients with primary antibody deficiency: evidence for persistent colonisation. Scand J Infect Dis 27:303–313PubMedGoogle Scholar
- 5.Hannan PCT, Windsor HM, Ripley PH (1997) In vitro susceptibilities of recent field isolates of Mycoplasma hyopneumoniae and Mycoplasma hyosynoviae to valnemulin (Econor®), tiamulin and enrofloxacin and the in vitro development of resistance to certain antimicrobial agents in Mycoplasma hyopneumoniae. Res Vet Sci 63:157–160PubMedGoogle Scholar
- 8.Poveda JB, Nicholas R (1998) Serological identification of mycoplasmas by growth and metabolic tests. In: Miles R, Nicholas R (eds) Methods in molecular biology, vol 104. Mycoplasma protocols. Humana Press, Totowa, NJ, pp 105–111Google Scholar
- 9.Poveda JB (1998) Biochemical characteristics in mycoplasma identification. In: Miles R, Nicholas R (eds) Methods in molecular biology, vol 104. Mycoplasma protocols. Humana Press, Totowa, NJ, pp 69–78Google Scholar
- 11.Cadieux N, Lebel P, Brousseau R (1993) Use of a triplex polymerase chain reaction for the detection and differentiation of Mycoplasma pneumoniae and Mycoplasma genitalium in the presence of human DNA. J Gen Microbiol 2431–2437Google Scholar
- 12.Johansson K-E, Heldtander M, Pettersson B (1998) Characterisation of mycoplasmas by PCR and sequence analysis with universal 16S rDNA primers. In: Miles R, Nicholas R (eds) Methods in molecular biology, vol 104. Mycoplasma protocols. Humana Press, Totowa, NJ, pp 145–165Google Scholar
- 15.Carson JL, Hu P-C, Collier AM (1992) Cell structural and functional elements. In: Maniloff J, McElhaney RN, Finch LR, Baseman JB (eds) Mycoplasmas, molecular biology and pathogenesis. American Society for Microbiology, Washington DC, pp 63–72Google Scholar
- 16.Tully JG, Taylor-Robinson D, Cole RM, Rose DL (1981) A newly discovered mycoplasma in the human urogenital tract. Lancet i:1288–1291Google Scholar
- 18.Hill AC (1985) Mycoplasma testudinis, a new species isolated from a tortoise. Int J Syst Bacteriol 35:489–492Google Scholar
- 19.Montagnier L, Blanchard A (1993) Mycoplasmas as cofactors in infection due to the human immunodeficiency virus. Clin Infect Dis 17 [Suppl 1]:309–315Google Scholar