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BackgroundMycoplasma amphoriforme has been associated with infection in patients with primary antibody deficiency (PAD). Little is known about the natural history of infection with this organism and its ability to be transmitted in the community.MethodsThe bacterial load was estimated in sequential sputum samples from 9 patients by quantitative polymerase chain reaction. The genomes of all available isolates, originating from patients in the United Kingdom, France, and Tunisia, were sequenced along with the type strain. Genomic data were assembled and annotated, and a high-resolution phylogenetic tree was constructed.ResultsBy using high-resolution whole-genome sequencing (WGS) data, we show that patients can be chronically infected with M. amphoriforme manifesting as a relapsing-remitting bacterial load, interspersed by periods when the organism is undetectable. Importantly, we demonstrate transmission of strains within a clinical environment. Antibiotic resistance mutations accumulate in isolates taken from patients who received multiple courses of antibiotics.ConclusionsMycoplasma amphoriforme isolates form a closely related species responsible for a chronic relapsing and remitting infection in PAD patients in the United Kingdom and from immunocompetent patients in other countries. We provide strong evidence of transmission between patients attending the same clinic, suggesting that screening and isolation may be necessary for susceptible patients. This work demonstrates the critical role that WGS can play in rapidly unraveling the biology of a novel pathogen.

Original publication

DOI

10.1093/cid/ciu820

Type

Journal

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

Publication Date

02/2015

Volume

60

Pages

381 - 388

Addresses

School of Medicine, University of St Andrews, United Kingdom.

Keywords

Sputum, Humans, Mycoplasma, Mycoplasma Infections, Immunologic Deficiency Syndromes, Recurrence, Genomics, Phylogeny, Drug Resistance, Bacterial, Mutation, Genome, Bacterial, Adult, Disease Transmission, Infectious, Bacterial Load