Antimicrobial susceptibilities of Mycoplasma isolated from bovine mastitis in Japan

Bovine mastitis, a worldwide impact disease: Prevalence, antimicrobial resistance, and viable alternative approaches

Bovine mastitis is globally considered one of the most important diseases within dairy herds, mainly due to the associated economic losses. The most prevalent etiology are bacteria, classified into contagious and environmental, with Staphylococcus aureus, Streptococcus agalactiae, Streptococcus uberis, Escherichia coli and Klebsiella pneumoniae being the most common pathogens associated with mastitis cases. To date these pathogens are resistant to the most common active ingredients used for mastitis treatment. According to recent studies resistance to new antimicrobials has increased, which is why developing of alternative treatments is imperative. Therefore the present review aims to summarize the reports about bovine mastitis along 10 years, emphasizing bacterial etiology, its epidemiology, and the current situation of antimicrobial resistance, as well as the development of alternative treatments for this pathology. Analyzed data showed that the prevalence of major pathogens associated with bovine mastitis varied according to geographical region. Moreover, these pathogens are classified as multidrug-resistant, since the effectiveness of antimicrobials on them has decreased. To date, several studies have focused on the research of alternative treatments, among them vegetal extracts, essential oils, or peptides. Some other works have reported the application of nanotechnology and polymers against bacteria associated with bovine mastitis. Results demonstrated that these alternatives may be effective on bacteria associated with bovine mastitis.

A GC-Rich Prophage-Like Genomic Region of Mycoplasma bovirhinis HAZ141_2 Carries a Gene Cluster Encoding Resistance to Kanamycin and Neomycin

Recently, a complete genome sequence of Mycoplasma bovirhinis HAZ141_2 was published showing the presence of a 54-kB prophage-like region. Bioinformatic analysis revealed that this region has a more than 40% GC content and a chimeric organization with three structural elements-a prophage continuous region, a restriction-modification cassette, and a highly transmittable aadE-sat4-aphA-3 gene cluster found in both Gram-positive and Gram-negative bacteria. It is known that aadE confers resistance to streptomycin, sat4 governs resistance to streptothricin/nourseothricin, and aphA-3 is responsible for resistance to kanamycin and structurally related antibiotics. An aadE-like (aadE*) gene of strain HAZ141_2 encodes a 228-amino acid (aa) polypeptide whose carboxy-terminal domain (positions 44 to 206) is almost identical to that of a functional 302-aa AadE (positions 140 to 302). Transcription analysis of the aadE*-sat4-aphA-3 genes showed their cotranscription in M. bovirhinis HAZ141_2. Moreover, a common promoter for aadE*-sat4-aphA-3 was mapped upstream of aadE* using 5' rapid amplification of cDNA ends analysis. Determination of MICs to aminoglycosides and nourseothricin revealed that M. bovirhinis HAZ141_2 is highly resistant to kanamycin and neomycin (≥512 μg/ml). However, MICs to streptomycin (64 μg/ml) and nourseothricin (16 to 32 μg/ml) were similar to those identified in the prophageless M. bovirhinis type strain PG43 and Israeli field isolate 316981. We cloned the aadE*-sat4-aphA-3 genes into a low-copy-number vector and transferred them into antibiotic-sensitive Escherichia coli cells. While the obtained E. coli transformants were highly resistant to kanamycin, neomycin, and nourseothricin (MICs, ≥256 μg/ml), there were no changes in MICs to streptomycin, suggesting a functional defect of the aadE*.

Molecular characteristics and antibiotic susceptibility profiles of Mycoplasma bovis associated with mastitis on dairy farms in China

Mycoplasma bovis (M. bovis) is regarded as the most prevalent mycoplasma species causing bovine mastitis worldwide. This study was conducted with the objectives to: (1) estimate M. bovis prevalence in samples from clinical mastitis and bulk tank milk; (2) assess genetic diversity and population structure of isolates; and (3) determine antibiotic susceptibility of isolates to nine antimicrobials. Milk samples (n = 476), including 450 clinical mastitis and 26 bulk tank milk samples from 23 farms (each with >1000 lactating cows) in 10 provinces of China were collected between May 2018 and September 2019. M. bovis cultured from milk samples were analyzed by multi-locus sequence typing. Minimum inhibitory concentrations of all isolates to nine antimicrobials were determined. Differences in minimum inhibitory concentration values were assessed by Kruskal-Wallis test with Bonferroni correction. The positive proportions of M. bovis in clinical mastitis samples and bulk tank milk samples were 39/450 (8.7%) and 11/26 (42.3%), respectively. Based on multi-locus sequence typing, the 50 isolates were identified as three sequence types, including sequence type 10 and two novel sequence types (newly registered as sequence type 172 and sequence type 173). The most prevalent type, sequence type 172 (31/50, 62.0%), had allelic profile 4, 3, 2, 3, 5, 7, 4. In addition, sequence type 10 with allelic profile 4, 3, 2, 3, 5, 3, 4 had a mid-range prevalence (11/50, 22.0%), whereas sequence type 173 with allelic profile 10, 3, 6, 13, 21, 6, 10 was the least prevalent (8/50, 16.0%). Both sequence type 10 and sequence type 172 were clustered in Clonal Complex 3, with isolates from the USA. M. bovis isolates in this study uniformly had low level minimum inhibitory concentrations to enrofloxacin and tiamulin. Overall variances among isolates were significant (Kruskal-Wallis test) for clindamycin (P = 0.006), erythromycin (P = 0.012) and tylosin (P =0.004). Relative to the sequence type 10 group, there were higher minimum inhibitory concentrations levels for the sequence type 173 group (H = -19.795, P = 0.003, for clindamycin; H = -19.574, P = 0.003, for erythromycin; and H = -18.881, P = 0.003, for tylosin) by post-hoc comparisons using pairwise comparisons of mean ranks following Kruskal-Wallis test with Bonferroni correction. Hence, increasing antimicrobial resistance may have contributed to emergence of novel sequence types. These data provided a baseline for elucidating genetic diversity and antibiotic susceptibility profiles of M. bovis in the main dairy-farming provinces in China.

Mycoplasma bovis in Spanish Cattle Herds: Two Groups of Multiresistant Isolates Predominate, with One Remaining Susceptible to Fluoroquinolones

Mycoplasma bovis is an important bovine pathogen causing pneumonia, mastitis, and arthritis and is responsible for major economic losses worldwide. In the absence of an efficient vaccine, control of M. bovis infections mainly relies on antimicrobial treatments, but resistance is reported in an increasing number of countries. To address the situation in Spain, M. bovis was searched in 436 samples collected from beef and dairy cattle (2016–2019) and 28% were positive. Single-locus typing using polC sequences further revealed that two subtypes ST2 and ST3, circulate in Spain both in beef and dairy cattle, regardless of the regions or the clinical signs. Monitoring of ST2 and ST3 isolates minimum inhibitory concentration (MIC) to a panel of antimicrobials revealed one major difference when using fluoroquinolones (FQL): ST2 is more susceptible than ST3. Accordingly, whole-genome sequencing (WGS) further identified mutations in the gyrA and parC regions, encoding quinolone resistance-determining regions (QRDR) only in ST3 isolates. This situation shows the capacity of ST3 to accumulate mutations in QRDR and might reflect the selective pressure imposed by the extensive use of these antimicrobials. MIC values and detection of mutations by WGS also showed that most Spanish isolates are resistant to macrolides, lincosamides, and tetracyclines. Valnemulin was the only one effective, at least in vitro, against both STs.

Phenotypic antimicrobial susceptibility of environmental bacteria from mastitic milk of pastured dairy cows of S. Miguel (Azores)

The aim of this study was to evaluate the phenotypic (in vitro) antimicrobial susceptibility of milk pathogens isolated from subclinical and clinical mastitis in outdoor dairy herds of S. Miguel, Azores. Between January and March 2018, a total of 144 isolates was obtained from dairy cows with mastitis. Escherichia coli (38.9%; n = 56), Streptococcus uberis (20.1%; n = 29), and coagulase-negative staphylococci (17.4%; n = 25) were the major milk pathogens isolated. An in vitro average susceptibility of 52.0% was observed for 13 different antimicrobials (n = 725). According to an analysis of the mean for proportions, the proportions of bacterial isolates presenting in vitro susceptibility to danofloxacin (75.3%; P < 0.001) and to trimethoprim-sulfamethoxazole (25.0%; P < 0.05) were outside of the upper (65.8%) and lower (25.6%) decision lines, respectively. This profile was related to mainly with E. coli and Strep. uberis isolates. Multidrug resistance was observed in 2.1% isolates, namely, in two Strep. uberis strains from the same farm and one Enterococcus sp. strain. In conclusion, varying degrees of in vitro susceptibility of milk pathogens to the tested antimicrobials were observed, suggesting that these environmental bacteria probably play an important role in the spread of antimicrobial resistances in pastures. The use of fluoroquinolones to treat mastitis of dairy cows should be carefully evaluated in order to maintain their suitability for human medicine.

Relationship between Antimicrobial Susceptibility and Multilocus Sequence Type of Mycoplasma bovis Isolates and Development of a Method for Rapid Detection of Point Mutations Involved in Decreased Susceptibility to Macrolides, Lincosamides, Tetracyclines, and Spectinomycin

Mycoplasma bovis isolates belonging to the sequence type 5 (ST5) group, the dominant group in Japan since 1999, were low susceptible to 16-membered macrolides and tetracyclines and were confirmed to have a guanine-to-adenine transition mutation at position 748 in the 23S rRNA gene (rrl) and adenine-to-thymine transversion mutations at positions 965 and 967 in the 16S rRNA gene (rrs) (Escherichia coli numbering). Moreover, isolates of ST93 and ST155, members of the ST5 group, were low susceptible to lincosamides and azithromycin and showed an adenine-to-guanine transition mutation at position 2059 of rrl Isolates of ST93 were additionally low susceptible to spectinomycin and showed a cytosine-to-adenine transversion mutation at position 1192 of rrs Strains of the ST5 group seem to spread to Japan and Europe from North America with imported cows, while strains of ST93 and ST155 originated in Japan. Melting curve analysis using hybridization probes revealed the existence of point mutations involved in decreased susceptibility to macrolides, lincosamides, and spectinomycin, as demonstrated by changes in the melting curve shape and/or decreases in the melting peak temperature, so the susceptibility to these antimicrobials can be assessed on the same day. For decreased susceptibility to fluoroquinolones to exist, nonsynonymous mutations in the DNA gyrase gene (gyrA) and topoisomerase IV gene (parC) had to coexist. The combination of amino acid substitutions of serine at position 83 in gyrA and serine at position 80 in parC resulted in particularly low susceptibility to fluoroquinolones.IMPORTANCE Mycoplasma bovis is the main causal species of bovine mycoplasmal disease and leads to significant economic losses because of its severe symptoms, strong infectivity, and refractoriness. As for mastitis, culling cows with intramammary infections is a general countermeasure to prevent spreading. The conventional antimicrobial susceptibility test for mycoplasma is time-consuming and troublesome, but no quick and easy method for grasping the antimicrobial susceptibility of the causal strain exists at present. Treatment without antimicrobial susceptibility information may be one reason why M. bovis infection is refractory. Detecting a mutation involved in decreased susceptibility to antimicrobial agents of the causal strain makes it possible to easily select suitable antimicrobials for treatment, and this technique will help improve the cure rate and prevent the overuse of ineffective antimicrobial agents. In this study, we developed a technique to quickly and easily assess antimicrobial susceptibility based on the genetic characteristics of M. bovis strains in Japan.

Effects of Neutrophil Extracellular Traps on Bovine Mammary Epithelial Cells in vitro

Bovine mastitis is a common infectious disease which causes huge economic losses in dairy cattle. Bovine mammary epithelial cell (BMEC) damage usually directly causes the decrease of milk production, which is one of the most important causes of economic loss. NETs, novel effector mechanisms, are reported to exacerbate the pathogenesis of several inflammatory diseases. NETs formation has also been observed in the milk and mammary glands of sheep. However, the effects and detailed mechanisms of NETs on BMEC damage remain unclear. Thus, we aim to examine the effects of NETs on BMECs in vitro, and further to investigate the detail mechanism. In this study, the cytotoxicity of NETs on BMECs was determined using lactic dehydrogenase (LDH) levels in culture supernatants. Histone-induced BMEC damage was examined by flow cytometry and immunofluorescence analysis. The activities of caspase 1, caspase 3, caspase 11, and NLRP3 was detected using western blotting and immunohistochemical analysis. The results showed that NETs and their component histone significantly increased cytotoxicity to BMECs, suggesting the critical role of NETs, and their component histone in BMEC damage. In addition, histone could also induce necrosis, pyroptosis, and apoptosis of BMECs, and the mechanisms by which histone leads to BMEC damage occurred via activating caspase 1, caspase 3, and NLRP3. Altogether, NETs formation regulates inflammation and BMEC damage in mastitis. Inhibiting excess NETs formation may be useful to ameliorate mammary gland damage associated with mastitis.

Antimicrobial Resistance in Mycoplasma spp

Mycoplasmas are intrinsically resistant to antimicrobials targeting the cell wall (fosfomycin, glycopeptides, or β-lactam antibiotics) and to sulfonamides, first-generation quinolones, trimethoprim, polymixins, and rifampicin. The antibiotics most frequently used to control mycoplasmal infections in animals are macrolides and tetracyclines. Lincosamides, fluoroquinolones, pleuromutilins, phenicols, and aminoglycosides can also be active. Standardization of methods used for determination of susceptibility levels is difficult since no quality control strains are available and because of species-specific growth requirements. Reduced susceptibility levels or resistances to several families of antimicrobials have been reported in field isolates of pathogenic Mycoplasma species of major veterinary interest: M. gallisepticum and M. synoviae in poultry; M. hyopneumoniae, M. hyorhinis, and M. hyosynoviae in swine; M. bovis in cattle; and M. agalactiae in small ruminants. The highest resistances are observed for macrolides, followed by tetracyclines. Most strains remain susceptible to fluoroquinolones. Pleuromutilins are the most effective antibiotics in vitro. Resistance frequencies vary according to the Mycoplasma species but also according to the countries or groups of animals from which the samples were taken. Point mutations in the target genes of different antimicrobials have been identified in resistant field isolates, in vitro-selected mutants, or strains reisolated after an experimental infection followed by one or several treatments: DNA-gyrase and topoisomerase IV for fluoroquinolones; 23S rRNA for macrolides, lincosamides, pleuromutilins, and amphenicols; 16S rRNAs for tetracyclines and aminoglycosides. Further work should be carried out to determine and harmonize specific breakpoints for animal mycoplasmas so that in vitro information can be used to provide advice on selection of in vivo treatments.

Mutations associated with change of susceptibility to lincosamides and/or macrolides in field and laboratory-derived Mycoplasma californicum strains in Japan, and development of a rapid detection method for these mutations

Five mutations involved in changing of susceptibility to lincosamides and/or macrolides were investigated in field isolates of Mycoplasma californicum in Japan, and reconfirmed in laboratory-derived mutants. In addition, a quick and easy detection method for these mutations was established. Guanine at position 748 (Escherichia coli numbering) of the 23S rRNA gene (rrl) was shown to be involved with decreased susceptibility to 16-membered macrolides, and adenines at positions 2059 and 2062 of rrl were involved with decreased susceptibility to both lincosamides and macrolides. Both guanine at position 2576, and change from cytosine to thymine at position 2611 of rrl were found to be involved with decreased susceptibility to lincosamides, and the latter mutation also increased the susceptibility to erythromycin. These mutations were easily induced by several to approximately 30 passages in a medium containing the respective antimicrobial, but they did not return after their initial appearance. The melting curve analysis using hybridization probes revealed the existence of these mutations by the change in the melting curve shape and/or decrease in the melting peak temperature. The detection limit in milk samples with a somatic cell count up to 716 × 10³ cell/mL was 133 cfu/mL, but an excessive increase in the cell count in milk or storage of the milk sample at chilling or freezing temperature decreased the sensitivity. This method requires only a few hours, so field veterinarians can make a same-day determination of susceptibility to macrolides and lincosamides, which are first-line antibiotics for bovine mycoplasmal mastitis.

Mycoplasma bovis isolates from dairy calves in Japan have less susceptibility than a reference strain to all approved macrolides associated with a point mutation (G748A) combined with multiple species-specific nucleotide alterations in 23S rRNA

Erythromycin, tylosin and tilmicosin are approved for use in cattle in Japan, the latter two being used to treat Mycoplasma bovis infection. In this study, 58 M. bovis isolates obtained from Japanese dairy calves all exhibited reduced susceptibility to these macrolides, this widespread reduced susceptibility being attributable to a few dominant lineages. All 58 isolates contained the G748A variant in both the rrl3 and rrl4 alleles of 23S rRNA, whereas a reference strain (PG45) did not. G748 localizes in the central loop of domain II (from C744 to A753) of 23S rRNA, which participates in binding to mycinose, a sugar residue present in both tylosin and tilmicosin. A number of in vitro-selected mutants derived from M. bovis PG45 showed reduced susceptibility to tylosin and tilmicosin and contained a nucleotide insertion within the central loop of domain II of rrl3 (U747-G748Ins_CU/GU or A743-U744Ins_UA), suggesting that mutations around G748 confer this reduced susceptibility phenotype. However, other Mycoplasma species containing G748A were susceptible to tylosin and tilmicosin. Sequence comparison with Escherichia coli revealed that M. bovis PG45 and isolates harbored five nucleotide alterations (U744C, G745A, U746C, A752C and A753G) in the central loop of domain II of 23S rRNA, whereas other Mycoplasma species lacked at least two of these five nucleotide alterations. It was therefore concluded that G748 mutations in combination with species-specific nucleotide alterations in the central loop of domain II of 23S rRNA are likely sufficient to reduce susceptibility of M. bovis to tylosin and tilmicosin.

Whole-Genome Sequencing and Concordance Between Antimicrobial Susceptibility Genotypes and Phenotypes of Bacterial Isolates Associated with Bovine Respiratory Disease

Extended laboratory culture and antimicrobial susceptibility testing timelines hinder rapid species identification and susceptibility profiling of bacterial pathogens associated with bovine respiratory disease, the most prevalent cause of cattle mortality in the United States. Whole-genome sequencing offers a culture-independent alternative to current bacterial identification methods, but requires a library of bacterial reference genomes for comparison. To contribute new bacterial genome assemblies and evaluate genetic diversity and variation in antimicrobial resistance genotypes, whole-genome sequencing was performed on bovine respiratory disease–associated bacterial isolates (Histophilus somni, Mycoplasma bovis, Mannheimia haemolytica, and Pasteurella multocida) from dairy and beef cattle. One hundred genomically distinct assemblies were added to the NCBI database, doubling the available genomic sequences for these four species. Computer-based methods identified 11 predicted antimicrobial resistance genes in three species, with none being detected in M. bovis. While computer-based analysis can identify antibiotic resistance genes within whole-genome sequences (genotype), it may not predict the actual antimicrobial resistance observed in a living organism (phenotype). Antimicrobial susceptibility testing on 64 H. somni, M. haemolytica, and P. multocida isolates had an overall concordance rate between genotype and phenotypic resistance to the associated class of antimicrobials of 72.7% (P < 0.001), showing substantial discordance. Concordance rates varied greatly among different antimicrobial, antibiotic resistance gene, and bacterial species combinations. This suggests that antimicrobial susceptibility phenotypes are needed to complement genomically predicted antibiotic resistance gene genotypes to better understand how the presence of antibiotic resistance genes within a given bacterial species could potentially impact optimal bovine respiratory disease treatment and morbidity/mortality outcomes.

Control of Pseudomonas mastitis on a large dairy farm by using slightly acidic electrolyzed water

The disinfection effect of slightly acidic electrolyzed water (SAEW) use in a farm where Pseudomonas mastitis has spread was evaluated. Despite the application of antibiotic therapy and complete cessation of milking infected quarters, numerous new and recurrent Pseudomonas aeruginosa clinical mastitis infections (5.8-7.1% of clinical mastitis cases) occurred on the farm from 2003 to 2005. Procedural changes and equipment modifications did not improve environmental contamination or the incidence of Pseudomonas mastitis. To more thoroughly decontaminate the milking parlor, an SAEW system was installed in 2006. All milking equipment and the parlor environment were sterilized with SAEW (pH 5-6.5, available chlorine 12 parts per million) before and during milking time. After adopting the SAEW system, the incidence of clinical and subclinical Pseudomonas mastitis cases decreased significantly (P < 0.0001) and disappeared. These findings suggest that SAEW effectively reduced the incidence of mastitis in a herd contaminated by Pseudomonas species. This is the first report to demonstrate the effectiveness of disinfection by SAEW against mastitis pathogens in the environment.

Mycoplasma bovis: Mechanisms of Resistance and Trends in Antimicrobial Susceptibility

Mycoplasma bovis is a cell-wall-less bacterium and belongs to the class Mollicutes. It is the most important etiological agent of bovine mycoplasmoses in North America and Europe, causing respiratory disease, mastitis, otitis media, arthritis, and reproductive disease. Clinical disease associated with M. bovis is often chronic, debilitating, and poorly responsive to antimicrobial therapy, resulting in significant economic loss, the full extent of which is difficult to estimate. Until M. bovis vaccines are universally available, sanitary control measures and antimicrobial treatment are the only approaches that can be used in attempts to control M. bovis infections. However, in vitro studies show that many of the current M. bovis isolates circulating in Europe have high minimum inhibitory concentrations (MIC) for many of the commercially available antimicrobials. In this review we summarize the current MIC trends indicating the development of antimicrobial resistance in M. bovis as well as the known molecular mechanisms by which resistance is acquired.

Antimicrobial susceptibility of Mycoplasma bovis isolates from veal calves and dairy cattle in the Netherlands

Control of Mycoplasma bovis infections depends on good husbandry practices and antibiotic treatment. To allow more prudent use of antimicrobial drugs, there is a need for information on the susceptibility profile of this pathogen. The objective of the present study was to analyse the in vitro antimicrobial susceptibility of clinical M. bovis isolates in the Netherlands. The collection comprised 95 bovine isolates, originating from lungs (n=56), mastitis milk (n=27), and synovial fluid (n=12), collected between 2008 and 2014. Minimal inhibitory concentrations (MICs) were assessed by broth microdilution, both by using in-house prepared MIC plates and by using commercially available MIC plates. For each antimicrobial agent, the range of MIC results, the MIC50, and MIC90 values were calculated. M. bovis strains recently isolated in the Netherlands appeared to be characterized by relatively high MIC values for antimicrobial agents that, until now, have been recommended by the Dutch Association of Veterinarians for treating pneumonia caused by Mycoplasma species. Fluoroquinolones appeared to be the most efficacious in inhibiting M. bovis growth, followed by tulathromycin and oxytetracycline. The highest MIC values were obtained for erythromycin, tilmicosin, and tylosin. Future studies should be done on determining M. bovis specific clinical breakpoints, standardization of methods to determine MIC values as well as molecular studies on detection of antimicrobial resistance mechanisms of M. bovis isolates to develop PCR assays for determining resistance.

In vitro antimicrobial susceptibility of Mycoplasma bovis clinical isolates recovered from bison (Bison bison)

Mycoplasma bovis is a pathogen globally affecting cattle and bison herds, causing pneumonia, arthritis, mastitis, abortions, and other symptoms, leading to huge economic losses. Many studies have been done regarding the antimicrobial susceptibility of M. bovis isolated from cattle, but no such study is available for isolates recovered from bison. For the first time, in vitro susceptibilities of 40 M. bovis clinical isolates collected from bison herds in Canada are reported here. Minimal inhibitory concentration (MIC) values were determined using Sensititre® plates. The most effective MIC50 and MIC90 were for spectinomycin (1 and >64 μg/mL), tiamulin (1 and >32 μg/mL), and tulathromycin (16 and 64 μg/mL), whereas tetracyclines, fluoroquinolones, and florfenicol failed to inhibit growth of M. bovis bison isolates. Isolates were nonsusceptible to tetracyclines (100%), fluoroquinolones (97.5%), and tilmicosin (100%), whereas the highest susceptibility of bison clinical isolates was seen with spectinomycin (95%) and tulathromycin (67.5%). Two lung isolates (Mb283 and 348) were found resistant to both spectinomycin and tulathromycin. These results show a marked difference in antimicrobial susceptibility of bison isolates as compared with previously reported and laboratory reference cattle isolates, emphasizing the necessity of testing antimicrobial susceptibility of M. bovis bison isolates and to generate better therapeutic regime for improved recovery chances for infected bison herds across North America.

Ex vivo pharmacokinetic and pharmacodynamic analysis of valnemulin against Mycoplasma gallisepticum S6 in Mycoplasma gallisepticum and Escherichia coli co-infected chickens

Pharmacokinetic and pharmacodynamic (PK/PD) indices against Mycoplasma gallisepticum (MG) S6 were investigated in an ex vivo PK/PD model following oral administration of valnemulin to chickens co-infected with M. gallisepticum and Escherichia coli. The minimum inhibitory concentrations (MICs) for valnemulin against MG S6 in artificial medium and chicken serum were determined. In vitro time-killing curves were established according to a series of multiples of the MIC value in an artificial medium, and ex vivo time-killing curves were established in serum samples obtained from infected chickens at different time points after oral administration with an initial titer of 1 × 10(6) color change units (CCU)/mL MG S6. The sigmoid Emax model was used to provide 24 h area under concentration-time curve/minimum inhibitory concentration ratios (AUC0-24h/MIC) for mycoplasmastasis, mycoplasmacidal activity and mycoplasmal elimination, respectively. The inoculum size and micro or macro methods exhibited little effect on MIC determination of MG, whereas matrix had a large effect. The rapid killing activity observed in in vitro time-killing curves seems to indicate that valnemulin was mycoplasmacidal and concentration dependent against MG. The AUC0-24h/MIC ratio for mycoplasmacidal activity and mycoplasmal elimination was 1321 h and 1960 h, respectively. A dosage regimen of 12.4 mg/kg/day and 18.3 mg/kg/day valnemulin was calculated for mycoplasmacidal activity and mycoplasmal elimination against MG S6, respectively.