GUIDELINE for Haemoplasmosis in Cats
貓血漿體症指南

Published: 01/01/2018  發佈日期:2018 年 1 月 1 日
Last updated: 04/04/2025
最後更新:2025 年 4 月 4 日

Last reviewed:   最後審閱:

The Haemoplasmosis in Cats Guideline was published by Séverine Tasker et al. in the Journal of Feline Medicine and Surgery 20, 2018, 256-261, http://journals.sagepub.com/doi/pdf/10.1177/1098612X18758594. This update was authored by Séverine Tasker and ABCD colleagues.
《貓血漿體症指南》由 Séverine Tasker 等人發表於《貓科醫學與外科雜誌》第 20 卷(2018 年)256-261 頁,網址:http://journals.sagepub.com/doi/pdf/10.1177/1098612X18758594。本次更新由 Séverine Tasker 與 ABCD 團隊成員共同撰寫。

Key points  重點摘要

    • Haemoplasmas are bacteria that attach themselves to the surface of red blood cells and can induce haemolysis, sometimes resulting in anaemia.
      血漿體是附著於紅血球表面的細菌,可能誘發溶血反應,有時會導致貧血。
    • Mycoplasma haemofelis is the most pathogenic of the three feline haemoplasma species.
      Mycoplasma haemofelis 是三種貓血漿體菌種中致病性最強的。
    • Candidatus Mycoplasma haemominutum’ and ‘Candidatus Mycoplasma turicensis’ infections are less pathogenic but can result in disease, especially in immunocompromised cats or cats with concurrent disease.
      「暫定黴漿菌血紅素微小種」(‘Candidatus Mycoplasma haemominutum’)與「暫定黴漿菌血紅素圖里種」(‘Candidatus Mycoplasma turicensis’)感染雖致病性較低,但仍可能引發疾病,特別是在免疫缺陷貓隻或併發其他疾病的貓隻身上。
    • Male non-pedigree cats of increasing age with outdoor access are more likely to be haemoplasma-infected.
      年長、非純種且具戶外活動習慣的公貓感染血漿菌的風險較高。
    • The natural mode of transmission of haemoplasma infection is not known; aggressive interactions and vertical transmission are possible routes.
      血漿菌感染的自然傳播途徑尚未明確,可能透過攻擊性互動或垂直傳播等途徑感染。
    • Transmission by blood transfusion can occur and all blood donors should be screened for haemoplasma infection.
      輸血可能傳播血漿支原體感染,所有捐血貓都應進行血漿支原體篩檢。
    • The evidence for transmission by vectors is very poor and it is unlikely that fleas act as vectors.
      目前極少證據支持病媒傳播途徑,跳蚤作為傳播媒介的可能性很低。
    • Polymerase chain reaction (PCR) assays are the preferred diagnostic method for haemoplasma infections.
      聚合酶鏈反應(PCR)檢測是診斷血漿支原體感染的首選方法。
    • Cats chronically infected with haemoplasmas do not usually show clinical signs of infection – subclinical infections can exist for all three feline haemoplasma species.
      慢性感染血漿支原體的貓通常不會表現臨床症狀——三種貓血漿支原體都可能存在亞臨床感染。
    • Treatment with doxycycline for 2 weeks is usually effective for the treatment of haemofelis-associated clinical disease, but doxycycline treatment does not always clear infection completely, even if clinical signs resolve. A protocol comprising 4 weeks of doxycycline, followed by 2 weeks of marbofloxacin for those cats that are still PCR-positive after the doxycycline treatment, has been described to clear chronic M. haemofelis infection. This protocol can be considered if clinical disease is severe and/or recurrent and/or when concurrent disease is present.
      使用多西環素治療 2 週通常對治療由血巴東體(haemofelis)引起的臨床疾病有效,但多西環素治療並不能完全清除感染,即使臨床症狀已緩解。對於慢性 M. haemofelis 感染,有文獻描述一種治療方案:先進行 4 週的多西環素治療,隨後對在多西環素治療後仍呈 PCR 陽性的貓咪,再給予 2 週的馬波沙星治療。若臨床疾病嚴重且/或反覆發作,且/或同時存在其他疾病時,可考慮採用此治療方案。
    • We do not recommend the use of corticosteroids for the treatment of haemoplasmosis unless a cat with a positive Coombs’ test fails to respond to appropriate antibiotic treatment alone and the diagnosis of haemoplasmosis is uncertain. In such cases, immune-mediated haemolytic anaemia could be the cause of the cat’s anaemia.
      除非貓咪的庫姆斯試驗(Coombs’ test)呈陽性且單獨使用適當抗生素治療無效,同時血巴東體病的診斷尚不確定,否則我們不建議使用皮質類固醇治療血巴東體病。在此類情況下,免疫介導性溶血性貧血可能是導致貓咪貧血的原因。
    • Treatment of healthy subclinical infections with any haemoplasma species, in which cats do not show any clinical signs, is not recommended.
      對於任何血巴東體物種引起的健康亞臨床感染(即貓咪未表現出任何臨床症狀),不建議進行治療。
    • Little information is currently available on the antibiotic responsiveness of ‘ M. haemominutum’ and ‘Ca. M. turicensis’.
      目前關於「M. haemominutum」和「Ca. M. turicensis」對抗生素反應性的資訊仍相當有限。

Agent properties  病原特性

The haemoplasmas are haemotropic mycoplasmas, bacteria that parasitize red blood cells and can induce haemolytic anaemia. The haemoplasmas were initially classified as rickettsial organisms within the Haemobartonella and Eperythrozoon genera, but sequence analysis of the 16S rRNA gene of haemoplasmas resulted in their reclassification within the genus Mycoplasma in the Mycoplasmataceae family (Neimark et al., 2001; Messick et al., 2002; Neimark et al., 2002). However, research suggests that although the haemoplasmas probably do belong to this family, they might be better placed in their own separate genus (Hicks et al., 2014a). In contrast to many ‘classical’ mycoplasmas, haemoplasmas are uncultivable. Their propagation is possible in living animals only, but not yet in vitro.
血漿菌是血性支原體,這類細菌會寄生在紅血球上並可能引發溶血性貧血。血漿菌最初被歸類為立克次體目下的血巴爾通體屬(Haemobartonella)和附紅血球體屬(Eperythrozoon),但透過對血漿菌 16S rRNA 基因的序列分析,現已將其重新分類為支原體科(Mycoplasmataceae)中的支原體屬(Mycoplasma)(Neimark 等人,2001;Messick 等人,2002;Neimark 等人,2002)。然而,研究顯示雖然血漿菌很可能確實屬於該科,但或許更適合歸類於其獨立的屬(Hicks 等人,2014a)。與許多「典型」支原體不同,血漿菌無法進行培養。它們只能在活體動物中繁殖,目前尚無法在體外培養。

The three main haemoplasma species known to infect cats are Mycoplasma haemofelis, ‘Candidatus Mycoplasma haemominutum’ and ‘Candidatus Mycoplasma turicensis’. These mycoplasmas have a worldwide distribution. A canine haemoplasma species-like organism, described as ‘Candidatus Mycoplasma haematoparvum’-like, has also been reported in a small number of cats in two studies (Sykes et al., 2007a; Martinez-Diaz et al., 2013). A bovine haemoplasma species, Mycoplasma wenyonii, was also reported in a cat in Turkey (Ceylan et al., 2024b). The clinical importance of these haemoplasma species in cats remains unclear.
已知會感染貓的主要血漿支原體有三種:貓血支原體(Mycoplasma haemofelis)、「暫定血漿支原體微小亞種」(‘Candidatus Mycoplasma haemominutum’)及「暫定血漿支原體蘇黎世亞種」(‘Candidatus Mycoplasma turicensis’)。這些支原體具有全球性分布。另有兩項研究(Sykes 等人,2007a;Martinez-Diaz 等人,2013)報告指出,在少數貓隻中發現一種類似犬血漿支原體的生物體,被描述為「暫定血漿支原體副血亞種」樣生物(‘Candidatus Mycoplasma haematoparvum’-like)。土耳其亦有案例報告(Ceylan 等人,2024b)在貓隻中檢測到牛源血漿支原體(Mycoplasma wenyonii)。這些血漿支原體物種對貓的臨床重要性目前尚不明確。

Epidemiology  流行病學

Prevalence  盛行率

In general, studies that evaluated domestic cats for the presence of all three of the feline haemoplasma species by PCR, found that ‘Ca. M. haemominutum’ is more prevalent (4.4 – 46.7% of cats are infected) than M. haemofelis (0.4 – 27.0% of cats) and ‘Ca. M. turicensis’ (0 – 26.0% of cats). Reported prevalences vary with geographical variation and also differ quite widely, likely because the cats sampled in different studies are very variable, i.e. some studies test only ill anaemic cats, whereas others sample only healthy cats, some test stray feral cats whereas others focus on owned cats registered with veterinary clinics.
一般而言,透過 PCR 檢測評估家貓是否感染三種貓血漿菌種的研究發現,'暫定血漿菌小種'('Ca. M. haemominutum')的感染率(4.4%-46.7%的貓隻)高於貓血漿菌(M. haemofelis)(0.4%-27.0%的貓隻)和'暫定血漿菌土種'('Ca. M. turicensis')(0%-26.0%的貓隻)。報告的盛行率會因地理差異而有所不同,且差異幅度相當大,這可能是因為不同研究中所採樣的貓隻存在很大變異性,例如有些研究僅檢測患病貧血貓隻,而有些則只採樣健康貓隻;部分研究檢測流浪野貓,另一些則專注於獸醫診所登記的家養貓隻。

Feline haemoplasma infections have been identified in prevalence studies performed worldwide, including in and around Europe: Cyprus (Attipa et al., 2017), Denmark (Rosenqvist et al., 2016), Germany (Bauer et al., 2008; Bergmann et al., 2017), Iran (Ghazisaeedi et al., 2014; Hoseinpoor et al., 2024), Ireland (Juvet et al., 2010), Italy (Gentilini et al., 2009; Persichetti et al., 2016; Ravagnan et al., 2017; Persichetti et al., 2018; Latrofa et al., 2020), Latvia (Berzina et al., 2021), Lithuania (Razgūnaitė et al., 2024), Malta (Mifsud et al., 2020), Portugal (Martinez-Diaz et al., 2013; Mesa-Sanchez et al., 2021), Romania (Imre et al., 2020), Serbia (Sarvani et al., 2018), Russia (Demkin and Kazakov, 2021), Spain (Roura et al., 2010; Ravicini et al., 2016; Diaz-Reganon et al., 2018; Mesa-Sanchez et al., 2021; Villanueva-Saz et al., 2023), Switzerland (Willi et al., 2006a), Turkey (Ural et al., 2009; Cetinkaya et al., 2016; Ceylan et al., 2024a) and the UK (Tasker et al., 2003; Willi et al., 2006b; Peters et al., 2008).
貓血漿體感染已在全球進行的盛行率研究中被確認,包括歐洲及其周邊地區:賽普勒斯(Attipa 等人,2017)、丹麥(Rosenqvist 等人,2016)、德國(Bauer 等人,2008;Bergmann 等人,2017)、伊朗(Ghazisaeedi 等人,2014;Hoseinpoor 等人,2024)、愛爾蘭(Juvet 等人,2010)、義大利(Gentilini 等人,2009;Persichetti 等人,2016;Ravagnan 等人,2017;Persichetti 等人,2018;Latrofa 等人,2020)、拉脫維亞(Berzina 等人,2021)、立陶宛(Razgūnaitė等人,2024)、馬爾他(Mifsud 等人,2020)、葡萄牙(Martinez-Diaz 等人,2013;Mesa-Sanchez 等人,2021)、羅馬尼亞(Imre 等人,2020)、塞爾維亞(Sarvani 等人,2018)、俄羅斯(Demkin 和 Kazakov,2021)、西班牙(Roura 等人,2010;Ravicini 等人,2016;Diaz-Reganon 等人,2018;Mesa-Sanchez 等人,2021;Villanueva-Saz 等人,2023)、瑞士(Willi 等人,2006a)、土耳其(Ural 等人,2009;Cetinkaya 等人,2016;Ceylan 等人,2024a)和英國(Tasker 等人,2003;Willi 等人,2006b;Peters 等人,2008)。

Haemoplasma infections in various wild felid species, including European wildcats, have also been documented around the world (Willi et al., 2007c; Andre et al., 2011; Krengel et al., 2013; Ribeiro et al., 2017; Kellner et al., 2018; Sacristan et al., 2019; Unterköfler et al., 2022; Alves et al., 2023; Souza et al., 2025).
全球各地已記錄到多種野生貓科動物(包括歐洲野貓)感染血漿支原體(Willi 等,2007c;Andre 等,2011;Krengel 等,2013;Ribeiro 等,2017;Kellner 等,2018;Sacristan 等,2019;Unterköfler 等,2022;Alves 等,2023;Souza 等,2025)。

Predisposing factors  誘發因素

Risk factors (Barker and Tasker, 2023) for haemoplasma infection have been studied in many cat populations.
在多個貓群體中已研究出血漿菌感染的風險因素(Barker 與 Tasker,2023)。

Varied results were obtained due to differences between the studies; these include sample size, which haemoplasma species was tested for, risk factor information collected and whether the information source was reliable, and the statistical analysis methods employed in the studies (e.g. univariable or multivariable analysis).
由於研究間存在差異(包括樣本量大小、檢測的血漿菌種類、收集的風險因素資訊及其來源可靠性,以及採用的統計分析方法[如單變量或多變量分析]),各研究結果呈現多樣性。

However, amongst the different studies, a number of characteristics have emerged as being risk factors for haemoplasma infection.
然而,在不同研究中,已發現多項特徵是貓血漿體感染的風險因子。

Being male was a risk factor for haemoplasma infection in many studies (Tasker et al., 2003; Luria et al., 2004; Tasker et al., 2004; Willi et al., 2006a; Willi et al., 2006b; Bauer et al., 2008; Sykes et al., 2008; Roura et al., 2010; Tanahara et al., 2010; Stojanovic and Foley, 2011; Georges et al., 2012; Lobetti and Lappin, 2012; Aquino et al., 2014; Ghazisaeedi et al., 2014; Raimundo et al., 2016; Walker Vergara et al., 2016; Bergmann et al., 2017; Ravagnan et al., 2017; Diaz-Reganon et al., 2018; Makino et al., 2018; Marcondes et al., 2018; Sarvani et al., 2018; Latrofa et al., 2020; Berzina et al., 2021; Demkin and Kazakov, 2021; Manvell et al., 2021; da Rosa Maciel et al., 2023; Villanueva-Saz et al., 2023; Carvalho et al., 2024; Roels et al., 2024; Safwat et al., 2025) but gender was not a risk factor in others (Inokuma et al., 2004; Bauer et al., 2008; Gentilini et al., 2009; Nibblett et al., 2009; Juvet et al., 2010; Maher et al., 2010; Nibblett et al., 2010; Martinez-Diaz et al., 2013; Firmino et al., 2016; Rosenqvist et al., 2016; Sacristan et al., 2019; Do et al., 2020; Imre et al., 2020; Razgūnaitė et al., 2024) and in one study being female increased the risk of being haemoplasma infected (Hoseinpoor et al., 2024).
在多項研究中,雄性被證實是感染血漿體(haemoplasma)的風險因素(Tasker 等人,2003;Luria 等人,2004;Tasker 等人,2004;Willi 等人,2006a;Willi 等人,2006b;Bauer 等人,2008;Sykes 等人,2008;Roura 等人,2010;Tanahara 等人,2010;Stojanovic 和 Foley,2011;Georges 等人,2012;Lobetti 和 Lappin,2012;Aquino 等人,2014;Ghazisaeedi 等人,2014;Raimundo 等人,2016;Walker Vergara 等人,2016;Bergmann 等人,2017;Ravagnan 等人,2017;Diaz-Reganon 等人,2018;Makino 等人,2018;Marcondes 等人,2018;Sarvani 等人,2018;Latrofa 等人,2020;Berzina 等人,2021;Demkin 和 Kazakov,2021;Manvell 等人,2021;da Rosa Maciel 等人,2023;Villanueva-Saz 等人,2023;Carvalho 等人,2024;Roels 等人,2024;Safwat 等人,2025),但在其他研究中性別並非風險因素(Inokuma 等人,2004;Bauer 等人,2008;Gentilini 等人,2009;Nibblett 等人,2009;Juvet 等人,2010;Maher 等人,2010;Nibblett 等人,2010;Martinez-Diaz 等人,2013;Firmino 等人,2016;Rosenqvist 等人,2016;Sacristan 等人,2019;Do 等人,2020;Imre 等人,2020;Razgūnaitė等人,2024),且在一項研究中,雌性反而增加了感染血漿體的風險(Hoseinpoor 等人,2024)。

Non-pedigree breeds were at increased risk in some studies (Tasker et al., 2004; Nibblett et al., 2009; Rosenqvist et al., 2016; Makino et al., 2018; Sarvani et al., 2018), but not others (Gentilini et al., 2009; Nibblett et al., 2010; Roura et al., 2010; Martinez-Diaz et al., 2013; Makino et al., 2018; Imre et al., 2020; Carvalho et al., 2024).
在某些研究中,非純種貓的感染風險較高(Tasker 等人,2004;Nibblett 等人,2009;Rosenqvist 等人,2016;Makino 等人,2018;Sarvani 等人,2018),但其他研究則未發現此關聯(Gentilini 等人,2009;Nibblett 等人,2010;Roura 等人,2010;Martinez-Diaz 等人,2013;Makino 等人,2018;Imre 等人,2020;Carvalho 等人,2024)。

Having outdoor access increased the risk of haemoplasma infection in most reports (Willi et al., 2006a; Sykes et al., 2007a; Roura et al., 2010; Walker Vergara et al., 2016; Attipa et al., 2017; Bergmann et al., 2017; Diaz-Reganon et al., 2018; Sarvani et al., 2018; Imre et al., 2020) but not all (Martinez-Diaz et al., 2013; da Rosa Maciel et al., 2023).
多數報告指出,戶外活動會增加貓隻感染血漿體菌的風險(Willi 等人,2006a;Sykes 等人,2007a;Roura 等人,2010;Walker Vergara 等人,2016;Attipa 等人,2017;Bergmann 等人,2017;Diaz-Reganon 等人,2018;Sarvani 等人,2018;Imre 等人,2020),但並非所有研究都支持此結論(Martinez-Diaz 等人,2013;da Rosa Maciel 等人,2023)。

Increasing age was sometimes identified as a risk factor for infection (Tasker et al., 2003; Tasker et al., 2004; Willi et al., 2006a; Sykes et al., 2007a; Bauer et al., 2008; Maher et al., 2010; Georges et al., 2012; Rosenqvist et al., 2016; Walker Vergara et al., 2016; Attipa et al., 2017; Ravagnan et al., 2017; Diaz-Reganon et al., 2018; Persichetti et al., 2018; Sarvani et al., 2018; Do et al., 2020; da Rosa Maciel et al., 2023; Ceylan et al., 2024a), although age was not a risk factor in others (Inokuma et al., 2004; Lobetti and Tasker 2004; Gentilini et al., 2009; Nibblett et al., 2009; Nibblett et al., 2010; Roura et al., 2010; Assarasakorn et al., 2012; Martinez-Diaz et al., 2013; Sacristan et al., 2019; Imre et al., 2020; Latrofa et al., 2020; Berzina et al., 2021; Carvalho et al., 2024; Hoseinpoor et al., 2024).
年齡增長有時被確認為感染的風險因素(Tasker 等,2003;Tasker 等,2004;Willi 等,2006a;Sykes 等,2007a;Bauer 等,2008;Maher 等,2010;Georges 等,2012;Rosenqvist 等,2016;Walker Vergara 等,2016;Attipa 等,2017;Ravagnan 等,2017;Diaz-Reganon 等,2018;Persichetti 等,2018;Sarvani 等,2018;Do 等,2020;da Rosa Maciel 等,2023;Ceylan 等,2024a),但在其他研究中年齡並非風險因素(Inokuma 等,2004;Lobetti 和 Tasker,2004;Gentilini 等,2009;Nibblett 等,2009;Nibblett 等,2010;Roura 等,2010;Assarasakorn 等,2012;Martinez-Diaz 等,2013;Sacristan 等,2019;Imre 等,2020;Latrofa 等,2020;Berzina 等,2021;Carvalho 等,2024;Hoseinpoor 等,2024)。

Young cats were likely to develop more severe clinical disease than older cats following M. haemofelis infection (Harvey and Gaskin, 1978; Shaw et al., 2004).
年輕貓隻在感染 M. haemofelis 後,比年長貓隻更可能出現嚴重的臨床症狀(Harvey 和 Gaskin,1978;Shaw 等,2004)。

An increased prevalence in stray, compared to owned cats, has been reported (Ceylan et al., 2024a).
有報告指出,流浪貓的感染率比家貓更高(Ceylan 等,2024a)。

Retrovirus infection (Sykes et al., 2008; Stojanovic and Foley, 2011; Georges et al., 2012; Martinez-Diaz et al., 2013; Attipa et al., 2017), especially feline immunodeficiency virus (FIV) (Luria et al., 2004; Sykes et al., 2007a; Macieira et al., 2008; Gentilini et al., 2009; Roura et al., 2010; Tanahara et al., 2010; Walker Vergara et al., 2016; Bergmann et al., 2017; Ravagnan et al., 2017; Diaz-Reganon et al., 2018; Persichetti et al., 2018; Sarvani et al., 2018) but also feline leukaemia virus (FeLV) (Inokuma et al., 2004; Luria et al., 2004; Sykes et al., 2007a; Roels et al., 2024) are risk factors.
反轉錄病毒感染(Sykes 等人,2008;Stojanovic 和 Foley,2011;Georges 等人,2012;Martinez-Diaz 等人,2013;Attipa 等人,2017),特別是貓免疫缺陷病毒(FIV)(Luria 等人,2004;Sykes 等人,2007a;Macieira 等人,2008;Gentilini 等人,2009;Roura 等人,2010;Tanahara 等人,2010;Walker Vergara 等人,2016;Bergmann 等人,2017;Ravagnan 等人,2017;Diaz-Reganon 等人,2018;Persichetti 等人,2018;Sarvani 等人,2018),以及貓白血病病毒(FeLV)(Inokuma 等人,2004;Luria 等人,2004;Sykes 等人,2007a;Roels 等人,2024)都是風險因素。

However, retrovirus infections are not always a risk factor (Willi et al., 2006a; Georges et al., 2012; Marcondes et al., 2018; Imre et al., 2020) and some studies found that FIV (Inokuma et al., 2004; Macieira et al., 2008; Demkin and Kazakov, 2021; Roels et al., 2024) nor FeLV (Sykes et al., 2007a; Macieira et al., 2008; Gentilini et al., 2009; Roura et al., 2010; Tanahara et al., 2010; Bergmann et al., 2017; Demkin and Kazakov, 2021; da Rosa Maciel et al., 2023) were risk factors for haemoplasma infection.
然而,反轉錄病毒感染並非總是風險因素(Willi 等人,2006a;Georges 等人,2012;Marcondes 等人,2018;Imre 等人,2020),且部分研究發現 FIV(Inokuma 等人,2004;Macieira 等人,2008;Demkin 和 Kazakov,2021;Roels 等人,2024)和 FeLV(Sykes 等人,2007a;Macieira 等人,2008;Gentilini 等人,2009;Roura 等人,2010;Tanahara 等人,2010;Bergmann 等人,2017;Demkin 和 Kazakov,2021;da Rosa Maciel 等人,2023)均非血漿體感染的風險因素。

Being anaemic or having a reduced packed cell volume can increase risk (Nibblett et al., 2010; Persichetti et al., 2018; Sarvani et al., 2018) (especially M. haemofelis infection (Jensen et al., 2001; Maher et al., 2010; Diaz-Reganon et al., 2018; da Rosa Maciel et al., 2023) but also ‘Ca. M. turicensis’ coinfection (Willi et al., 2006b)). Epidemiology studies suggest that the host phenotype (e.g. being an aggressive male phenotype) could drive some of these associations and risk factors, rather than infections being simple risk factors for each other (Carver et al., 2015).
貧血或紅血球容積減少可能增加感染風險(Nibblett 等人,2010;Persichetti 等人,2018;Sarvani 等人,2018)(尤其是 M. haemofelis 感染(Jensen 等人,2001;Maher 等人,2010;Diaz-Reganon 等人,2018;da Rosa Maciel 等人,2023),但也包括「Ca. M. turicensis」共同感染(Willi 等人,2006b))。流行病學研究顯示,宿主表型(例如具有攻擊性的雄性表型)可能是這些關聯性和風險因素的部分原因,而非單純的相互感染風險因素(Carver 等人,2015)。

Leishmania infection was associated with ‘Ca. M. turicensis’ coinfection in one study (Attipa et al., 2017).
一項研究發現,利什曼原蟲感染與「Ca. M. turicensis」共同感染有關聯(Attipa 等人,2017)。

Additionally, Felis catus gammaherpesvirus 1 (FcaGHV1), a potential feline pathogen, has been found to be significantly associated with haemoplasma infection in studies (McLuckie et al., 2016; Novacco et al., 2019), suggesting similar transmission routes, but the significance of FcaGHV1 in cats has not yet been elucidated (Beatty et al., 2014); see also the ABCD Guidelines on FcaGHV1.
此外,研究發現貓伽瑪皰疹病毒 1 型(FcaGHV1)——一種潛在的貓病原體——與血漿體感染有顯著關聯(McLuckie 等人,2016;Novacco 等人,2019),暗示兩者可能有相似的傳播途徑,但 FcaGHV1 在貓體內的意義尚未明確(Beatty 等人,2014);另請參閱 ABCD 關於 FcaGHV1 的指南。

Case reports of cats with haemophagocytic syndrome with concurrent ‘Ca. M. haemominutum’ (Strandberg et al., 2023) or M. haemofelis infection (Fonseca et al., 2023) have been described; this significance of the haemoplasma infection in these cases is not known although haemoplasma-associated haemophagocytic syndrome has been described in a human (Hattori et al., 2020).
已有文獻記載貓隻同時感染「貓血黴漿菌」(Strandberg 等人,2023 年)或貓血巴東體(Fonseca 等人,2023 年)併發噬血細胞綜合症的病例報告;雖然人類病例中曾報告過血黴漿菌相關噬血細胞綜合症(Hattori 等人,2020 年),但這些貓病例中血黴漿菌感染的確切致病機轉尚不明確。

No association between blood genotype or phenotype and haemoplasma infection has been found in a study evaluating UK and Italian cats (Spada et al., 2023).
一項針對英國與義大利貓隻的研究顯示(Spada 等人,2023 年),未發現血液基因型或表現型與血黴漿菌感染存在關聯性。

Transmission  傳播途徑

Summary on haemoplasma transmission routes:
血漿體傳播途徑摘要:

The natural mode of transmission of feline haemoplasma infections in the field has not yet been confirmed. Studies have failed to convincingly show that vectors (including fleas) are involved in the transmission of feline haemoplasmas, despite haemoplasmas often being considered as vector-borne agents.
貓血漿菌感染在自然環境中的傳播途徑尚未被確認。儘管血漿菌常被視為病媒傳播病原體,但研究至今未能確切證明病媒(包括跳蚤)參與了貓血漿菌的傳播。

Indeed, a recent study (Moore et al., 2024) has shown that previous high haemoplasma prevalence rates in fleas were likely false positive results.
事實上,近期研究(Moore 等人,2024 年)顯示,過去在跳蚤中檢測到的高血漿菌盛行率很可能是偽陽性結果。

It is known that haemoplasma transmission can occur via contaminated blood transfusions and it is possible that fighting transmits infection, particularly in cats with high levels of bacteraemia. Vertical transmission may also occur but this has not been confirmed in cats.
已知血漿菌可透過受污染的輸血傳播,且貓隻打鬥(尤其是菌血症程度高的貓)也可能造成感染傳播。垂直傳播雖可能發生,但尚未在貓隻身上獲得證實。

Blood transfusion  輸血

Transmission via contaminated blood transfusions has been reported (Willi et al., 2006a) and the use of freshly collected blood from a haemoplasma-infected blood donor for transfusion would very likely result in transmission of infection to the recipient cat.
已有文獻報告指出,經由受污染輸血途徑傳播的案例(Willi 等人,2006a),若使用來自感染血漿寄生菌捐血者剛採集的新鮮血液進行輸血,極可能導致受血貓隻感染。

The risk of haemoplasma transmission when using stored blood for transfusions will depend on the viability of haemoplasmas in stored blood. A study using the canine haemoplasma species, Mycoplasma haemocanis, suggested that survival within stored blood was possible, although inoculation of blood into naïve dogs was not performed to confirm viability (Camargo Castillo et al., 2023). One study (Gary et al., 2006) evaluated the survival of haemoplasma organisms in blood collected into citrate-phosphate-dextrose-adenine (CPDA) anticoagulant using inoculation studies.
使用儲存血液進行輸血時的血漿寄生菌傳播風險,取決於病原體在儲存血液中的存活能力。一項針對犬血漿寄生菌(Mycoplasma haemocanis)的研究顯示,該病原體在儲存血液中可能存活,但未通過接種實驗於未感染犬隻來證實其活性(Camargo Castillo 等人,2023)。另一研究(Gary 等人,2006)則透過接種實驗,評估了血漿寄生菌在檸檬酸-磷酸-葡萄糖-腺嘌呤(CPDA)抗凝劑採集血液中的存活狀況。

Haemoplasma survival was assessed by the ability to transmit M. haemofelis or ‘Ca. M. haemominutum’ infection into naïve cats via the intravenous inoculation of infected blood which had been stored in CPDA at 4°C for 1 hour, 1 week or 1 month. M. haemofelis was only successfully transmitted to the naïve cat using the blood that had been stored for 1 hour, and in this cat there was evidence of subsequent in vivo amplification of M. haemofelis in the blood, as organism numbers increased during the 3-week post-inoculation monitoring period. Some evidence for ‘Ca. M. haemominutum’ transmission was also found using the blood stored for 1 hour, although organism numbers in the recipient naïve cat’s blood did not increase post-inoculation. ‘Ca. M. haemominutum’-infected blood that had been stored for 1 week resulted in a single positive PCR result in the naïve cat, in only one of the two PCR assays used to detect infection, so successful ‘persistent’ transmission was not seen. But this work suggested that ‘Ca. M. haemominutum’ may be able to survive for up to 1 week in CPDA.
透過靜脈接種已於 4°C CPDA 保存液中儲存 1 小時、1 週或 1 個月的感染血液,評估血漿支原體傳播貓血巴東蟲(M. haemofelis)或「暫定血漿支原體微小型」('Ca. M. haemominutum')感染至未感染貓隻的能力。僅使用儲存 1 小時的血液成功將 M. haemofelis 傳播至未感染貓,且該貓血液中 M. haemofelis 在接種後 3 週監測期內出現體內增殖證據,微生物數量持續增加。雖然接種後未感染貓血液中微生物數量未見增長,但使用儲存 1 小時的血液也發現部分'Ca. M. haemominutum'傳播證據。使用儲存 1 週的'Ca. M. haemominutum'感染血液,在兩項 PCR 檢測中僅一項出現單次陽性結果,未見持續性傳播成功案例。但此研究顯示'Ca. M. haemominutum'可能可在 CPDA 中存活達 1 週。

Interestingly, and in contrast to these results, experimental studies at the University of Bristol have found that the viability of haemoplasma organisms in blood collected into EDTA or heparin anticoagulants is very short-lived (< 1 hour) as inoculations with blood stored for longer periods have failed (ST, personal communication).
有趣的是,與這些結果相反,布里斯托大學的實驗研究發現,採集到 EDTA 或肝素抗凝劑中的血液,其血漿支原體存活時間非常短暫(<1 小時),因為儲存時間較長的血液接種已告失敗(ST,個人通訊)。

Survival of haemoplasma organisms outside of the host is hard to research because of the current absence of a haemoplasma in vitro culture system meaning that only in vivo inoculation can prove organism viability. Nevertheless, it is important that blood donors are screened for all haemoplasma species (Tasker, 2010).
由於目前缺乏血漿支原體體外培養系統,意味著只能通過體內接種來證明生物體存活,因此研究血漿支原體在宿主外的存活情況十分困難。然而,對所有血漿支原體物種進行捐血貓篩檢仍十分重要(Tasker, 2010)。

Studies have documented haemoplasma infections in healthy blood donor cats; 3.7% of healthy indoor only retrovirus negative feline blood donors were haemoplasma-infected in one study (Mesa-Sanchez et al., 2021) whilst another showed that 5.2% of recruited blood donors were haemoplasma species PCR positive (Roels et al., 2024).
研究已記錄健康捐血貓感染血漿支原體的情況;一項研究顯示 3.7%健康室內飼養且逆轉錄病毒陰性的貓捐血者感染血漿支原體(Mesa-Sanchez 等,2021),而另一研究則顯示 5.2%招募的捐血貓 PCR 檢測對血漿支原體物種呈陽性(Roels 等,2024)。

Vertical  垂直傳播

Vertical transmission of haemoplasmas in cats has not been definitively proven using molecular methods. No predeliction for reproductive tissues was found in one study that reported haemoplasma detection rate in different feline tissues (Manvell et al., 2021).
目前尚未透過分子生物學方法證實貓血漿支原體存在垂直傳播。一項針對不同貓科動物組織中血漿支原體檢出率的研究顯示,生殖組織並未表現出特別易感性(Manvell 等人,2021 年)。

However, other haemoplasma species are vertically (likely transplacentally) transmitted, such as in pigs (Stadler et al., 2019; Ade et al., 2022), cattle (Sasaoka et al., 2015; Girotto-Soares et al., 2016; Niethammer et al., 2018; de Souza Ferreira et al., 2024), beetles (Hulcr et al., 2012) and probably shrews and mice (Millán et al., 2024), although in cattle it is not believed to be a predominant mode of transmission, and is believed to be an unlikely route of transmission in bats (Wang et al., 2023).
然而,其他種類的血漿支原體已被證實可垂直(可能經胎盤)傳播,例如豬(Stadler 等人,2019 年;Ade 等人,2022 年)、牛(Sasaoka 等人,2015 年;Girotto-Soares 等人,2016 年;Niethammer 等人,2018 年;de Souza Ferreira 等人,2024 年)、甲蟲(Hulcr 等人,2012 年),以及可能包括鼩鼱與小鼠(Millán 等人,2024 年),不過在牛隻中不被認為是主要傳播途徑,而在蝙蝠中則被視為不太可能的傳播方式(Wang 等人,2023 年)。

Vertical transmission has been strongly suggested for M. haemocanis in dogs (Lashnits et al., 2019).
犬血漿支原體(M. haemocanis)的垂直傳播已在犬隻中獲得強力佐證(Lashnits 等人,2019 年)。

Fighting  打鬥

Studies investigated the presence of haemoplasmas in the saliva and/or salivary glands of a small number of cats infected with ‘Ca. M. haemominutum’ or M. haemofelis: only a low proportion of samples from ‘Ca. M. haemominutum’ (Dean et al., 2008) or M. haemofelis (Tasker et al., 2009a) experimentally infected cats were found to be PCR positive . A more comprehensive study found ‘Ca. M. turicensis’ DNA in the saliva of cats during early experimental ‘Ca. M. turicensis’ infection, but failed to find either ‘Ca. M. haemominutum’ or M. haemofelis in the saliva of natural infected cats (Willi et al., 2007a). Others have found M. haemofelis DNA in occasional saliva samples collected from experimentally infected cats (Baumann et al., 2015), notably in those with high levels of bacteraemia. Transmission studies found that subcutaneous inoculation of blood containing ‘Ca. M. turicensis’, but not saliva containing ‘Ca. M. turicensis’ (both the blood and saliva contained the same copy numbers of ‘Ca. M. turicensis’), resulted in infection transmission (Museux et al., 2009), suggesting that social contact (saliva via mutual grooming etc.) is less likely to transmit haemoplasma (at least ‘Ca. M. turicensis’) than aggressive interactions (e.g. blood transmission during cat bites) (Museux et al., 2009). In that study as little as 10 µl of blood containing 103 copies of ‘Ca. M. turicensis’ was associated with transmission. It is possible that fighting can transmit feline haemoplasma species, particularly in cats with high levels of bacteraemia, and the fact that male outdoor cats are predisposed to feline haemoplasma infection may reflect an association with fighting.
研究調查了少數感染「貓血黴漿菌」('Ca. M. haemominutum')或「貓血巴東體」(M. haemofelis)的貓隻唾液及/或唾液腺中血漿體的存在情況:在實驗感染的貓隻中,僅有少量「貓血黴漿菌」(Dean 等人,2008 年)或「貓血巴東體」(Tasker 等人,2009a 年)樣本經 PCR 檢測呈陽性。一項更全面的研究發現,在實驗性感染「土耳其血黴漿菌」('Ca. M. turicensis')的早期階段,貓唾液中含有該病原體 DNA,但未在自然感染貓的唾液中檢測到「貓血黴漿菌」或「貓血巴東體」(Willi 等人,2007a 年)。其他研究則在實驗感染貓隻的零星唾液樣本中發現「貓血巴東體」DNA(Baumann 等人,2015 年),特別是在那些具有高水平菌血症的個體中。傳播研究發現,皮下接種含有「土耳其血黴漿菌」的血液(而非含有相同拷貝數「土耳其血黴漿菌」的唾液)會導致感染傳播(Museux 等人,2009 年),這表明社交接觸(如透過相互理毛等行為接觸唾液)傳播血漿體(至少對於「土耳其血黴漿菌」而言)的可能性較低。 相較於攻擊性互動(例如貓咬傷時的血液傳播),『Candidatus Mycoplasma turicensis』更可能透過社交互動傳播(Museux 等人,2009 年)。該研究發現,僅需 10 微升含有 10 3 個『Ca. M. turicensis』複製體的血液即可導致傳播。打架行為可能傳播貓血漿體菌種,特別是在菌血症程度高的貓隻中,而雄性戶外貓較易感染貓血漿體的事實,可能反映與打架行為的關聯性。

Vectors  病媒

The clustered geographical distribution of infection in some studies supported the role of an arthropod vector in feline haemoplasma transmission (Sykes et al., 2007a). However, Huggins et al.
部分研究中觀察到的感染群聚地理分布,支持節肢動物媒介在貓血漿體傳播中的作用(Sykes 等人,2007a)。然而,Huggins 等人

(2023) found that a parasiticide use to kill fleas and ticks was ineffective at preventing haemoplasma transmission between dogs, suggesting that haemoplasmas were indeed transmitted by mechanisms that did not involve these vectors.
(2023 年)發現,用於殺滅跳蚤和壁蝨的寄生蟲藥劑並不能有效防止犬隻間的血漿體傳播,這表明血漿體確實是透過不涉及這些媒介的機制進行傳播。

Indeed, in that study (Huggins et al., 2023), dog aggression and fighting were frequently observed, highlighting fighting as a potential mode of transmission. It may well be that the situation is similar in cats, and this is supported further by a study suggesting that haemoplasma transmission by fleas is unlikely, as described below (Moore et al., 2024).
確實,在該研究(Huggins 等人,2023 年)中,經常觀察到狗的攻擊行為和打鬥,這突顯了打鬥作為潛在傳播途徑的可能性。貓的情況很可能也類似,這進一步得到一項研究的支持,該研究表明血漿體透過跳蚤傳播的可能性不大,如下所述(Moore 等人,2024 年)。

Fleas  跳蚤

Of 153 cats in Bangkok, Thailand, around 33% were infested with fleas, and feline haemoplasma DNA (usually ‘Ca. M. haemominutum’ or M. haemofelis) was found in 34% of the 50 flea pools collected from infested cats (Assarasakorn et al., 2012). Additionally cats had blood samples tested for haemoplasma DNA and of the 35 cats that were blood haemoplasma DNA positive, seven were found to have haemoplasma positive fleas (Assarasakorn et al., 2012).
在泰國曼谷的 153 隻貓中,約 33%感染了跳蚤,而從受感染貓咪收集的 50 組跳蚤中,有 34%檢測出貓血漿體 DNA(通常是「暫定血漿體微小種」或貓血漿體)(Assarasakorn 等人,2012 年)。此外,這些貓咪的血液樣本也進行了血漿體 DNA 檢測,在 35 隻血液血漿體 DNA 陽性的貓咪中,有 7 隻被發現其跳蚤也呈血漿體陽性(Assarasakorn 等人,2012 年)。

Interestingly, only 11% of haemoplasma-positive cats in this study had the same haemoplasma species in their blood and fleas, suggesting that the fleas may be feeding on more than one cat (Assarasakorn et al., 2012).
有趣的是,在這項研究中,只有 11%的血漿體陽性貓咪的血液和跳蚤中發現了相同的血漿體物種,這表明跳蚤可能以多隻貓為食(Assarasakorn 等人,2012 年)。

Other studies have found evidence of feline haemoplasma DNA in fleas collected from cats (Shaw et al., 2004; Lappin et al., 2006; Willi et al., 2007a; Kamrani et al., 2008; Barrs et al., 2010; Hornok et al., 2010; Abdullah et al., 2019; Mifsud et al., 2020; Madder et al., 2022; Razgūnaitė et al., 2024), although the rates of positivity in the fleas are variable and studies differ as to whether flea pools or individual fleas were used for extraction and PCR.
其他研究也從貓隻身上採集的跳蚤中發現貓血漿支原體 DNA 的證據(Shaw 等人,2004;Lappin 等人,2006;Willi 等人,2007a;Kamrani 等人,2008;Barrs 等人,2010;Hornok 等人,2010;Abdullah 等人,2019;Mifsud 等人,2020;Madder 等人,2022;Razgūnaitė等人,2024),儘管跳蚤的陽性率存在差異,且各研究在提取和 PCR 檢測時使用的是跳蚤群體還是單隻跳蚤也有所不同。

One study (Yamakawa et al., 2023) has reported an association between haemoplasma infection and flea infestation whilst another (Madder et al., 2022) found an association between M. haemofelis and Ctenocephalides felis (compared to the other fleas species, Echidnophaga, found on cats in the study). Other studies have failed to document any statistical association between flea infestation and haemoplasma infection in cats (Assarasakorn et al., 2012; Martinez-Diaz et al., 2013; Sacristan et al., 2019). Importantly, in a systematic review, meta‑analysis, and reinvestigation study that Moore et al.
一項研究(Yamakawa 等人,2023)報告了血漿支原體感染與跳蚤侵擾之間的關聯,而另一項研究(Madder 等人,2022)則發現 M. haemofelis 與貓蚤(Ctenocephalides felis)之間的關聯(相較於該研究中在貓隻身上發現的其他跳蚤物種 Echidnophaga)。其他研究則未能證實跳蚤侵擾與貓隻血漿支原體感染之間存在任何統計學上的關聯(Assarasakorn 等人,2012;Martinez-Diaz 等人,2013;Sacristan 等人,2019)。值得注意的是,在 Moore 等人進行的系統性回顧、統合分析及再調查研究中

(2024) performed to investigate transmission of haemoplasmas by the cat flea C. felis, a poor specificity of primers previously used to amplify haemoplasma DNA in some flea studies (Jensen et al., 2001) was found. Use of these primers resulted in an over estimation of haemoplasma presence due to false positive results being obtained due to amplification of Spiroplasma or other bacteria. Six published studies had used the primers believed to be non-specific to investigate haemoplasma carriage in fleas (Shaw et al., 2004; Lappin et al., 2006; Kamrani et al., 2008; Barrs et al., 2010; Assarasakorn et al., 2012; Mifsud et al., 2020), resulting in falsely high haemoplasma carriage rates in fleas.
(2024 年)針對貓蚤(C. felis)傳播血漿菌的能力進行研究時發現,先前用於某些蚤類研究中擴增血漿菌 DNA 的引子(primer)特異性不佳(Jensen 等人,2001 年)。使用這些引子會因擴增出螺旋原體(Spiroplasma)或其他細菌而產生偽陽性結果,導致高估血漿菌的存在率。共有六篇已發表研究使用這些被認為非特異性的引子來調查蚤類攜帶血漿菌的狀況(Shaw 等人,2004 年;Lappin 等人,2006 年;Kamrani 等人,2008 年;Barrs 等人,2010 年;Assarasakorn 等人,2012 年;Mifsud 等人,2020 年),這些研究因此得出蚤類血漿菌攜帶率偏高的錯誤數據。

The authors (Moore et al., 2024) concluded that haemoplasma infection in C. felis is rare (less than 1% of fleas harbour haemoplasma DNA when more specific haemoplasma primers are used), and future flea prevalence studies should always sequence positive PCR amplicons to validate PCR specificity.
作者(Moore 等人,2024 年)得出結論:貓蚤(C. felis)感染血漿菌的情況相當罕見(當使用特異性更高的血漿菌引子時,僅有不到 1%的蚤類攜帶血漿菌 DNA),未來進行蚤類盛行率研究時,應對所有 PCR 陽性擴增產物進行定序以驗證 PCR 特異性。

Evidence for C. felis as a haemoplasma vector via transmission studies is also very limited. ‘Ca. M. haemominutum’ and M. haemofelis have been shown to be ingested by C. felis when allowed to feed on experimentally infected cats, and the DNA of both haemoplasmas was detected in flea faeces or eggs (Woods et al., 2005). However, only very transient M. haemofelis infection was reported (detected by PCR on day 12 [in only one of nine timepoints] after flea exposure) in only one of six cats exposed to the haematophagous activity of fleas that had previously fed on M. haemofelis-infected cats. Additionally, clinical and haematological signs of M. haemofelis infection were not induced in the recipient cat (Woods et al., 2005). Another study (Woods et al., 2006) evaluated whether ingestion, rather than the feeding, of fleas could transmit infection; but this study did not detect any evidence of transmission of either M. haemofelis (two cats) or ‘Ca. M. haemominutum’ (two cats) via ingestion of haemoplasma-infected fleas.
關於貓蝨(C. felis)作為血漿體病媒的傳播研究證據也非常有限。當允許貓蝨吸食實驗感染貓隻時,已證實會攝入「貓血漿體微小亞種」('Ca. M. haemominutum')和貓血漿體(M. haemofelis),並在跳蚤糞便或卵中檢測到這兩種血漿體的 DNA(Woods 等人,2005 年)。然而,在六隻暴露於曾吸食過 M. haemofelis 感染貓隻之跳蚤吸血活動的貓中,僅有一隻報告出現非常短暫的 M. haemofelis 感染(僅在跳蚤暴露後第 12 天[九個時間點中僅一個]透過 PCR 檢測到)。此外,接受感染的貓隻並未出現 M. haemofelis 感染的臨床和血液學徵狀(Woods 等人,2005 年)。另一項研究(Woods 等人,2006 年)評估了攝入(而非叮咬)跳蚤是否可能傳播感染,但該研究未發現任何證據表明 M. haemofelis(兩隻貓)或「貓血漿體微小亞種」(兩隻貓)可透過攝入受血漿體感染的跳蚤而傳播。

Thus, it appears that fleas are unlikely to play a significant role in haemoplasma transmission.
因此,跳蚤似乎不太可能在血漿體傳播中扮演重要角色。

Ticks  蜱蟲

Feline haemoplasma DNA has also been occasionally reported in ticks (Razgūnaitė et al., 2024). In Switzerland ‘Ca. M. haemominutum’ was found in only two of 71 Ixodes sp. ticks collected from 39 cats (Willi et al., 2007a) whilst ‘Ca. M. haemominutum’ was found in only three (in two I. ricinus and one Ixodes trianguliceps), M. haemofelis in only one (I. trianguliceps) and ‘Ca. M. turicensis’ in only one (I. ricinus) of 540 ticks collected from 540 cats in the UK (Duplan et al., 2018). Interestingly, one study (Taroura et al., 2005) reported ‘Ca. M. haemominutum’ DNA in three of eight pools of unfed Ixodes ovatus (both male and female) ticks and in some Haemaphysalis flava unfed ticks collected from vegetation in Japan. Both I. ovatus and H. flava are common ticks of cats in Japan.  All the ticks in this study (Taroura et al., 2005) were adult stage, so the ixodid ticks might have been infected with ‘Ca. M. haemominutum’ by feeding on blood from animals infected with ‘Ca. M. haemominutum’ at their nymphal stage. Thus, transstadial transmission probably occurred in these ixodid ticks, but experimental transmission studies are needed to confirm these findings. Studies have reported the lack of any association between feline haemoplasma infection and tick infestations (Martinez-Diaz et al., 2013; Yamakawa et al., 2023).
貓血漿體 DNA 偶爾也在蜱蟲中被報告發現(Razgūnaitė等人,2024 年)。在瑞士,從 39 隻貓身上採集的 71 隻硬蜱屬蜱蟲中,僅在兩隻發現『Candidatus Mycoplasma haemominutum』(Willi 等人,2007a 年);而在英國從 540 隻貓採集的 540 隻蜱蟲中,僅在三隻(兩隻蓖子硬蜱與一隻三角硬蜱)發現『Ca. M. haemominutum』、一隻(三角硬蜱)發現 M. haemofelis,以及一隻(蓖子硬蜱)發現『Ca. M. turicensis』(Duplan 等人,2018 年)。值得注意的是,一項研究(Taroura 等人,2005 年)報告在日本從植被採集的八組未吸血卵形硬蜱(包含雄雌個體)中,有三組檢測到『Ca. M. haemominutum』DNA,部分未吸血黃色血蜱也呈陽性。卵形硬蜱與黃色血蜱均為日本貓隻常見蜱種。該研究(Taroura 等人,2005 年)中所有蜱蟲均為成蟲階段,推測這些硬蜱可能在若蟲階段透過吸食感染『Ca. M. haemominutum』的動物血液而帶原。因此,跨齡期傳播可能發生於這些硬蜱體內,但需透過實驗性傳播研究證實此發現。 研究報告指出,貓血漿支原體感染與蜱蟲侵擾之間並無任何關聯(Martinez-Diaz 等人,2013;Yamakawa 等人,2023)。

In one study that tested 321 ticks collected from 59 cats in Lithuania, one (an Ixodes ricinus) tick was reported as PCR positive for haemoplasma species, but sequencing of the PCR product revealed it to be a Rickettsiella species, again confirming the need for additional methods to confirm the identity of a species when less specific primers are used for PCR analysis (Razgūnaitė et al., 2024).
一項針對立陶宛 59 隻貓身上採集的 321 隻蜱蟲進行檢測的研究中,報告有一隻(蓖子硬蜱)蜱蟲的 PCR 檢測對血漿支原體物種呈陽性,但對 PCR 產物進行定序後發現其為立克次體物種,這再次證實當使用特異性較低的引子進行 PCR 分析時,需採用額外方法來確認物種身份(Razgūnaitė 等人,2024)。

Mosquitoes  蚊子

Only one study evaluated mosquitoes for feline haemoplasma presence and transmission (Reagan et al., 2017). While 6.2% of 81 cats tested in feral colonies were ‘Ca. M. haemominutum’ or M. haemofelis positive, none of the pools of mosquitoes trapped near these cat colonies were haemoplasma PCR positive. In transmission studies ‘Ca. M. haemominutum’ or M. haemofelis DNA was amplified from Aedes aegypti mosquitoes immediately after taking a blood meal from haemoplasma-infected cats, but then DNA was no longer detected at 7 and 14 days after feeding. Additionally, neither of the two naïve cats that were subsequently exposed to the previously (7 days) fed A. aegypti mosquitoes became positive for either haemoplasma in the 10-week observation period. These results suggest that ‘Ca. M. haemominutum’ and M. haemofelis do not colonize A. aegypti and that this mosquito is not a biological vector for these haemoplasmas (Reagan et al., 2017).
僅有一項研究評估了蚊子傳播貓血漿蟲的可能性(Reagan 等人,2017 年)。在 81 隻野貓群體檢測中,6.2%呈「貓血漿蟲微小型」(‘Ca. M. haemominutum’)或貓血漿蟲(M. haemofelis)陽性,但在這些貓群附近捕捉的蚊子群組中,未檢出血漿蟲 PCR 陽性結果。傳播研究顯示,埃及斑蚊(Aedes aegypti)在吸食受感染貓隻血液後,可立即檢測到「貓血漿蟲微小型」或貓血漿蟲的 DNA,但在吸血後第 7 天及第 14 天即無法再偵測到。此外,兩隻未感染貓隻在接觸 7 天前吸過血的埃及斑蚊後,於 10 週觀察期內均未出現任何血漿蟲陽性反應。這些結果表明「貓血漿蟲微小型」與貓血漿蟲無法在埃及斑蚊體內定殖,且該蚊種並非這些血漿蟲的生物性傳播媒介(Reagan 等人,2017 年)。

Lice  蝨子

One study (Sanchez-Montes et al., 2023) identified M. haemofelis by PCR in the lice (Felicola subrostratus) collected from one cat in Mexico. This work does not confirm the role of lice as biological vectors, as the PCR positivity could be due to the haematophagous activity of the lice only.
一項研究(Sanchez-Montes 等人,2023 年)在墨西哥從一隻貓身上採集的蝨子(Felicola subrostratus)中,透過 PCR 檢測出 M. haemofelis。這項研究並未證實蝨子作為生物載體的角色,因為 PCR 陽性結果可能僅源自蝨子的吸血活動。

Multiple modes of transmission
多重傳播途徑

As the natural route of transmission of feline haemoplasma species in the field has not yet been determined, it may be that different routes predominate for different host and haemoplasma species. Indeed, work on the transmission of ‘Ca. M. haemominutum’ in domestic and wild felids (Kellner et al., 2018) suggests that multiple transmission pathways exist concurrently.
由於貓血漿體物種在自然環境中的傳播途徑尚未確定,不同宿主與血漿體物種可能以不同途徑為主要傳播方式。事實上,關於家貓與野生貓科動物中「Ca. M. haemominutum」傳播的研究(Kellner 等人,2018 年)顯示,多重傳播途徑可能同時存在。

These could include indirect spread (e.g. vector-borne, although evidence for this is lacking, as explained earlier) and direct spread (e.g. via predation [of larger wild felid species on smaller cats] or fighting) and it will be interesting for future work to evaluate other haemoplasmas using a similar approach.
這些途徑可能包括間接傳播(例如透過病媒,但如前所述尚缺乏證據)與直接傳播(例如透過捕食[大型野生貓科動物獵食小型貓科動物]或打鬥)。未來研究若採用類似方法評估其他血漿體,將極具研究價值。

Others (Sacristan et al., 2019), evaluating both wild and domestic cats, have not found evidence for domestic cats being a reservoir for infection of the wild cats. These variable results make it difficult to make firm conclusions about transmission routes.
其他研究(Sacristan 等人,2019 年)同時評估野生貓與家貓後,並未發現家貓作為感染源傳播給野生貓的證據。這些不一致的研究結果使得傳播途徑難以確切定論。

Pathogenesis  致病機轉

The attachment of haemoplasma organisms to erythrocytes can result in direct damage to the RBC membrane leading to haemolysis (Carney and England, 1993).  Membrane damage can also result in an increase in osmotic fragility (OF) and a shortened erythrocyte lifespan.
血漿體附著於紅血球可能直接損害紅血球細胞膜,導致溶血(Carney 和 England,1993 年)。細胞膜損傷還可能造成滲透脆性(OF)增加及紅血球壽命縮短。

  In one experimental study (Maede and Hata, 1975), it was found that the erythrocyte OF not only increased after the first appearance of haemoplasmas on blood smears, but continued to increase following the disappearance of organisms from blood smears.
一項實驗研究(Maede 和 Hata,1975 年)發現,紅血球滲透脆性不僅在血液抹片首次出現血漿體後增加,更在血漿體從抹片消失後持續上升。

Although some intravascular haemolysis may occur due to direct damage to erythrocytes (Willi et al., 2005; Willi et al., 2006a), the majority of haemolysis in haemoplasma infection is thought to be extravascular in nature.  Macrophage erythrophagocytosis occurs in the spleen, liver, lungs and bone marrow (Maede and Murata, 1978; Simpson et al., 1978).
雖然部分血管內溶血可能因紅血球直接受損而發生(Willi 等人,2005;Willi 等人,2006a),但多數血漿體感染引起的溶血被認為屬於血管外性質。巨噬細胞的紅血球吞噬作用發生於脾臟、肝臟、肺臟及骨髓(Maede 與 Murata,1978;Simpson 等人,1978)。

Anaemia is variably associated with haemoplasma infection (Safwat et al., 2025) likely due to the variable pathogenicity of the different species and the time of sampling (healthy carriers versus clinically sick cats) for epidemiological studies.
貧血與血漿體感染的關聯性存在差異(Safwat 等人,2025),這可能源於不同菌種的致病力差異,以及流行病學研究中採樣時機的差異(健康帶原貓與臨床發病貓)。

One study (Ider et al., 2024) has evaluated endothelial glycocalyx damage in cats with haemoplasmosis. The endothelial glycocalyx is a 1–3 μm thick dynamic layer that covers the apical surface of all endothelial cells and maintains vascular haemostasis, tone and permeability. Mycoplasma haemofelis-infected cats had significantly higher endothelial glycocalyx degradation biomarker concentrations (syndecan-1 and endothelin-1) than healthy cats. The authors concluded that acute inflammation and disruption to the glycocalyx may contribute to the pathogenesis of haemoplasmosis in cats.
一項研究(Ider 等人,2024)評估了血漿體感染貓隻的內皮糖萼損傷情況。內皮糖萼是覆蓋所有內皮細胞頂端表面、厚度 1-3 微米的動態層,負責維持血管穩態、張力與通透性。感染 Mycoplasma haemofelis 的貓隻,其內皮糖萼降解生物標記(多配體聚糖-1 與內皮素-1)濃度顯著高於健康貓。作者結論指出,急性發炎與糖萼結構破壞可能是貓血漿體症發病機制的重要因素。

Mycoplasma haemofelis is the most pathogenic feline haemoplasma species; immunocompetent cats with no other comorbidities can develop disease following infection. It can result in severe, sometimes fatal, haemolytic anaemia following acute infection although some cats develop only mild anaemia, so variability in outcome occurs.
貓血黴漿菌(Mycoplasma haemofelis)是致病性最強的貓血漿體菌種;即使免疫功能正常且無其他共病的貓隻,在感染後仍可能發病。急性感染可能導致嚴重(有時甚至致命)的溶血性貧血,但部分貓隻僅出現輕微貧血,因此臨床結果存在差異性。

The haemolytic anaemia is primarily extravascular (such as within the spleen) in nature, but occasionally intravascular haemolysis is reported (Willi et al., 2005). This could be due to host response differences or M. haemofelis strain variation, but severe disease can occur including in immunocompetent cats (Tasker et al., 2009b). Chronic infection is usually not associated with significant anaemia, and carrier cats exist which show no evidence of anaemia (Willi et al., 2006a; Laberke et al., 2010). In line with this, some epidemiological studies have not shown associations between anaemia and M. haemofelis infection (Willi et al., 2006a; Bauer et al., 2008; Juvet et al., 2010; Munhoz et al., 2018), probably due to the inclusion of chronically M. haemofelis-infected cats without clinical signs.
此類溶血性貧血本質上主要屬於血管外溶血(例如發生於脾臟內),但偶有文獻報告血管內溶血案例(Willi 等人,2005 年)。這可能源於宿主免疫反應差異或 M. haemofelis 菌株變異,值得注意的是,免疫功能正常的貓隻也可能出現嚴重病症(Tasker 等人,2009b)。慢性感染通常不會引發顯著貧血,且存在無貧血症狀的帶原貓(Willi 等人,2006a;Laberke 等人,2010 年)。據此,部分流行病學研究未發現貧血與 M. haemofelis 感染間的關聯性(Willi 等人,2006a;Bauer 等人,2008 年;Juvet 等人,2010 年;Munhoz 等人,2018 年),這可能與研究納入無臨床症狀的慢性 M. haemofelis 感染貓隻有

Although ‘Ca. M. haemominutum’ infection can cause erythrocyte parameters (e.g. red blood cell count, haemoglobin, haematocrit) to decrease (Tasker et al., 2009b), anaemia is not commonly seen following infection unless the cat has concurrent problems, e.g. immunosuppression, undergoing chemotherapy, FeLV infection or concurrent disease (George et al., 2002; De Lorimier and Messick, 2004).
雖然「貓血黴漿菌」('Ca. M. haemominutum')感染可能導致紅血球參數(如紅血球計數、血紅蛋白、血容比)下降(Tasker 等,2009b),但除非貓咪同時存在其他問題(如免疫抑制、正在接受化療、貓白血病病毒感染或併發疾病),否則通常不會出現貧血症狀(George 等,2002;De Lorimier 和 Messick,2004)。

However, splenectomised cats do not seem to be at an increased risk of developing disease (Sykes et al., 2007b). Many carrier cats of ‘Ca. M. haemominutum’ exist, which do not show any clinical signs (Willi et al., 2006a; Safwat et al., 2025). ‘Ca. M. haemominutum’ has also been associated with the development of myeloproliferative disease in cats with FeLV infection in one experimental study (George et al., 2002). However, cases of anaemia have been reported in cats in which only ‘Ca. M. haemominutum’ infection was diagnosed, with other causes of the anaemia ruled out, and so it appears that in some cases, ‘Ca. M. haemominutum’ can cause anaemia in the absence of concurrent disease (Reynolds and Lappin, 2007; Weingart et al., 2016).
然而,脾臟切除的貓似乎並不會增加發病風險(Sykes 等,2007b)。許多帶有「貓血黴漿菌」的貓咪並不會表現出任何臨床症狀(Willi 等,2006a;Safwat 等,2025)。一項實驗研究也發現,「貓血黴漿菌」與感染貓白血病病毒的貓咪發生骨髓增生性疾病有關(George 等,2002)。不過,也有病例報告顯示,在排除其他貧血原因後,僅診斷出「貓血黴漿菌」感染的貓咪仍出現貧血症狀,這表明在某些情況下,「貓血黴漿菌」確實可能在沒有併發疾病的情況下引發貧血(Reynolds 和 Lappin,2007;Weingart 等,2016)。

Ca. M. turicensis’ infection has caused anaemia or a mild decrease of erythrocyte parameters in some experimental studies (Willi et al., 2005), but generally anaemia is uncommon (Tasker et al., 2009b). Concurrent disease, infections and immunosuppression are both thought to be involved in the pathogenesis of ‘Ca. M. turicensis’ disease (Willi et al., 2005; Willi et al., 2006b; Safwat et al., 2025), similar to ‘Ca. M. haemominutum’.
在某些實驗研究中,'Ca. M. turicensis'感染曾導致貧血或紅血球參數輕微下降(Willi 等人,2005 年),但通常貧血症狀並不常見(Tasker 等人,2009b)。與'Ca. M. haemominutum'類似,併發疾病、其他感染及免疫抑制都被認為與'Ca. M. turicensis'疾病的發病機制有關(Willi 等人,2005 年;Willi 等人,2006b;Safwat 等人,2025 年)。

Determining the pathogenicity of ‘Ca. M. haemominutum’ and ‘Ca. M. turicensis’ in naturally infected cats can be difficult as cats are often co-infected with other haemoplasma species, confounding disease associations. However, in one study it was found that ‘Ca. M. haemominutum’ infection was significantly associated with being the only haemoplasma species infection present in the cat, rather than being part of a dual or triple infection with other haemoplasma species (Safwat et al., 2025), showing that this species also exists as a single haemoplasma infection.
由於貓咪常同時感染其他血漿體菌種,使得疾病關聯性難以釐清,因此在自然感染情況下判定'Ca. M. haemominutum'和'Ca. M. turicensis'的致病性相當困難。然而,一項研究發現,'Ca. M. haemominutum'感染顯著傾向於作為貓咪體內唯一存在的血漿體菌種感染,而非與其他血漿體菌種形成雙重或三重混合感染(Safwat 等人,2025 年),這顯示該菌種也能以單一血漿體感染的形式存在。

Carrier cats often have subclinical infections, but reactivation of infection can occur, although rarely, and can result in clinical disease (Harvey and Gaskin, 1977; Harvey and Gaskin, 1978; Foley et al., 1998; Weingart et al., 2016; Razgūnaitė et al., 2024). Reactivation can occur when the cat has failed to eliminate infection.
帶原貓通常呈現亞臨床感染,但極少情況下可能發生感染再活化並導致臨床疾病(Harvey and Gaskin, 1977; Harvey and Gaskin, 1978; Foley et al., 1998; Weingart et al., 2016; Razgūnaitė et al., 2024)。當貓隻未能完全清除感染時,可能發生再活化現象。

One report has documented relapse of anaemia in three cats around 11 days after completion of a 21-day course of doxycycline (Razgūnaitė et al., 2024). One study found that cats that had previously recovered from M. haemofelis infection were protected from homologous re-challenge with M. haemofelis, confirming the presence of protective immunity (Hicks et al., 2014b), possibly in those that have previously eliminated the infection, and thus, reinfection seems unlikely. However, another study found that cats that had recovered from previous ‘Ca. M. turicensis’ infection actually showed more severe and rapid M. haemofelis infection signs than naïve cats infected with M. haemofelis (Baumann et al., 2013). Thus, more research is required into the relationship between infection with different haemoplasma species and their pathogenesis and immunity.
一份報告記載三隻貓在完成 21 天 doxycycline 療程後約 11 天出現貧血復發案例(Razgūnaitė et al., 2024)。研究發現曾從 M. haemofelis 感染康復的貓隻對同源 M. haemofelis 再感染具有保護力(Hicks et al., 2014b),顯示先前成功清除感染的個體可能產生保護性免疫,因此再次感染可能性較低。然而另一研究指出,曾感染『Ca. M. turicensis』後康復的貓隻,在感染 M. haemofelis 時反而比未經感染的對照組表現出更嚴重且快速的臨床症狀(Baumann et al., 2013)。故針對不同血漿菌種間的感染關係及其致病機制與免疫反應,仍需進一步研究。

Immunity  免疫力

The existence of co-infections with dual and triple haemoplasma infections in cats suggests that cross-protection across the haemoplasma species does not occur. Indeed, a study has shown that not only were ‘Ca. M. turicensis’-recovered cats not protected against M. haemofelis challenge, they became PCR-positive for M. haemofelis significantly earlier than the naïve cats, suggesting possible antibody-dependent enhancement (Baumann et al., 2015). Furthermore, passive immunization via transfusion of a small volume of pooled plasma from M. haemofelis recovered cats failed to provide protection from infection with M. haemofelis and may have exacerbated clinical disease (Sugiarto et al., 2016). However, as mentioned earlier, protective immunity can develop following infection, and M. haemofelis– and ‘Ca. M. turicensis’-recovered cats were protected against re-challenge with the same species (Novacco et al., 2012; Hicks et al., 2014b), suggesting immunity due to previous infection.
貓隻同時感染兩種或三種血漿菌的現象表明,不同血漿菌種之間並不存在交叉保護作用。事實上,一項研究顯示,曾感染「Candidatus Mycoplasma turicensis」後康復的貓隻不僅無法抵禦 M. haemofelis 的攻擊,其 PCR 檢測呈現 M. haemofelis 陽性的時間甚至顯著早於未接觸過病原的對照組貓隻,這可能暗示存在抗體依賴性增強效應(Baumann 等人,2015 年)。此外,通過輸注少量來自 M. haemofelis 康復貓隻的混合血漿進行被動免疫,不僅未能提供對 M. haemofelis 感染的保護,反而可能加劇臨床症狀(Sugiarto 等人,2016 年)。然而,如前所述,感染後確實可能產生保護性免疫——研究證實 M. haemofelis 與「Ca. M. turicensis」康復貓隻對同種菌株的再次攻擊具有抵抗力(Novacco 等人,2012 年;Hicks 等人,2014b 年),這顯示先前感染能誘發特異性免疫。

This may suggest that if cats do clear infection after acute haemoplasmosis, they may become immune to re-infection with the same species, although they may well still be susceptible to infection with other feline haemoplasma species, possibly with more severe disease developing.
這可能意味著,若貓隻在急性血漿體病後確實清除感染,牠們可能對同一物種的再感染產生免疫力,但仍很可能對其他貓血漿體物種的感染具有易感性,甚至可能發展出更嚴重的病症。
 

Clinical signs  臨床症狀

Common clinical signs associated with acute pathogenic haemoplasma infections are lethargy, weakness, reduced appetite, dehydration, weight loss and intermittent pyrexia (with a temperature > 102.5oF [39.2oC]) (Tasker, 2010; Ameldev and Tresamol, 2017; Ider et al., 2024). Pallor, associated with anaemia, is also reported. Splenomegaly can be evident in some cats. Severe anaemia can result in tachycardia, tachypnoea and weak or bounding femoral pulses with haemic cardiac murmurs.
與急性致病性血漿體感染相關的常見臨床症狀包括嗜睡、虛弱、食慾減退、脫水、體重減輕及間歇性發熱(體溫>102.5℉[39.2℃])(Tasker, 2010;Ameldev 與 Tresamol, 2017;Ider 等, 2024)。與貧血相關的蒼白也被報告。部分貓隻可能出現明顯的脾腫大。嚴重貧血可能導致心搏過速、呼吸急促、股動脈搏動微弱或洪大,並伴隨貧血性心雜音。

Icterus is uncommon, despite the haemolytic nature of the anaemia, possibly because the haemolysis is not severe enough to cause significant elevations in bilirubin concentrations, but it does occur (Ider et al., 2024). The reasons for this are unknown as the haemolysis can be very severe in some cases.
儘管貧血具有溶血性質,黃疸並不常見,這可能是因為溶血程度尚未嚴重到足以引起膽紅素濃度顯著升高,但確實會發生(Ider 等, 2024)。其原因尚不明確,因在某些病例中溶血可能非常嚴重。

Lymphadenopathy with palpation of enlarged peripheral lymph nodes, such as submandibular or popliteal, is occasionally described (Willi et al., 2007b; Barker, 2019).
偶爾會描述到周邊淋巴結腫大的淋巴結病變,例如下頜或膝膕淋巴結可觸及腫大(Willi 等人,2007b;Barker,2019)。

As mentioned earlier, chronic haemoplasma infection is usually not associated with clinical signs, although reactivation of infection is possible and can be associated with disease.
如前所述,慢性血漿支原體感染通常不會伴隨臨床症狀,但感染可能重新活化並引發疾病。

Diagnosis  診斷

Laboratory changes including haematology
包含血液學在內的實驗室變化

Pathogenic haemoplasma infections typically cause a regenerative macrocytic hypochromic anaemia although pronounced reticulocytosis is not always evident (Kewish et al., 2004) and some cases present with a non-regenerative anaemia (da Rosa Maciel et al., 2023). Normoblasts (nucleated red blood cells) can be present.
致病性血漿支原體感染通常會引起再生性大細胞性低色素性貧血,儘管明顯的網狀紅血球增多症並不總是明顯(Kewish 等人,2004 年),且部分病例會呈現非再生性貧血(da Rosa Maciel 等人,2023 年)。可能出現正母紅血球(有核紅血球)。

White blood cell changes can also occur including leukopenia, lymphopenia, eosinopenia and monocytosis. Mild thrombocytopenia (Ider et al., 2024; Pimpjong et al., 2025), and concurrent thrombocytopenia and leucocytosis (Carvalho et al., 2024), have been reported in association with haemoplasma infection, but the clinical significance of these haematological changes is unclear.
白血球變化也可能發生,包括白血球減少症、淋巴球減少症、嗜酸性球減少症和單核球增多症。輕度血小板減少症(Ider 等人,2024 年;Pimpjong 等人,2025 年),以及同時發生的血小板減少症與白血球增多症(Carvalho 等人,2024 年),已被報導與血漿支原體感染相關,但這些血液學變化的臨床意義尚不明確。

Positive Coombs’ test results can occur, particularly with cold agglutinins, and persistent autoagglutination has been reported in acute haemoplasmosis, indicating the presence of erythrocyte-bound antibodies.
可能出現陽性庫姆斯試驗結果,特別是與冷凝集素相關,且在急性血漿支原體病中已報導持續性自體凝集現象,這表明存在紅血球結合抗體。

However, in experimental studies (Tasker et al., 2009b) these antibodies appear after the development of anaemia; the absence of erythrocyte-bound antibodies at the onset of development of anaemia could be due to reduced sensitivity for their detection or because erythrocyte-bound antibodies appear as a result of haemoplasma-induced haemolysis rather than mediating it.
然而,在實驗研究中(Tasker 等人,2009b),這些抗體是在貧血發展後才出現的;貧血發展初期缺乏紅血球結合抗體,可能是由於檢測靈敏度不足,或是因為紅血球結合抗體是血漿體誘發溶血後的結果,而非導致溶血的原因。

Indeed erythrocyte-bound antibodies disappear with antibiotic and supportive treatment alone, without glucocorticoid treatment  (Tasker et al., 2009b).
事實上,僅透過抗生素和支持性治療(無需糖皮質激素治療),紅血球結合抗體就會消失(Tasker 等人,2009b)。

Hyperbilirubinaemia is seen occasionally, due to haemolysis. Hypoxic liver damage can result in increased activities of alanine aminotransferase. A polyclonal hypergammaglobulinaemia is also sometimes seen (Baumann et al., 2015; Soto et al., 2017).
偶爾可見因溶血引發的高膽紅素血症。缺氧性肝損傷可能導致丙氨酸轉氨酶活性升高。有時也會觀察到多克隆性高γ球蛋白血症(Baumann 等人,2015;Soto 等人,2017)。

One study (Ider et al., 2024) described that albumin, and the albumin to globulin ratio, were significantly lower in cats with feline haemoplasmosis compared to healthy cats, consistent with the presence of an acute phase response.
一項研究(Ider 等人,2024)指出,與健康貓相比,患有貓血漿體病貓隻的白蛋白及白蛋白與球蛋白比值顯著較低,這與急性期反應的存在相符。

Detection of the infectious agent
感染性病原體的檢測

Direct detection  直接檢測

Blood smear cytology  血液抹片細胞學檢查

Cytology of blood smears, stained with Romanowsky type stains (e.g. Wright Giemsa or Diff-Quick), can reveal haemoplasmas on the surface of erythrocytes but this is known to be very unreliable for diagnosis.
使用羅曼諾夫斯基型染色劑(如 Wright Giemsa 或 Diff-Quick)染色的血液抹片細胞學檢查,可在紅血球表面觀察到血漿菌,但已知此方法用於診斷非常不可靠。

Sensitivity is a particular issue with figures of only 0% to 37.5% reported in various studies (Jensen et al., 2001; Westfall et al., 2001; Tasker et al., 2003; Ghazisaeedi et al., 2014; Firmino et al., 2016), with cytology revealing infection only when very high numbers of organisms are present in the blood (likely only in acute infections); indeed ‘Ca. M. turicensis’ has never been seen on blood smears due to the low numbers of organisms present in the blood during infection (Willi et al., 2006a; Willi et al., 2011).
敏感性是一個特別的問題,各項研究報告的數值僅在 0%至 37.5%之間(Jensen 等人,2001;Westfall 等人,2001;Tasker 等人,2003;Ghazisaeedi 等人,2014;Firmino 等人,2016),且細胞學檢查僅在血液中存在極高數量病原體時(可能僅在急性感染期間)才能發現感染;事實上,由於感染期間血液中病原體數量較少,「Candidatus M. turicensis」從未在血液抹片中被觀察到(Willi 等人,2006a;Willi 等人,2011)。

Specificity is usually higher, with values of 84 to 98% (Jensen et al., 2001; Westfall et al., 2001; Tasker et al., 2003; Ghazisaeedi et al., 2014), although, importantly, these figures are based upon board-certified clinical pathologists examining and interpreting blood smears (Tasker, 2010).
特異性通常較高,數值在 84%至 98%之間(Jensen 等人,2001;Westfall 等人,2001;Tasker 等人,2003;Ghazisaeedi 等人,2014),但重要的是,這些數據是基於由委員會認證的臨床病理學家檢查和判讀血液抹片所得(Tasker,2010)。

The cytological detection of organisms during acute infection can be useful as a bench-side and immediate diagnostic test, although the expert interpretation of blood smears needed for this may only be available when sending blood smears to an external laboratory.
在急性感染期間透過細胞學檢測病原體可作為一種即時診斷測試,但這種檢測所需的血液抹片專家判讀可能僅在將血液抹片送至外部實驗室時才能獲得。

However, in reality, many cases diagnosed as being haemoplasma-infected on the basis of blood smear interpretation in practice have been false positives, with stain precipitate, Howell-jolly bodies and artefacts due to slow blood smear drying all being common reasons for error. Additionally, cytology cannot differentiate between haemoplasma species.
然而,實際上許多在臨床上透過血液抹片判讀診斷為血漿支原體感染的案例都屬於偽陽性,染色沉澱、豪威爾-喬利小體以及血液抹片乾燥速度過慢所造成的人工偽影,都是常見的誤判原因。此外,細胞學檢查也無法區分不同種類的血漿支原體。

Culture  文化

Haemoplasmas are currently unculturable in vitro including on bacteriological and cell culture media, despite numerous attempts in experimental studies (Schreiner et al., 2012; Filler, 2020) (personal communication RHL). This also means that antimicrobial sensitivity testing is not possible. A number of haemoplasmas have been subjected to whole genome sequencing, including sequencing of two feline haemoplasma species; M. haemofelis strain Langford 1 (Barker et al., 2011) and ‘Ca. M. haemominutum’ strain Birmingham 1 (Barker et al., 2012). These data have highlighted the limited metabolic capabilities of these important pathogens (glucose is their only energy source), which likely contribute to the haemoplasmas’ current uncultivable status. Such knowledge of haemoplasma metabolic capabilities has allowed studies to direct in vitro cultivation attempts but successful growth has not yet been possible (Schreiner et al., 2012; Baumann et al., 2013).
儘管在實驗研究中進行了多次嘗試(Schreiner 等人,2012 年;Filler,2020 年)(RHL 個人通訊),目前仍無法在體外培養血漿支原體,包括使用細菌學和細胞培養基。這也意味著無法進行抗菌藥物敏感性測試。已有數種血漿支原體進行了全基因組測序,包括兩種貓血漿支原體物種:M. haemofelis Langford 1 株(Barker 等人,2011 年)和「Ca. M. haemominutum」Birmingham 1 株(Barker 等人,2012 年)。這些數據突顯了這些重要病原體有限的代謝能力(葡萄糖是其唯一能量來源),這可能是導致血漿支原體目前無法培養的原因。對血漿支原體代謝能力的了解使得研究能夠指導體外培養嘗試,但至今尚未成功實現生長(Schreiner 等人,2012 年;Baumann 等人,2013 年)。

PCR  聚合酶鏈式反應 (PCR)

Polymerase chain reaction (PCR) assays, to detect haemoplasma DNA, are now the diagnostic method of choice for haemoplasma infection. PCR is performed in specialised diagnostic laboratories following DNA extraction from submitted EDTA blood samples (as little as 0.5 ml of EDTA blood is required).
聚合酶連鎖反應(PCR)檢測現已成為診斷貓血漿體感染的首選方法,該技術可檢測出血漿體 DNA。此檢測需由專業診驗室操作,從送檢的 EDTA 抗凝血樣本中提取 DNA 進行分析(僅需 0.5 毫升 EDTA 血液即可)。

PCR is far more sensitive and specific than cytology and allows differentiation of the haemoplasma species present, as well as the detection of co-infections, when species-specific PCR assays are used. Currently available PCR assays for haemoplasmas are typically based on the detection of segments of the 16S rRNA gene.
相較於細胞學檢查,PCR 技術具有更高的敏感度與特異性。當使用物種特異性 PCR 檢測時,不僅能區分現存的血漿體種類,還能偵測出混合感染情形。目前常用的血漿體 PCR 檢測技術,主要基於 16S rRNA 基因片段進行辨識。

PCRs can be duplexed with a cat housekeeping gene PCR (Peters et al., 2008; Barker et al., 2010b) as an internal control, so that any false negative results due to the failure of DNA extraction, the presence of PCR inhibitors or PCR set-up errors are detected.
PCR 檢測可與貓科管家基因 PCR(Peters 等學者 2008 年;Barker 等學者 2010b 年報告)進行雙重檢測作為內部對照,如此便能發現因 DNA 提取失敗、PCR 抑制物存在或 PCR 設定錯誤所導致的假陰性結果。

Other PCR assays amplify cat housekeeping genes in a separate PCR (i.e. these are not duplex PCR assays) (Soto et al., 2017), which is less optimal as the control PCR is separate from the test PCR.
另有其他 PCR 檢測採用獨立反應來擴增貓管家基因(即非雙重 PCR 檢測)(Soto 等學者 2017 年報告),此種方式因對照 PCR 與檢測 PCR 分開進行,故較不理想。

Quantitative PCR (qPCR) assays also allow quantification of haemoplasma DNA in the sample being analysed, allowing monitoring of response to treatment.
定量聚合酶鏈反應 (qPCR) 檢測可對分析樣本中的血漿支原體 DNA 進行定量,從而監測治療反應。

Blood samples for PCR should be taken before antibiotic treatment is started as effective treatment can result in a rapid and dramatic fall in organism numbers within a few days, as shown in Figure 1, which could result in negative PCR results. It is also known that M. haemofelis blood organism numbers can fluctuate markedly in some cats for several months following infection; the reason for this is not known but could be related to antigenic variation (Tasker et al., 2006a; Tasker et al., 2009a). No evidence of significant tissue sequestration of M. haemofelis, to explain reduced blood organism numbers, has been found (Tasker et al., 2009a). This is in contrast to ‘Ca. M. turicensis’, in which evidence of tissue sequestration was found in PCR-negative cats (Novacco et al., 2013).
PCR 血液樣本應在抗生素治療開始前採集,因為有效治療可能導致生物體數量在幾天內急劇下降(如圖 1 所示),從而可能導致 PCR 結果呈陰性。已知在某些貓隻感染後數月內,M. haemofelis 血液中的生物體數量可能出現顯著波動;其原因尚不清楚,但可能與抗原變異有關(Tasker 等人,2006a;Tasker 等人,2009a)。目前尚未發現 M. haemofelis 有明顯組織隔離的證據來解釋血液中生物體數量減少的原因(Tasker 等人,2009a)。這與「Ca. M. turicensis」形成對比,後者在 PCR 陰性的貓隻中發現了組織隔離的證據(Novacco 等人,2013)。

Fig. 1. Variation in M. haemofelis organism numbers in the blood of a cat, measured by quantitative polymerase chain reaction (qPCR), over time. The cat’s packed cell volume (PCV) measurements are also shown over time, together with a pink shaded area illustrating PCV reference interval. The cat received doxycycline therapy (10/mg/kd PO SID; grey shaded areas) on day 19 post-infection and then again for 21 days from day 28 post-infection. It can be seen that there is a marked drop in organism numbers in the blood with doxycycline treatment. Cycles of increasing and decreasing organism numbers occurred following completion of the 21-day course of doxycycline, but these were not associated with anaemia. Figure adapted from Tasker (2008).

Fig. 1. Variation in M. haemofelis organism numbers (DNA copies) in the blood of a cat over time, measured by quantitative polymerase chain reaction (qPCR). The cat’s packed cell volume (PCV) measurements are also shown over time, together with a pink shaded area illustrating PCV reference interval.
圖 1. 透過定量聚合酶鏈反應(qPCR)測量貓血液中 M. haemofelis 菌體數量(DNA 拷貝數)隨時間的變化。同時顯示該貓的紅血球壓積(PCV)測量值隨時間變化,並以粉色陰影區域標示 PCV 參考區間。

The cat received doxycycline therapy (10 mg/kg q24h PO; grey shaded areas) on day 19 post-infection and then again for 21 days from day 28 post-infection. It can be seen that there is a marked drop in organism numbers in the blood with doxycycline treatment.
該貓於感染後第 19 天開始接受強力黴素治療(10 mg/kg q24h 口服;灰色陰影區域),並於感染後第 28 天起再次進行 21 天療程。可見強力黴素治療後血液中菌體數量顯著下降。

Cycles of increasing and decreasing organism numbers occurred following completion of the 21-day course of doxycycline, but these were not associated with anaemia. Figure adapted from Tasker (2008).
在完成 21 天強力黴素療程後,菌體數量出現週期性增減,但這些變化與貧血無關。本圖改編自 Tasker(2008)的研究。

In-house PCR is not available, although a point-of-care machine (Hawley et al., 2018) that uses isothermal non-quantitative amplification of DNA to diagnose M. haemofelis infection has been described. This method requires in-house extraction of DNA from blood and the extraction technique markedly influences sensitivity, precluding routine recommendation of this method.
目前尚無院內 PCR 檢測,但已有一種使用等溫非定量 DNA 擴增技術來診斷 M. haemofelis 感染的即時檢測儀器(Hawley 等,2018)。此方法需在院內從血液中提取 DNA,且提取技術會顯著影響靈敏度,故不建議常規使用此方法。

Indirect detection  間接檢測

Haemoplasma antibody tests
血漿體抗體檢測

Tests to detect antibodies to haemoplasma species have been difficult to develop due to the inability to culture haemoplasmas in vitro preventing the easy production of significant amounts of haemoplasma protein for use in antibody assays; they are currently only available for use in experimental studies. These antibody assays, based on a M. haemofelis dnaK protein, in experimental studies, have suggested that antibody levels can differentiate between acute and chronic infection with M. haemofelis (Barker et al., 2010a) and have been more sensitive than PCR in detecting haemoplasma exposure (as PCR-negative antibody-positive cats have been identified) (Novacco et al., 2011). However, these assays are not appropriate for use in naturally infected cats yet as their validation in field samples (particularly looking at their specificity) has not been completed.
由於無法在體外培養血漿支原體,難以大量生產用於抗體檢測的血漿支原體蛋白,因此開發檢測血漿支原體物種抗體的測試一直面臨困難;目前這些檢測僅限於實驗研究使用。這些基於 M. haemofelis dnaK 蛋白的抗體檢測在實驗研究中顯示,抗體水平可區分 M. haemofelis 的急性與慢性感染(Barker 等人,2010a),且在檢測血漿支原體暴露方面比 PCR 更敏感(因已發現 PCR 陰性但抗體陽性的貓隻)(Novacco 等人,2011)。然而,這些檢測尚不適用於自然感染的貓隻,因為其對野外樣本的驗證(特別是針對特異性的評估)尚未完成。

Treatment  治療

Antibiotic treatment  抗生素治療

Haemoplasmosis generally has a good prognosis if prompt appropriate treatment is instigated (Tasker, 2022) (Table 1). However, as haemoplasmas lack a cell wall around their cell membrane, ß-lactams (e.g. penicillins, cephalosporins) are not effective in treatment. Tetracyclines (primarily doxycycline) and fluoroquinolones (e.g. marbofloxacin, pradofloxacin) are effective for the treatment of haemoplasmosis. The majority of studies have evaluated the response of M. haemofelis only to treatment.
若能及時採取適當治療,血漿體症通常預後良好(Tasker,2022)(表 1)。然而,由於血漿體缺乏細胞壁包覆細胞膜,β-內醯胺類抗生素(如青黴素、頭孢菌素)治療無效。四環素類(主要是強力黴素)和氟喹諾酮類(如馬波沙星、普拉多沙星)對治療血漿體症有效。多數研究僅評估了 M. haemofelis 對治療的反應。

A 2-week course is usually adequate for uncomplicated haemoplasmosis – courses can be extended if only a partial clinical response occurs. Adapted from Tasker (2022). Enrofloxacin is not a preferred fluoroquinolone in cats as has the potential for irreversible retinal toxicity as an idiosyncratic reaction, although this is rare.
對於無併發症的血漿體症,通常 2 週療程即足夠——若僅出現部分臨床反應,可延長療程。改編自 Tasker(2022)。恩諾沙星並非貓用首選氟喹諾酮類藥物,因其可能引發不可逆視網膜毒性作為特異性反應,儘管此情況罕見。

Antibiotic   抗生素 Dosage (mg/kg) *  劑量 (mg/kg) * Route & frequency  給藥途徑與頻率 Notes  註記
Tetracycline: Doxycycline
四環黴素:強力黴素
5

10

PO q12h  每 12 小時口服一次

PO q24h  每 24 小時口服一次

First line antibiotic for acute haemoplasmosis. Can be associated with gastrointestinal side effects when given q24h. Tablets have been associated with oesophagitis if incompletely swallowed, so always follow with food or water. Paste formulations of doxycycline may be used, if available, when tablets are difficult to administer.
急性血漿體症的第一線抗生素。若每 24 小時給藥一次,可能伴隨胃腸道副作用。若藥片未完全吞服可能導致食道炎,因此務必搭配食物或水服用。若藥片難以投藥且可取得時,可使用多西環素糊劑劑型。
Fluoroquinolone: Marbofloxacin
氟喹諾酮類:馬波沙星
2-5.5 PO q24h  每 24 小時口服一次 Reserve fluoroquinolones as second line antibiotics. Reported use in combination (sequentially) with doxycycline to clear M. haemofelis infection (Novacco et al., 2018)
保留氟喹諾酮類作為二線抗生素。有報告指出與多西環素合併使用(序貫療法)可清除貓血黴漿菌感染(Novacco 等人,2018 年)
Fluoroquinolone:  氟喹諾酮類
Pradofloxacin  普拉多沙星
3-5 PO q24h  每 24 小時口服一次 Reserve fluoroquinolones as second line antibiotics. May be more efficacious at clearing M. haemofelis than doxycycline (Dowers et al., 2009)
保留氟喹諾酮類作為二線抗生素。在清除貓血黴漿菌方面可能比強力黴素更有效(Dowers 等人,2009 年)

* Licensed dosages (e.g. for marbofloxacin) and drug availability vary by country and licensed product.
* 許可劑量(例如馬波沙星)和藥物可用性因國家和許可產品而異。

Doxycycline (10 mg/kg q24h PO or 5 mg/kg q12h PO) is often used as a first line treatment, typically for 2-4 weeks with the longer treatment courses recommended by some to increase the chance of eliminating infection.
強力黴素(每 24 小時口服 10 毫克/公斤或每 12 小時口服 5 毫克/公斤)通常作為一線治療使用,一般療程為 2-4 週,部分建議採用較長療程以增加消除感染的機會。

Straightforward cases which show a rapid response to doxcycyline (typically within 3 days), a 2-week course of doxycycline is usually adequate with no further monitoring required. Administration of the hyclate pill preparation of doxycycline should always be followed by food or water because of the possibility of it inducing oesophagitis in cats with incomplete swallowing.
對於明顯病例若對強力黴素(doxycycline)呈現快速反應(通常在 3 天內),通常 2 週的強力黴素療程即已足夠,無需進一步監測。由於可能引發食道炎,投予鹽酸強力黴素(doxycycline hyclate)錠劑時,務必伴隨食物或水一同給予,以防貓咪吞嚥不完全。

Paste forms of doxycycline, if available, may be preferable. Figure 1 above shows that when treatment is effective, it can be associated with a rapid fall in organism numbers in the blood.
若有凝膠狀強力黴素製劑可供使用,可能是更理想的選擇。如上圖 1 所示,當治療有效時,可觀察到血液中病原體數量快速下降。

One study (Dowers et al., 2009) suggested that 2 weeks of pradofloxacin (at two dosages; both the standard 5 mg/kg q24h PO, as well as a higher dosage of 10 mg/kg q24h PO) can be more effective at clearing M. haemofelis than doxycycline. It has been found that ‘Ca. M. haemominutum’ infection does not necessarily respond to antibiotics similarly to M. haemofelis; in one study (Tasker et al., 2006b) ‘Ca. M. haemominutum’ organism numbers in the blood fell only temporarily during marbofloxacin (2 mg/kg q24h PO) treatment, with organism numbers re-increasing to pre-treatment levels following completion of a 4 weeks course of treatment. Another study found that ‘Ca. M. haemominutum’ infection was not as effectively treated by doxycycline as M. haemofelis (Sykes et al., 2007b), again highlighting the varying response of different haemoplasma species to the same antibiotic. The response of ‘Ca. M. turicensis’ to antibiotic treatment has not been fully evaluated but doxycycline can be effective (Museux et al., 2009).
一項研究(Dowers 等人,2009 年)指出,使用普多沙星(兩種劑量:標準劑量 5 毫克/公斤每日一次口服,以及較高劑量 10 毫克/公斤每日一次口服)進行兩週治療,在清除貓血黴漿菌(M. haemofelis)方面可能比強力黴素更有效。研究發現,「候選黴漿菌微小血型」('Ca. M. haemominutum')感染對抗生素的反應與貓血黴漿菌不盡相同;在一項研究(Tasker 等人,2006b)中,馬波沙星(2 毫克/公斤每日一次口服)治療期間,血液中「候選黴漿菌微小血型」的數量僅暫時下降,在完成 4 週療程後又回升至治療前水平。另一項研究發現,強力黴素治療「候選黴漿菌微小血型」感染的效果不如治療貓血黴漿菌理想(Sykes 等人,2007b),再次突顯不同血漿菌種對相同抗生素的反應差異。「候選黴漿菌土利血型」('Ca. M. turicensis')對抗生素治療的反應尚未完全評估,但強力黴素可能有效(Museux 等人,2009 年)。

Azithromycin was not effective in the treatment of clinical haemoplasmosis in a partially controlled study of cats infected with M. haemofelis and/or ‘Ca. M. haemominutum’ (Westfall et al., 2001).
在一項針對感染 M. haemofelis 和/或'Ca. M. haemominutum'貓隻的部分對照研究中,阿奇黴素對臨床血漿體病症的治療效果不佳(Westfall 等人,2001 年)。

Novacco et al. (2018) described a method for clearance of M. haemofelis infection, should this be required. Here doxycycline treatment was given for 28 days followed by monitoring of copy numbers in the blood by quantitative PCR; if the cat remained PCR-positive, treatment was switched to a fluoroquinolone (marbofloxacin was used in the study) for 14 days and this was associated with apparent clearance of infection.
Novacco 等人(2018 年)描述了一種清除 M. haemofelis 感染的方法(若需要時)。該方法先給予 28 天的強力黴素治療,隨後透過定量 PCR 監測血液中的拷貝數;若貓隻仍呈 PCR 陽性,則改用氟喹諾酮類藥物(該研究中使用馬波沙星)治療 14 天,此方法與明顯的感染清除相關。

So, this study suggests that the use of doxycycline followed by marbofloxacin could be useful for clearance of M. haemofelis. Attempts to clear infection can be considered when M. haemofelisassociated clinical disease is particularly severe and/or has been recurrent. Moreover, clearance of M. haemofelis infection may be required in certain situations, such as for cats living in multicat environments together with M. haemofelis-naïve cats, since acute primary infection can lead to severe haemolytic anaemia, for cats with immunodeficiency, for cats to be used as blood donors and for cats living with immunocompromised persons. However, treatment of carrier cats that do not show any clinical signs is not generally recommended.
因此,這項研究表明,使用多西環素(doxycycline)後接馬波沙星(marbofloxacin)可能有助於清除貓血黴漿菌(M. haemofelis)。當貓血黴漿菌相關臨床病症特別嚴重或反覆發作時,可考慮嘗試清除感染。此外,在某些情況下可能需要清除貓血黴漿菌感染,例如:與未接觸過貓血黴漿菌的貓隻共同生活在多貓環境中的貓(因為急性原發性感染可能導致嚴重溶血性貧血)、免疫缺陷貓隻、將作為供血貓使用的貓隻,以及與免疫功能低下者共同生活的貓隻。然而,通常不建議對無任何臨床症狀的帶原貓進行治療。

Supportive care  支持性照護

Other supportive care for haemoplasma-infected cats can be important; correction of dehydration with fluid therapy is important, as well as tempting the cat to eat or assisted feeding if the cat is anorexic.
對於感染血黴漿菌的貓隻,其他支持性照護可能相當重要;透過輸液療法治療脫水至關重要,若貓隻出現厭食情況,還需設法誘導進食或進行輔助餵食。

Blood transfusions (ideally packed red blood cells if available) may be required if the anaemia is very severe; in one study 35% of cats received blood transfusions for severe anaemia due to haemoplasmosis (Razgūnaitė et al., 2024).
若貧血情況極其嚴重,可能需要進行輸血(理想情況下應使用濃縮紅血球,如有供應);一項研究顯示,35%的貓隻因血黴漿菌病導致嚴重貧血而接受輸血治療(Razgūnaitė等人,2024 年)。

However, anaemic cats are at risk of fluid overload due to increased circulating volume, particularly in the presence of occult cardiac disease (Barker, 2019), so care should be taken with intravenous fluid treatment and blood administration. Oxygen therapy can be provided pending stabilization of the patient’s oxygen carrying capacity.
然而,貧血貓咪由於循環血量增加,特別是在存在隱性心臟疾病的情況下(Barker, 2019),有體液過負荷的風險,因此在進行靜脈輸液治療和輸血時應謹慎。在患者攜氧能力穩定前可提供氧氣治療。

Corticosteroid treatment
皮質類固醇治療

Corticosteroids have been used as adjunct treatment for any immune-mediated component of haemoplasma-associated anaemia (Razgūnaitė et al., 2024), although cats (even those with positive Coombs’ tests) usually recover without any need for corticosteroid treatment, as antibiotic and supportive care alone is usually adequate (Tasker et al., 2009b).
雖然皮質類固醇曾被用作治療血漿體相關貧血中任何免疫介導成分的輔助療法(Razgūnaitė等,2024),但貓咪(即使是庫姆斯試驗陽性者)通常無需皮質類固醇治療即可康復,因為僅靠抗生素和支持性照護通常就已足夠(Tasker 等,2009b)。

Immunosuppressive dosages of glucocorticoids have been used experimentally to increase haemoplasma bacteraemia and induce reactivation of subclinical infection (Harvey and Gaskin, 1978; Dowers et al., 2002; Yuan et al., 2007; Dowers et al., 2009; Novacco et al., 2018), also suggesting that they should not be used in clinical haemoplasmosis.
實驗中曾使用免疫抑制劑量的糖皮質激素來增加血漿體菌血症並誘發亞臨床感染的再活化(Harvey 和 Gaskin,1978;Dowers 等,2002;Yuan 等,2007;Dowers 等,2009;Novacco 等,2018),這也表明它們不應被用於臨床血漿體症治療。

Thus, we do not recommend the use of corticosteroids for the treatment of haemoplasmosis unless a cat with a positive Coombs’ test fails to respond to appropriate antibiotic treatment alone and the diagnosis of haemoplasmosis is uncertain. In such cases, immune-mediated haemolytic anaemia could be the cause of the cat’s anaemia.
因此,除非貓隻庫姆斯試驗(Coombs’ test)呈陽性且對單獨使用適當抗生素治療無反應,同時血漿體病診斷尚不確定,否則我們不建議使用皮質類固醇治療血漿體病。此類情況下,免疫介導性溶血性貧血可能是造成貓隻貧血的原因。

Prognosis  預後

Haemoplasmosis generally has a good prognosis if prompt appropriate treatment is instigated quickly but mortality can be high in severe disease (Ider et al., 2024).
若能及時採取適當治療,血漿體病通常預後良好,但在嚴重病例中死亡率可能較高(Ider 等人,2024 年)。

One study (Ider et al., 2024) described that the albumin to globulin ratio was a good prognostic indicator for predicting mortality with 92% sensitivity and 88% specificity at a cut-off point of 0.46. The same study reported that the serum endothelin-1 and vascular endothelial growth factor-A concentrations could be used as prognostic biomarkers in feline haemotropic mycoplasmosis but more research is required before this can be applied to clinical cases.
一項研究(Ider 等人,2024 年)指出,白蛋白與球蛋白比值是預測死亡率的良好預後指標,當截斷值設為 0.46 時,其敏感性達 92%,特異性達 88%。該研究同時報告血清內皮素-1 和血管內皮生長因子-A 濃度可作為貓血漿黴漿菌病的預後生物標記,但在應用於臨床病例前仍需更多研究驗證。

If infection is not cleared, cats may have subsequent reactivation of infection with recurrence of clinical disease.
如果感染未被清除,貓咪可能會在後續出現感染再活化,伴隨臨床疾病復發。

Vaccination  疫苗接種

There are no vaccines against feline haemoplasmosis.
目前尚無針對貓血漿體病的疫苗。

Prevention  預防措施

As the natural route of transmission of haemoplasma infections is not known, it is difficult to be precise regarding how to prevent infection.
由於貓血漿體感染的自然傳播途徑尚未明確,因此難以精確說明如何預防感染。

As biting may be involved in transmission, attempts to reduce any inter-cat aggression may be considered. Keeping cats indoors is also likely to prevent infection as outdoor status has been identified as a risk factor, but this is likely to be impractical and stressful for cats used to having outdoor access.
由於咬傷可能涉及傳播途徑,可考慮採取措施減少貓隻間的攻擊行為。將貓隻飼養在室內也可能預防感染,因為戶外活動已被確認為風險因子,但對於習慣戶外活動的貓隻而言,這種做法可能不切實際且會造成壓力。

Blood donors should be screened for haemoplasma infection by PCR to prevent inadvertent transmission by blood transfusion from carrier cats that do not show any clinical signs (Pennisi et al., 2015).
為避免無臨床症狀的帶原貓經由輸血造成意外傳播,應透過 PCR 篩檢血液捐贈者是否感染血漿菌(Pennisi 等人,2015 年)。

One study (Mesa-Sanchez et al., 2021) describing the screening of healthy, client-owned, indoor cats to become blood donors in Spain and Portugal found that in 4,880 retroviral (FIV antibody and FeLV antigen) seronegative cats, haemoplasmas were detected in 3.7% of cats (1.3% were positive for M. haemofelis; 2.3% for ‘Ca. M. haemominutum’ and 0.12% for ‘Ca. M. turicensis’) showing that haemoplasma infections should be screened for even in cats deemed to be of low risk for infections.
一項針對西班牙與葡萄牙健康家養室內貓作為血液捐贈者的篩檢研究(Mesa-Sanchez 等人,2021 年)發現,在 4,880 隻反轉錄病毒(貓免疫缺陷病毒抗體與貓白血病病毒抗原)血清陰性的貓隻中,有 3.7%檢測出血漿菌感染(1.3%為 M. haemofelis 陽性;2.3%為「Ca. M. haemominutum」陽性;0.12%為「Ca. M. turicensis」陽性),顯示即使被認為感染風險低的貓隻也應進行血漿菌篩檢。

Although vectors have not been proven to transmit haemoplasma infection, preventative flea and tick treatment is probably wise to help prevent infection in case vectors are involved.
雖然尚未證實病媒會傳播血漿菌感染,但為預防可能的病媒傳播途徑,實施跳蚤與壁蝨的預防性治療仍是明智之舉。

Zoonotic risk  人畜共通傳染風險

Haemoplasma infections with novel haemoplasma species have been described in humans (Steer et al., 2011; Maggi et al., 2013; Alcorn et al., 2020; Hattori et al., 2020), as well as with species that have possibly originated in animals, including one case in an immunocompromised human with M. haemofelis (dos Santos et al., 2008), raising the possibility of zoonotic infections. We do not believe that there is a significant risk of human infection with feline haemoplasma species. As with the routine handling of clinical samples, vets should handle the blood and tissues from cats suspected to be haemoplasma-infected with caution.
新型血漿菌屬感染已在人類中被報導(Steer 等人,2011;Maggi 等人,2013;Alcorn 等人,2020;Hattori 等人,2020),包括可能源自動物的菌種,其中一例為免疫功能低下人類感染 M. haemofelis 的病例(dos Santos 等人,2008),這提高了人畜共通傳染的可能性。我們認為貓血漿菌屬感染人類的風險並不高。如同常規處理臨床檢體時應注意的事項,獸醫師應謹慎處理疑似感染血漿菌屬貓隻的血液與組織樣本。

Acknowledgement  致謝

ABCD Europe gratefully acknowledges the support of Boehringer Ingelheim (the founding sponsor of the ABCD), MSD Animal Health, Vétoquinol, Virbac and IDEXX.
ABCD Europe 誠摯感謝勃林格殷格翰(ABCD 創始贊助商)、MSD Animal Health、威隆藥廠、維克藥廠以及愛德士生物科技的支持。

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