Genomic investigations unmask Mycoplasma amphoriforme, a new respiratory pathogen
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Background. Mycoplasma 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. Methods. The bacterial load was estimated in sequential sputum samples from nine patients by qPCR. The genomes of all available isolates, originating from patients in the UK, France and Tunisia, were sequenced along with the type strain. Genomic data was assembled, annotated and a high-resolution phylogenetic tree constructed. Results. By using high-resolution whole genome sequence 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. Conclusions. Mycoplasma amphoriforme isolates form a closely related species responsible for a chronic relapsing and remitting infection in PAD patients in the UK 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 whole genome sequencing can play in unravelling the biology of a novel pathogen rapidly.
Gillespie , S H , Ling , C L , Oravcova , K , Pinheiro , M , Wells , L , Bryant , J M , McHugh , T D , Bébéar , C , Webster , D , Harris , S R , Seth-Smith , H M B & Thomson , N R 2015 , ' Genomic investigations unmask Mycoplasma amphoriforme , a new respiratory pathogen ' Clinical Infectious Diseases , vol 60 , no. 3 , pp. 381-388 . DOI: 10.1093/cid/ciu820
Clinical Infectious Diseases
© The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/ by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
The Wellcome Trust [grants 098051 and 097831/Z/11/B (to J. M. B., S. R. H., H. M. B. S.-S., N. R. T.)], The Medical Research Council (grant number G1000413 [to J. M. B.]), The Special Trustees of the Royal Free London, National Health Service Foundation Trust (S. H. G., T. Mc. H., C. L.), and The University of St Andrews Medical School (S. H. G., K. O.).
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