Microbiology Unit.
Department of Infectious Diseases, The Alfred Hospital and Monash University.
Clin Infect Dis. 2017 Oct 16;65(9):1504-1508. doi: 10.1093/cid/cix601.
Invasive and disseminated Mycoplasma hominis infections are well recognized but uncommon complications in solid organ transplant recipients. In a single center, a cluster of M. hominis infections were identified in lung transplant recipients from the same thoracic intensive care unit (ICU). We sought to determine the source(s) of these infections.
Medical records of the donor and infected transplant recipients were reviewed for clinical characteristics. Clinical specimens underwent routine processing with subculture on Mycoplasma-specific Hayflick agar. Mycoplasma hominis identification was confirmed using sequencing of the 16S ribosomal RNA gene. Mycoplasma hominis isolates were subjected to whole-genome sequencing on the Illumina NextSeq platform.
Three lung transplant recipients presented with invasive M. hominis infections at multiple sites characterized by purulent infections without organisms detected by Gram staining. Each patient had a separate donor; however, pretransplant bronchoalveolar lavage fluid was only available from the donor for patient 1, which subsequently grew M. hominis. Phylo- and pangenomic analyses indicated that the isolates from the donor and the corresponding recipient (patient 1) were closely related and formed a distinct single clade. In contrast, isolates from patients 2 and 3 were unrelated and divergent from one another.
Mycoplasma hominis should be considered a cause of donor-derived infection. Genomic data suggest donor-to-recipient transmission of M. hominis. Additional patients co-located in the ICU were found to have genetically unrelated M. hominis isolates, excluding patient-to-patient transmission.
侵袭性和播散性人型支原体感染是实体器官移植受者中公认但罕见的并发症。在一个单一的中心，从同一个胸重症监护病房（ICU）的肺移植受者中发现了一组人型支原体感染。我们试图确定这些感染的来源。
回顾供体和感染移植受者的病历，以了解临床特征。对临床标本进行常规处理，在支原体特异性 Hayflick 琼脂上进行亚培养。使用 16S 核糖体 RNA 基因测序确认人型支原体的鉴定。对人型支原体分离株进行 Illumina NextSeq 平台的全基因组测序。
三名肺移植受者在多个部位出现侵袭性人型支原体感染，表现为化脓性感染，革兰氏染色未检出病原体。每位患者都有单独的供体；然而，只有患者 1的供体有移植前支气管肺泡灌洗液，随后该灌洗液中生长出人型支原体。系统发育和全基因组分析表明，供体和相应受者（患者 1）的分离株密切相关，并形成一个独特的单分支。相比之下，患者 2 和 3 的分离株彼此无关，且存在差异。
人型支原体应被视为供体源性感染的原因。基因组数据表明存在人型支原体从供体到受者的传播。在 ICU 中发现了其他具有遗传上无关的人型支原体分离株的患者，排除了患者间的传播。
