The Evolution of Advanced Molecular Diagnostics for the Detection and Characterization of Mycoplasma pneumoniae

Abstract

Over the past decade there have been significant advancements in the methods used for detecting and characterizing Mycoplasma pneumoniae, a common cause of respiratory illness and community-acquired pneumonia worldwide. The repertoire of available molecular diagnostics has greatly expanded from nucleic acid amplification techniques (NAATs) that encompass a variety of chemistries used for detection, to more sophisticated characterizing methods such as multi-locus variable-number tandem-repeat analysis (MLVA), Multi-locus sequence typing (MLST), matrix-assisted laser desorption ionization–time-of-flight mass spectrometry (MALDI-TOF MS), single nucleotide polymorphism typing, and numerous macrolide susceptibility profiling methods, among others. These many molecular-based approaches have been developed and employed to continually increase the level of discrimination and characterization in order to better understand the epidemiology and biology of M. pneumoniae. This review will summarize recent molecular techniques and procedures and lend perspective to how each has enhanced the current understanding of this organism and will emphasize how Next Generation Sequencing may serve as a resource for researchers to gain a more comprehensive understanding of the genomic complexities of this insidious pathogen.

Staphylococcus epidermidis, Clonality and Accessory Gene Regulator Diversity in Clinical Isolates

“…The MLVA is a method for typing bacteria, which has been applied to several different species of bacteria. This method has appropriate differentiation power, is low cost, does not take long to run, and can be performed for a large number of samples (18)(19)(20)(21)(22)(23)(24)(25).…”

Inter- and Intra-Strain Variability of Tandem Repeats in Mycoplasma Pneumoniae Based on Next-Generation Sequencing Data

“…Despite their extremely small genome size, approximately 5-8% of the genome sequence in both species is composed of repetitive DNA, mostly present in the P1 adhesion operon in M. pneumoniae or its counterpart MgPa operon in M. genitalium, and their chromosomal repetitive elements, known as RepMPs and MgPars, respectively [5,6]. These loci have been frequently used as the targets for molecular typing to help understand the epidemiology and pathogenesis of both pathogens [13][14][15][16][17][18]. Of note, numerous studies of VNTRs in M. genitalium have demonstrated extensive intrastrain repeat number variations despite its genome size being the smallest among all sequenced mycoplasma species [14,[18][19][20][21][22][23][24], whereas there has been a scarcity of reports of such variations in M. pneumoniae [25] and other mycoplasma species.…”

Atypical Pneumonia

“…76–78 The age group most often affected by M pneumoniae include school-aged children and young adults with outbreaks typically occurring during the autumn season. 76–79 Outbreaks occur among close contacts and members within the same household or confined spaces. 80 Apart from its atypical symptoms, M pneumoniae presentations can vary dramatically ranging from the mild upper respiratory symptoms to pneumonia and other extrapulmonary manifestations in absence of pneumonia, 6 including dermatologic, cardiovascular, and central nervous system findings.…”

“…Given the fastidious nature of M pneumoniae it is not routinely cultured anymore because it is slow growing and culture results are often inconsistent and provide poor clinical utility given the length of time the organism takes to grow. 77,79 …”