Detection and characterization of Mycoplasma pneumoniae during an outbreak of respiratory illness at a university

Abstract

An outbreak at a university in Georgia was identified after 83 cases of probable pneumonia were reported among students. Respiratory specimens were obtained from 21 students for the outbreak investigation. The TaqMan array card (TAC), a quantitative PCR (qPCR)-based multipathogen detection technology, was used to initially identify Mycoplasma pneumoniae as the causative agent in this outbreak. TAC demonstrated 100% diagnostic specificity and sensitivity compared to those of the multiplex qPCR assay for this agent. All M. pneumoniae specimens (n=12) and isolates (n=10) were found through genetic analysis to be susceptible to macrolide antibiotics. The strain diversity of M. pneumoniae associated with this outbreak setting was identified using a variety of molecular typing procedures, resulting in two P1 genotypes (types 1 [60%] and 2 [40%]) and seven different multilocus variable-number tandem-repeat analysis (MLVA) profiles. Continued molecular typing of this organism, particularly during outbreaks, may enhance the current understanding of the epidemiology of M. pneumoniae and may ultimately lead to a more effective public health response.

FIG 1

All agents detected by TAC according to the result of M. pneumoniae qPCR. *, Coronavirus type 3 was detected in the follow-up swab specimen. The patient specimen was initially positive for M. pneumoniae and then negative for M. pneumoniae in the follow-up swab collected 5 weeks after the initial specimen. The total number of specimens tested with the TAC was 22.

FIG 2

Distribution of MLVA types in this outbreak: comparison of MLVA typing based on five loci (A) or four loci (B).