Yu Yefu, Wang Yanan, Mao Weifang, Wang Huiyu, Jin Faxiang, Xu Wenfang
Department of Clinical Laboratory, Affiliated Hospital of Shaoxing University, Shaoxing, 312000, People's Republic of China.
Infect Drug Resist. 2025 Aug 30;18:4549-4556. doi: 10.2147/IDR.S548195. eCollection 2025.
commonly colonizes the genitourinary tract and primarily affects immunocompromised individuals. It is mostly confined to localized infections, with bloodstream dissemination being rare. Because of its fastidious nutritional requirements, the organism is seldom recovered by routine blood culture, and the absence of a cell wall renders it intrinsically resistant to many first-line antimicrobials. Consequently, the diagnosis and treatment of bloodstream infections remain challenging.
A 72-year-old man developed persistent fever and marked systemic inflammation after lumbar spine surgery. Despite empirical broad-spectrum antibiotics, he progressed to severe incisional infection, pulmonary infection, and effusions in multiple serous cavities-including the left interlobar fissure, pleural space, and pericardium. Routine blood and urine cultures remained negative until two weeks after surgery, when was first isolated from incisional exudate and definitively identified by MALDI-TOF MS. The patient ultimately recovered after surgical debridement and combination therapy with doxycycline plus moxifloxacin. During this period, we used Mycoplasma-specific liquid media combined with Columbia blood agar and subsequently recovered from the patient's sputum, urethral swabs, and initially culture-negative blood samples. MALDI-TOF MS cluster analysis confirmed that all isolates belonged to a single clonal group responsible for disseminated infection.
Immunocompromised patients with postoperative indwelling catheters constitute a high-risk population for hematogenous dissemination of . In patients with persistent fever and negative routine cultures, infection should be actively suspected. Timely targeted mycoplasma culture and MALDI-TOF MS confirmation are essential.
通常定植于泌尿生殖道，主要影响免疫功能低下的个体。它大多局限于局部感染，血行播散很少见。由于其苛刻的营养需求，该菌很少通过常规血培养检出，且缺乏细胞壁使其对许多一线抗菌药物具有内在抗性。因此，血流感染的诊断和治疗仍然具有挑战性。
一名72岁男性在腰椎手术后出现持续发热和明显的全身炎症。尽管使用了经验性广谱抗生素，他仍进展为严重的切口感染、肺部感染以及多个浆膜腔积液，包括左叶间裂、胸腔和心包。常规血培养和尿培养一直为阴性，直到术后两周，才首次从切口渗出物中分离出该菌，并通过基质辅助激光解吸电离飞行时间质谱（MALDI-TOF MS）明确鉴定。患者最终在手术清创以及强力霉素加莫西沙星联合治疗后康复。在此期间，我们使用支原体特异性液体培养基结合哥伦比亚血琼脂，随后从患者痰液、尿道拭子以及最初培养阴性的血样中分离出该菌。MALDI-TOF MS聚类分析证实所有分离株属于导致播散性感染的单个克隆群。
术后留置导管的免疫功能低下患者是该菌血行播散的高危人群。对于持续发热且常规培养阴性的患者，应积极怀疑该菌感染。及时进行针对性的支原体培养和MALDI-TOF MS确认至关重要。
