The Resurgence of Mycoplasma Pneumonia: A Silent Threat

Verified By Dr. Swapnil Shikha | 16-Dec-2023

Mycoplasma pneumonia, a type of atypical pneumonia caused by the bacterium Mycoplasma pneumonia, has been making a notable resurgence in recent years. This respiratory infection is characterized by its unique features, diagnostic challenges, and a tendency to cause community outbreaks.

What is Mycoplasma Pneumonia?

Mycoplasma pneumonia is a form of atypical pneumonia caused by Mycoplasma pneumoniae, a bacterium that lacks a cell wall. This feature makes it resistant to common antibiotics like penicillin, as they primarily target bacterial cell walls. Mycoplasma pneumonia typically affects the upper and lower respiratory tracts, leading to symptoms such as cough, fever, headache, and chest pain.

Mycoplasma pneumonia commonly referred to as "walking pneumonia" reflects the perception that individuals infected with Mycoplasma pneumoniae can carry on with their routine tasks, including walking, despite being unwell. This is in contrast to more severe forms of pneumonia, which often result in significant debilitation and may require bed rest.

It's important to note that the term "walking pneumonia" does not imply that the infection should be taken lightly. While Mycoplasma pneumonia may be less severe than some other forms of pneumonia, it can still lead to complications, especially in vulnerable populations such as the elderly or those with weakened immune systems.

Global Scenario of Mycoplasma Pneumonia

With fresh memories of COVID-19, China experienced another spike in hospitalisations due to numerous cases of pneumonia among children.

In a global surveillance study published in  The Lancet Microbe journal , researchers have identified a resurgence of infections caused by the mycoplasma pneumonia bacteria in various regions, particularly in Europe and Asia. Overall, out of 149,980 tests conducted during the six-month period, M pneumonia was detected by PCR in 1,067 cases. Europe reported the most frequent detections, with Denmark, Sweden, Switzerland, Wales, and Slovenia leading the list. In Asia, Singapore recorded the highest number of cases at 172.

Surprisingly, the study observed the re-emergence of M. pneumonia more than three years after the introduction of COVID-19 pandemic restrictions. Its detection sharply declined worldwide following the implementation of NPIs against COVID-19 in March 2020.  Nevertheless, a slight increase in case numbers was noted in some countries during the last months of the third year (January to March 2023), prompting increased vigilance.

The Indian Scenario

India, like many other countries, has witnessed a rise in Mycoplasma pneumonia cases. The densely populated urban areas and the high prevalence of respiratory infections make India susceptible to outbreaks. Additionally, the challenges in accurate diagnosis and the availability of specific treatment contribute to the burden of Mycoplasma pneumonia in the country.

As per a study published in Lancet Microbe, a total of seven samples tested positive in India between April and September 2023. One of the cases was detected via a PCR test which was administered in the early stages of the infection. The remaining six cases were detected through the IgM Elisa test which can be administered at later stages of the infection. Out of the 67 tests conducted, seven samples tested positive.

However, an official statement from the Health Ministry has stated that none of these cases are been linked to bacteria causing a surge in China. "It is clarified that these seven cases have no link whatsoever to the recent surge in respiratory infections in children reported from some parts of the world, including China. The seven cases have been detected as a part of an ongoing study at AIIMS Delhi in the six month period (April to September 2023) and is no cause for worry,"  stated AIIMS New Delhi .

"Mycoplasma pneumonia is the commonest bacterial cause of community acquired pneumonia. It is the reason for nearly 15-30% of all such infections. Such a surge has not been reported from any part of India.," stated AIIMS New Delhi.

Diagnostic Challenges and Advances

Diagnosing Mycoplasma pneumonia presents unique challenges in front of Physicians due to its atypical nature. Traditional diagnostic methods, such as sputum culture, have limitations, as Mycoplasma pneumoniae is fastidious and may not grow well in standard laboratory conditions. Serological tests, including enzyme immunoassays and polymerase chain reaction (PCR), have become more common for its diagnosis.

Management Strategies

Effective management of Mycoplasma pneumonia involves a combination of antibiotics, supportive care and monitoring by your  nearest Physician  for complications. Macrolides, tetracyclines, and fluoroquinolones are commonly prescribed, but antibiotic resistance is a growing concern. Healthcare providers must carefully consider the choice of antibiotics based on local resistance patterns and individual patient factors. Supportive care, including rest, hydration, and over-the-counter medications for symptom relief, plays a crucial role in managing Mycoplasma pneumonia. Complications, such as respiratory distress or secondary bacterial infections, may require hospitalization and more intensive interventions.

Preventive Measures

Individuals can reduce their risk of Mycoplasma pneumonia by practicing good respiratory hygiene, including regular handwashing, avoiding close contact with infected individuals, and using masks in crowded or high-risk settings. Vaccination, although not widely available, remains an area of research and development that could offer a promising preventive strategy in the future.