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Background  Increasing evidence incriminates bacteria, especially  Mycoplasma fermentans , as possible arthritogenic agents in humans. The purpose of this study was to investigate  M. fermentans  in the bloodstream of patients with rheumatoid arthritis.    Methods  Two hundred and nineteen blood samples from patients with rheumatoid arthritis, systemic lupus erythematosus, antiphospholipid syndrome, and healthy individuals were screened by bacterial culture and direct PCR in order to detect mycoplasmas; IgM and IgG against  M. fermentans  PG18 were also detected by ELISA and Immunoblotting assays in patients with rheumatoid arthritis and healthy individuals.    Results  Blood samples from patients with antiphospholipid syndrome and healthy individuals were negative for mycoplasma by culture or direct PCR. In blood samples from patients with systemic lupus erythematosus were detected by direct PCR  M. fermentans  in 2/50 (2%),  M. hominis  in 2/50 (2%) and  U. urealyticum  in 1/50 (0.5%). In patients with RA  M. fermentans  was detected by culture in 13/87 blood samples and in 13/87 by direct PCR, however, there was only concordance between culture and direct PCR in six samples, so  M. fermentans  was detected in 20/87(23%) of the blood samples from patients with RA by either culture or PCR. Antibody-specific ELISA assay to  M. fermentans  PG18 was done, IgM was detected in sera from 40/87 patients with RA and in sera of 7/67 control individuals, IgG was detected in sera from 48/87 RA patients and in sera from 7/67 healthy individuals. Antibody-specific immunoblotting to  M. fermentans  PG18 showed IgM in sera from 35/87 patients with RA and in sera from 4/67 healthy individuals, IgG was detected in sera from 34/87 patients and in sera from 5/67 healthy individuals.    Conclusion  Our findings show that only  M. fermentans  produce bacteremia in a high percentage of patients with RA. This finding is similar to those reported in the literature. IgM and IgG against  M. fermentans  PG18 were more frequent in patients with RA than healthy individuals.

bmc musculoskeletal disorders

Presence of Mycoplasma fermentans in the bloodstream of Mexican patients with rheumatoid arthritis and IgM and IgG antibodies against whole microorganism