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Journal of Clinical Microbiology, November 1998, p. 3155-3159, Vol. 36, No. 11
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.
Diagnosis of Mycoplasma pneumoniae
Pneumonia in Children
Matti E.
Waris,1,*
Pia
Toikka,2
Taina
Saarinen,2
Simo
Nikkari,3
Olli
Meurman,4
Raija
Vainionpää,1
Jussi
Mertsola,2 and
Olli
Ruuskanen2
Department of
Virology,1
Department of
Pediatrics,2 and
Department of
Microbiology,3 University of Turku, and
Turku University Hospital Central
Laboratory,4 Turku, Finland
Received 5 December 1997/Returned for modification 27 April
1998/Accepted 3 August 1998
We evaluated a commercial immunoglobulin M (IgM)-capture
immunoassay for the detection of Mycoplasma pneumoniae
infections in 278 pediatric patients with community-acquired,
radiographically defined pneumonia. Acute- and convalescent-phase serum
samples were collected from all patients and were tested for M. pneumoniae-specific IgM and IgG antibodies by Platelia enzyme
immunoassays (Sanofi Diagnostica Pasteur, Marnes la Coquette, France).
Nasopharyngeal aspirates (NPAs) were collected at the time of admission
to the hospital. A total of 227 NPAs were subjected to the detection of
M. pneumoniae DNA by PCR, and 191 NPAs were cultured by
using the Pneumofast kit (International Mycoplasma, Signeswere,
France). Southern hybridization of PCR products and the IgM test with
solid-phase antigen (Serion Immunodiagnostica, Würzburg, Germany)
were used for additional confirmation of a positive result, which
required agreement of at least two different methods. A total of 24 (9%) confirmed diagnoses of mycoplasma infection were made, 5 (21%) of which were in children <5 years of age. Of the positive children, 24 of 24 (sensitivity, 100%) were positive by the IgM-capture test
with convalescent-phase serum, 19 of 24 (79%) were positive by the
IgM-capture test with acute-phase serum, 19 of 24 (79%) were positive
by IgG serology, 10 of 20 (50%) were positive by PCR, and 8 of 17 (47%) were positive by culture. An additional 5 (of 254) children were
positive by the Platelia IgM test alone (specificity, 98%). When the
PCR with Southern hybridization result was combined with the
IgM-capture test result with the acute-phase sera, the sensitivity of
rapid laboratory diagnosis increased to 95%. In conclusion, the IgM
serology test was the single most valuable tool for the diagnosis of
M. pneumoniae pneumonia in children of any age.
*
Corresponding author. Mailing address: Department of
Medical Physics and Chemistry, University of Turku, Tykistönkatu
6, FIN-20520 Turku, Finland. Phone: 358 2 333 7059. Fax: 358 2 333 7060. E-mail: matti.waris{at}utu.fi.
Journal of Clinical Microbiology, November 1998, p. 3155-3159, Vol. 36, No. 11
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.
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