The rare pathogen Mycoplasma amphoriforme causes infectious diseases in patients with primary antibody deficiency (PAD). This pathogen was first isolated from a patient with X-linked agammaglobulinemia in 1999. At the same time, very little is known about the natural development of the infectious process caused by this microorganism, as well as its ability to spread in a vulnerable patient population.

Scientists at the University of St. Andrews (University of St Andrews, St. Andrews, Fife, UK) analyzed the medical records of patients with primary antibody immunodeficiency and the complete genome sequence in 9 of 17 M. amphoriforme isolated from these patients. During the study, quantitative PCR was used to determine the bacterial load in sputum samples collected sequentially from 9 patients. The genomes of all available isolates were obtained from patients in the United Kingdom, France and Tunisia and sequenced to determine the genus of the pathogen.

Sputum samples were taken over a period of 2 to 5 years from patients with chronic productive cough and, in some cases, with a large volume of sputum. Half of the patients showed signs of obstructive pulmonary disease due to infection with M. amphoriforme. Using high sensitivity whole genome sequencing (WGS) data, it has been shown that patients can be chronically infected with M. amphoriforme, which manifests as a recurrent bacterial load- remitting, alternating with periods when the microorganism is not detected in the sputum.

Since most of the strains are M. amphoriforme was isolated from hospital patients, this may indicate an unrecognized outbreak of nosocomial infection in immunocompromised patients. It is important to note that the study revealed the spread of strains in the clinical environment of patients. Mutations leading to the emergence of resistance, accumulated in strains of microorganisms obtained from patients who have received antibiotic therapies several times.

Thus, the microorganisms Mycoplasma amphoriforme are the species responsible for a chronic infection with a recurrent-relapsing course in patients with a primary antibody deficiency. The study obtained strong evidence of the spread of this microorganism between patients visiting the same clinic, indicating the need for an examination to identify this microorganism in patients potentially susceptible to the development of this infection.