MYCOPLASMA SPP

PATHOGEN SAFETY DATA SHEET - INFECTIOUS SUBSTANCES

SECTION I - INFECTIOUS AGENT

NAME: Mycoplasma spp. (excluding M. hominis , M. genitalium , M. pneumoniae)

SYNONYM OR CROSS REFERENCE: Mycoplasmas, pleuropneumonia-like organism (PPLO), L-form⁽¹⁾

CHARACTERISTICS: Mycoplasmas are ubiquitous intracellular pleomorphic gram negative bacteria, which belong to the family Mycoplasmataceae , in the Mollicutes class ^(2,3) . Most are motile, using gliding motility instead of pili or flagella^(4,5). They are the smallest organism capable of self replication (0.2 to 2 µm in diameter), and they lack the genes coding for the cell wall, leading them to a parasitic and saprophytic existence⁽⁶⁾. Instead of a cell wall, they possess a three-layered membrane, containing sterol, which is taken up from the environment. Most are facultative anaerobic, but some are strictly anaerobic. In Mycoplasmas, the UGA codon codes for tryptophan rather than being a Stop codon⁽⁷⁾. Mycoplasmas may metabolize glucose or arginine, but not urea.

SECTION II – HAZARD IDENTIFICATION

PATHOGENICITY/TOXICITY: Mycoplasmas (except M. pneumoniae) are usually commensal respiratory and urogenital tract inhabitants, but they can become pathogenic⁽⁴⁾. M. orale and M. salivarium , usually commensals of the oro-pharynx, may be found in the lower respiratory tract of patients with chronic bronchitis, although it is not clear that they have an effect on severity of bronchitis⁽²⁾. M. salivarium has been found in a biofilm of an occluded biliary stent and is implicated in periodontal disease^(8,9). This pathogen may also cause arthritis in cases of hypogammaglobulinemia⁽⁴⁾. M. fermentans is a co-factor of HIV and may cause lung and brain infection in AIDS patients⁽¹⁰⁾. M. fermentans is also detected in patients with inflammatory arthritic disorders, gulf war syndrome. It may implicated in the chronic fatigue syndrome but it is unclear, since other reports have infirmed that. It has been detected in adults suffering from an acute influenza-like illness, sometimes progressing rapidly to an often-fatal respiratory distress syndrome, proving that this pathogen is not always opportunistic⁽²⁾. The prevalence of infection with mycoplasmas is probably underestimated, because they are often contaminants of cell cultures and are usually ignored⁽¹⁰⁾.

EPIDEMIOLOGY: These pathogens are prevalent worldwide⁽³⁾. Immunocompromised, agammaglobulinemia suffering patients and patients taking immunosuppressive drug are particularly at risk.

HOST RANGE: 16 species are known to colonize humans⁽³⁾. M. orale and M. salivarium may also colonize non-human primate. M. fermentans have been found in genital infections of sheep. Other animals can be hosts, depending on the species.

INFECTIOUS DOSE: Unknown.

MODE OF TRANSMISSION: They are transferred by intimate contact and exchange of material between mucosal surfaces⁽³⁾. M. fermentans may be transmitted by deer ticks⁽¹¹⁾.

INCUBATION PERIOD: Days to months depending of bacterium⁽²⁾.

COMMUNICABILITY: Since most human mycoplasmas are considered part of the normal human flora, their communicability is unknown⁽²⁾.

SECTION III - DISSEMINATION

RESERVOIR: Almost all animals may contain mycoplasmas⁽³⁾.

ZOONOSIS: Almost all animals may spread the pathogens to human, but it is rarely seen⁽³⁾. An unknown Mycoplasma spp. was responsible for zoonotic outbreaks in China since 1994⁽¹²⁾.

VECTORS: Deer ticks (Ixodes scapularis) have been reported to be a vector for M. fermentans⁽¹¹⁾.

SECTION IV – STABILTY AND VIABILITY

DRUG SUSCEPTIBILITY: Mycoplasmas are susceptible to tetracycline, macrolides, and lincosamides, and they are all resistant to penicillins and rifampin⁽⁴⁾.

SUSCEPTIBILITY TO DISINFECTANTS: Phenolic disinfectants, 1% sodium hypochlorite, 70% ethanol, formaldehyde, glutaraldehyde, iodophore, and peracedic acid are effective against Mycoplasma spp .⁽¹³⁾ .

PHYSICAL INACTIVATION: Mycoplasma spp. are inactivated by UV, microwave, gamma radiation, moist heat (121°C for at least 20 min) and dry heat (165-170°C for 2 h)^{(14,15,16,17)}.

SURVIVAL OUTSIDE HOST: If protected from evaporation, Mycoplasma spp . can survive for one hour in liquid specimen⁽¹⁸⁾.

SECTION V – FIRST AID / MEDICAL

SURVEILLANCE: Monitor for symptoms. Diagnosis can be confirmed with microbial culture and PCR⁽¹⁸⁾.

Note: All diagnostic methods are not necessarily available in all countries.

FIRST AID/TREATMENT: Give appropriate drug therapy⁽⁴⁾.

IMMUNIZATION: Vaccines are used in animals (e.g. cattle, goat, sheep, pigs, and poultry), but none are currently available for humans⁽¹⁹⁾.

PROPHYLAXIS: None available.

SECTION VI - LABORATORY HAZARDS

LABORATORY-ACQUIRED INFECTIONS: 13 LAIs reported, one caused by M. caviae and 12 caused by M. pulmonis up to 1971^(20,21).

SOURCES/SPECIMENS: Mycoplasmas may be found in blood, synovial fluid, urine, oro- pharynx, lower respiratory tract, bronchoalveolar lavage, amniotic fluid, cerebrospinal fluid, prostatic secretion, semen, wound aspirate, sputum, pleural fluid, swabs from naso-pharynx, cervix, vagina, wounds, urethra placenta, endometrium, bone chip, and urinary calculi, depending on the species and clinical conditions⁽¹⁸⁾.

PRIMARY HAZARDS: Laboratory workers should pay attention to droplets exposure of mucous membrane, infectious aerosol, parenteral inoculation, and ingestion⁽¹⁸⁾. Infections may also be transmitted by laboratory animals^(20,21).

SPECIAL HAZARDS: None.

SECTION VII – EXPOSURE CONTROLS / PERSONAL PROTECTION

RISK GROUP CLASSIFICATION: Risk Group 2⁽²²⁾. This risk group classification applies to the genus as a whole, but may not be representative of every species within the genus.

CONTAINMENT REQUIREMENTS: Containment Level 2 facilities, equipment, and operational practices for work involving infectious or potentially infectious materials, animals, or cultures. These containment requirements apply to the genus as a whole, and may not apply to each species within the genus.

PROTECTIVE CLOTHING: Lab coat. Gloves when direct skin contact with infected materials or animals is unavoidable. Eye protection must be used where there is a known or potential risk of exposure to slashes, and respirator should be used when exposed to infectious aerosols⁽²³⁾.

OTHER PRECAUTIONS: All procedures that may produce aerosols, or involve high concentrations or large volumes should be conducted in a biological safety cabinet (BSC). The use of needles, syringes, and other sharp objects should be strictly limited⁽²³⁾. Additional precautions should be considered with work involving animals or large scale activities.

SECTION VIII - HANDLING AND STORAGE

SPILLS: Allow aerosols to settle and, wearing protective clothing, gently cover spill with paper towels and apply appropriate disinfectant, starting at the perimeter and working towards the centre. Allow sufficient contact time before clean up (30 min)⁽²³⁾.

DISPOSAL: All material should be decontaminated before disposal with steam sterilization, incineration or chemical disinfection⁽²³⁾.

STORAGE: Samples and biological material should be store in appropriately labelled sealed containers⁽²³⁾.

SECTION IX – REGULATORION AND OTHER INFORMATION

REGULATORY INFORMATION: The import, transport, and use of pathogens in Canada is regulated under many regulatory bodies, including the Public Health Agency of Canada, Health Canada, Canadian Food Inspection Agency, Environment Canada, and Transport Canada. Users are responsible for ensuring they are compliant with all relevant acts, regulations, guidelines, and standards.

UPDATED: September 2010

PREPARED BY: Pathogen Regulation Directorate, Public Health Agency of Canada.

Although the information, opinions and recommendations contained in this Pathogen Safety Data Sheet are compiled from sources believed to be reliable, we accept no responsibility for the accuracy, sufficiency, or reliability or for any loss or injury resulting from the use of the information. Newly discovered hazards are frequent and this information may not be completely up to date.

Copyright ©
Public Health Agency of Canada, 2010
Canada

REFERENCES:

1. Waites, K. B., & Talkington, D. F. (2004). Mycoplasma pneumoniae and its role as a human pathogen. Clinical Microbiology Reviews, 17 (4), 697.
    
2. Taylor-Robinson, D. (1996). Infections due to species of Mycoplasma and Ureaplasma: an update. Clinical Infectious Diseases, 23 (4), 671-682.
    
3. Pitcher, D. G., & Nicholas, R. A. J. (2005). Mycoplasma host specificity: Fact or fiction? The Veterinary Journal, 170 (3), 300-306.
    
4. Taylor-Robinson, D., & Bebear, C. (1997). Antibiotic susceptibilities of mycoplasmas and treatment of mycoplasmal infections. Journal of Antimicrobial Chemotherapy, 40 (5), 622.
    
5. Charon, N. W. (2005). Mycoplasma takes a walk. Proceedings of the National Academy of Sciences of the United States of America, 102 (39), 13713-13714. doi:10.1073/pnas.0506508102
    
6. Waites, K. B. (2006). Mycoplasma and ureaplasma. Congenital and Perianal Infections (pp. 271-288) Springer.
    
7. Jensen, J. S. (2006). Mycoplasma genitalium infections. Dan.Med.Bull, 53 , 1-27.
    
8. Henrich, B., Schmitt, M., Bergmann, N., Zanger, K., Kubitz, R., Haussinger, D., & Pfeffer, K. (2010). Mycoplasma salivarium detected in a microbial community with Candida glabrata in the biofilm of an occluded biliary stent. Journal of Medical Microbiology, 59 (Pt 2), 239- 241. doi:10.1099/jmm.0.013110-0
    
9. Grisold, A. J., Hoenigl, M., Leitner, E., Jakse, K., Feierl, G., Raggam, R. B., & Marth, E. (2008). Submasseteric Abscess Caused by Mycoplasma Salivarium. Journal of Clinical Microbiology,
    
10. Afshar, B., Pitcher, D., Nicholas, R. A. J., & Miles, R. J. (2008). An evaluation of PCR methods to detect strains of Mycoplasma fermentans. Biologicals, 36 (2), 117-121. doi:DOI: 10.1016/j.biologicals.2007.07.003
     
11. Eskow, E., Adelson, M. E., Rao, R. V. S., & Mordechai, E. (2003). Evidence for disseminated Mycoplasma fermentans in New Jersey residents with antecedent tick attachment and subsequent musculoskeletal symptoms. JCR: Journal of Clinical Rheumatology, 9 (2), 77.
     
12. Hu, Z., Yin, J., Shen, K., Kang, W., & Chen, Q. (2009). Outbreaks of hemotrophic mycoplasma infections in China. Emerging Infectious Diseases, 15 (7), 1139-1140.
     
13. Collins, C. H., & Kennedy, D. A. (1999). Decontamination. Laboratory-Acquired Infections: History, Incidence, Causes and Prevention. (4th ed., pp. 160-186). London, UK: Buttersworth.
     
14. Katara, G., Hemvani, N., Chitnis, S., Chitnis, V., & Chitnis, D. S. (2008). Surface disinfection by exposure to germicidal UV light. Indian Journal of Medical Microbiology, 26 (3), 241-242.
     
15. Wu, Y., & Yao, M.Inactivation of bacteria and fungus aerosols using microwave irradiation. Journal of Aerosol Science, In Press, Corrected Proof doi:DOI: 10.1016/j.jaerosci.2010.04.004
     
16. Farkas, J. (1998). Irradiation as a method for decontaminating food. A review. International Journal of Food Microbiology, 44 (3), 189-204.
     
17. Csucos, M., & Csucos, C. (1999). Microbiological obseration of water and wastewater . United States: CRC Press.
     
18. Waites, K. B., Rikihisa, Y., & Taylor-Robinson, D. (2003). Mycoplasma and Ureaplasma . In P. R. Murray, E. J. Baron, M. A. Pfaller, J. H. Jorgensen & R. H. Yolken (Eds.), Manual of Clinical Microbiology (8th ed., pp. 972-990). Washington, D.C.: ASM Press.
     
19. Nicholas, R. A. J., Ayling, R. D., & McAuliffe, L. (2009). Vaccines for Mycoplasma Diseases in Animals and Man. Journal of Comparative Pathology, 140 (2-3), 85-96. doi:DOI: 10.1016/j.jcpa.2008.08.004
     
20. Hill, A. (1971). Accidental infection of man with Mycoplasma caviae. British Medical Journal, 2 (5763), 711.
     
21. Ferreira, J. B., Yamaguti, M., Marques, L. M., Oliveira, R. C., Neto, R. L., Buzinhani, M., & Timenetsky, J. (2008). Detection of Mycoplasma pulmonis in Laboratory Rats and Technicians. Zoonoses and Public Health, 55 (5), 229-234.
     
22. Human pathogens and toxins act. S.C. 2009, c. 24, Second Session, Fortieth Parliament, 57- 58 Elizabeth II, 2009. (2009).
     
23. Public Health Agency of Canada. (2004). In Best M., Graham M. L., Leitner R., Ouellette M. and Ugwu K. (Eds.), Laboratory Biosafety Guidelines (3rd ed.). Canada: Public Health Agency of Canada.