肺炎支原体导致高达20% 的社区获得性肺炎病例,并且还与一些医院流行病有关联。呼吸道感染主要发生在儿童和年轻成人中,常见于人口密集的社区环境中,例如寄宿学校、大学和军事基地。报告显示,在世界某些地区,婴儿可能是主要感染群体。[17]Xu YC, Zhu LJ, Xu D, et al. Epidemiological characteristics and meteorological factors of childhood Mycoplasma pneumoniae pneumonia in Hangzhou. World J Pediatr. 2011;7:240-244.http://www.ncbi.nlm.nih.gov/pubmed/21822990?tool=bestpractice.com[18]Gadsby NJ, Reynolds AJ, McMenamin J, et al. Increased reports of Mycoplasma pneumoniae from laboratories in Scotland in 2010 and 2011 - impact of the epidemic in infants. Euro Surveill. 2012;17:pii:20110.http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20110http://www.ncbi.nlm.nih.gov/pubmed/22433597?tool=bestpractice.com 在一些国家中,夏末和秋季的发病率相对升高。[17]Xu YC, Zhu LJ, Xu D, et al. Epidemiological characteristics and meteorological factors of childhood Mycoplasma pneumoniae pneumonia in Hangzhou. World J Pediatr. 2011;7:240-244.http://www.ncbi.nlm.nih.gov/pubmed/21822990?tool=bestpractice.com[19]Chalker V, Stocki T, Litt D, et al. Increased detection of Mycoplasma pneumoniae infection in children in England and Wales, October 2011 to January 2012. Euro Surveill. 2012;17:pii:20081.http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20081http://www.ncbi.nlm.nih.gov/pubmed/22340973?tool=bestpractice.com[20]Nir-Paz R, Abutbul A, Moses AE, et al. Ongoing epidemic of Mycoplasma pneumoniae infection in Jerusalem, Israel, 2010 to 2012. Euro Surveill. 2012;17:pii:20095.http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20095http://www.ncbi.nlm.nih.gov/pubmed/22401504?tool=bestpractice.com[21]Uldum SA, Bangsborg JM, Gahrn-Hansen B, et al. Epidemic of Mycoplasma pneumoniae infection in Denmark, 2010 and 2011. Euro Surveill. 2012;17:pii:20073.http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20073http://www.ncbi.nlm.nih.gov/pubmed/22321137?tool=bestpractice.com 流行通常每隔3 至 5 年发生,并且被认为是多克隆性。[19]Chalker V, Stocki T, Litt D, et al. Increased detection of Mycoplasma pneumoniae infection in children in England and Wales, October 2011 to January 2012. Euro Surveill. 2012;17:pii:20081.http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20081http://www.ncbi.nlm.nih.gov/pubmed/22340973?tool=bestpractice.com[22]Pereyre S, Charron A, Hidalgo-Grass C, et al. The spread of Mycoplasma pneumoniae is polyclonal in both an endemic setting in France and in an epidemic setting in Israel. PLoS One. 2012;7:38585.http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0038585http://www.ncbi.nlm.nih.gov/pubmed/22701675?tool=bestpractice.com 对于上呼吸道感染中肺炎支原体的精确患病率知之甚少,但是此类型感染被认为较常见。[23]Esposito S, Bosis S, Begliatti E, et al. Acute tonsillopharyngitis associated with atypical bacterial infection in children: natural history and impact of macrolide therapy. Clin Infect Dis. 2006;43:206-209.http://cid.oxfordjournals.org/content/43/2/206.fullhttp://www.ncbi.nlm.nih.gov/pubmed/16779748?tool=bestpractice.com[24]Jain S, Williams DJ, Arnold SR, et al. Community-acquired pneumonia requiring hospitalization among US children. N Engl J Med. 2015;372:835-845.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4697461/http://www.ncbi.nlm.nih.gov/pubmed/25714161?tool=bestpractice.com 已注意到此病原体的带菌状态可能较常见于儿科人群中,[25]Spuesens EB, Fraaij PL, Visser EG, et al. Carriage of Mycoplasma pneumoniae in the upper respiratory tract of symptomatic and asymptomatic children: an observational study. PLoS Med. 2013;10:e1001444.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3653782/http://www.ncbi.nlm.nih.gov/pubmed/23690754?tool=bestpractice.com但一些研究无法证实此类带菌状态。[24]Jain S, Williams DJ, Arnold SR, et al. Community-acquired pneumonia requiring hospitalization among US children. N Engl J Med. 2015;372:835-845.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4697461/http://www.ncbi.nlm.nih.gov/pubmed/25714161?tool=bestpractice.com在遍及国家范围的流行情况下,应考虑到重度肺炎支原体感染会导致入住 ICU 的患者数量增加。[26]Ferguson GD, Gadsby NJ, Henderson SS, et al. Clinical outcomes and macrolide resistance in Mycoplasma pneumoniae infection in Scotland, UK. J Med Microbiol. 2013;62:1876-1882.http://www.ncbi.nlm.nih.gov/pubmed/24008501?tool=bestpractice.com
多达 80% 的性生活活跃女性可见生殖道支原体(脲原体、生殖支原体人型支原体,但大多数情况下,这些细菌不导致活动性感染。但是,生殖支原体导致多达20% 的非淋菌性尿道炎、[27]Shahmanesh M, Moi H, Lassau F, et al. 2009 European guideline on the management of male non-gonococcal urethritis. Int J STD AIDS. 2009;20:458-464.http://ijsa.rsmjournals.com/cgi/content/full/20/7/458http://www.ncbi.nlm.nih.gov/pubmed/19541886?tool=bestpractice.com[28]Taylor-Robinson D, Jensen JS. Mycoplasma genitalium: from Chrysalis to multicolored butterfly. Clin Microbiol Rev. 2011;24:498-514.http://www.ncbi.nlm.nih.gov/pubmed/21734246?tool=bestpractice.com宫颈炎、[28]Taylor-Robinson D, Jensen JS. Mycoplasma genitalium: from Chrysalis to multicolored butterfly. Clin Microbiol Rev. 2011;24:498-514.http://www.ncbi.nlm.nih.gov/pubmed/21734246?tool=bestpractice.com[29]Bjartling C, Osser S, Persson K. The association between Mycoplasma genitalium
and pelvic inflammatory disease after termination of pregnancy. BJOG. 2010;117:361-364.http://www.ncbi.nlm.nih.gov/pubmed/20015303?tool=bestpractice.com 及妊娠后PID。[28]Taylor-Robinson D, Jensen JS. Mycoplasma genitalium: from Chrysalis to multicolored butterfly. Clin Microbiol Rev. 2011;24:498-514.http://www.ncbi.nlm.nih.gov/pubmed/21734246?tool=bestpractice.com[30]Gaydos C, Maldeis NE, Hardick A, et al. Mycoplasma genitalium as a contributor to the multiple etiologies of cervicitis in women attending sexually transmitted disease clinics. Sex Transm Dis. 2009;36:598-606.http://www.ncbi.nlm.nih.gov/pubmed/19704398?tool=bestpractice.com 研究表明,HIV 阳性患者中生殖支原体感染患病率更高。[31]Mavedzenge SN, Van Der Pol B, Weiss HA, et al. The association between Mycoplasma genitalium and HIV-1 acquisition in African women. AIDS. 2012;26:617-624.http://www.ncbi.nlm.nih.gov/pubmed/22210630?tool=bestpractice.com[32]Vandepitte J, Muller E, Bukenya J, et al. Prevalence and correlates of Mycoplasma genitalium infection among female sex workers in Kampala, Uganda. J Infect Dis. 2012;205:289-296.http://jid.oxfordjournals.org/content/205/2/289.longhttp://www.ncbi.nlm.nih.gov/pubmed/22102734?tool=bestpractice.com 泌尿生殖道感染的患病率与较差的社会经济状况、多个性伴侣及非洲裔美国人种族相关。[2]Waites KB, Katz B, Schelonka RL. Mycoplasmas and ureaplasmas as neonatal pathogens. Clin Microbiol Rev. 2005;18:757-789.http://cmr.asm.org/content/18/4/757.fullhttp://www.ncbi.nlm.nih.gov/pubmed/16223956?tool=bestpractice.com