What's the reason behind the high incidence of mycoplasma infections?
Host-dependent microbes known as mycoplasmas can lead to severe lung infections.
These pathogens, such as Mycoplasma pneumoniae, aren't viruses but instead parasitic bacteria. As biologist Roger Dumke, head of the reference laboratory for mycoplasmas at the University Hospital Dresden's Institute of Medical Microbiology and Virology, explains, "Mycoplasmas are largely dependent on the host, and that's exclusively humans." These bacteria are distinct from others due to their lack of cell walls, making conventional antibiotics like penicillin ineffective for treating them. Mycoplasma pneumoniae was initially detected in 1938.
The danger level of an infection
While infections with Mycoplasma pneumoniae are typically mild, they can sometimes be severe. The pathogen is commonly transmitted via coughing and sneezing. Generally, most individuals recover without medical intervention. According to Dumke, individuals with strong immune systems tend to cope well with the pathogen. However, some may require specialized medication to recover. "Effective antibiotics are available for this purpose," says the scientist. Resistant strains are infrequent in Germany.
Current infection situation
"We're currently seeing a significant increase in cases and thus a higher percentage of severe illnesses," explains Dumke. "The trend is undeniable." Compared to pre-COVID-19 levels, there's been a ten- to twenty-fold increase in infections.
In his pulmonology practice in Munich, Dr. Frank Powitz has noticed a rise in lung infections since summer, including those caused by mycoplasmas. However, his counterpart Dr. Norbert Mülleneisen in Leverkusen has not observed an increase in mycoplasma pneumoniae pneumonias in his practice.
No thorough investigation has been conducted in Germany to determine the prevalence of mycoplasma infections. The reporting obligation for detecting the pathogen through nasal or throat swabs or blood tests exists only in Saxony.
By mid-September, about 12,000 infection reports had been made in Saxony, according to the State Institute for Health and Veterinary Medicine. While this includes various mycoplasma species besides Mycoplasma pneumoniae, Dumke believes that the lung pathogen is primarily responsible for the increase. For comparison, there were around 2,000 reports of mycoplasma infections at this time in 2023, and around 1,200 in 2019, before the COVID-19 pandemic.
Reasons for the increased infections
Dumke attributes this trend to a post-COVID-19 pandemic catch-up effect. Possible shifts in subtypes of the pathogen could contribute to this increase. Every few years, subtle changes to these subtypes have resulted in higher infection rates in the past. Following the easing of COVID-19 safety measures, these subtype shifts could be more pronounced this time and could potentially bypass the immune system of more people.
Additionally, Dumke believes that individuals had limited exposure to the pathogen due to pandemic-related hygiene measures. As a result, the specific immune response to Mycoplasma pneumoniae in the German population may require rebuilding. "The surge will eventually subside," says Dumke. "When that will happen is still uncertain."
Symptoms
Symptoms may take between one and four weeks to manifest after exposure to the bacteria, as reported by the U.S. health authority, the CDC. Most commonly, these symptoms resemble a cold, including cough, fatigue, fever, or sore throat. Younger individuals may experience diarrhea, vomiting, or wheezing. If complications arise, asthma attacks or severe lung infections could develop.
The disease often develops gradually, making it hard to recognize immediately. This is in part because it differs from typical lung infections, which are often characterized by high fever, chills, and severe cough, while mycoplasma-induced lung infections present with mild fever, dry cough, and shortness of breath. According to Munich physician Powitz, lung infections caused by mycoplasma may be more severe and prolonged compared to those caused by other pathogens.
Even though Mycoplasma pneumoniae infections usually result in mild symptoms, bacterial antibiotics like tetracycline or macrolides are essential for treating severe cases, as mentioned by Dumke. Regrettably, some strains of bacteria, such as Mycoplasma pneumoniae, are resistant to common antibiotics like penicillin due to their unique structure, specifically their lack of cell walls.
