Mycoplasma infections in children

Mycoplasma bacteria are very tiny microbes that lack a cell wall, but instead have a unique cell membrane not found in other microbes or viruses. In fact Mycoplasma species were once thought to be viruses they were so small, and could fit through bacterial filters.

Mycoplasma contain both RNA and DNA, are hard to culture in the lab because they are slow growing and fastidious, and are considered a human pathogen. Special testing is required to detect many Mycoplasma species.

Mycoplasma bacteria adhere to the surface of epithelial cells of the respiratory and genital tracts using a special membrane protein. The attachment site then later causes damage to the cell and cell death, along with an inflammatory response.

This article discusses only the Mycoplasma varieties known to cause genital disease (not respiratory disease like pneumonia). This includes:

• Mycoplasma hominis,
• M. fermentans,
• M. genitalium; and
• Ureaplasma species.

These bacteria have been implicated in preterm labour and bacteria in preterm newborns. Sexual contact is the most common form of transmission, however Mycoplasma species infections in infants most commonly occurs due to an infected birth canal.

Genital Mycoplasma organisms have been isolated from the upper respiratory tract of 15 per cent of infants. Typically colonisation does not extend beyond two years of age, but it can.

Symptoms of Mycoplasma infection generally, and in the vagina of a child

• Wheezing
• Retractions
• Respiratory failure
• Seizures
• Lethargy
• Neurologic deficits
• Burning on urination
• Vaginal discharge
• Symptoms of pelvic inflammatory disease
• Fever
• Cough
• Meningitis
• Brain abscess

M. hominis and Ureaplasma are found more commonly in baby girls than in baby boys.

What else could it be?

• Chlamydia
• The flu
• Other genitourinary infection

Testing for genital Mycoplasma infections

Ureaplasma takes 24-48 hours to grow in culture, whereas M. hominis takes about a week. Mycoplasma genitalium may take 1-2 months to grow, which is why PCR or other testing is required so treatment can be given in a timely manner.

Treatment of Mycoplasma infections

Treatment is typically antibiotics, however treatment may need to be longer than usual, and with specific antibiotics due to the lack of cell wall that doesn’t respond to all antibiotics equally. The risk of antibiotic resistant is high, so treatment needs to be swift and hard.