Comparison of Oropharyngeal and Nasopharyngeal Swab Specimens for the Detection of  Mycoplasma pneumoniae  in Children with Lower Respiratory Tract Infection

Kakuya, Fujio; Kinebuchi, Takahiro; Ōkubo, H.; Matsuo, Kumihiro

doi:10.1016/j.jpeds.2017.06.038

Cited by 14 publications

(14 citation statements)

References 17 publications

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“…The most common of the bacterial targets was M. pneumoniae, with 24 detections, more than the 19 detected with FARPv1.7. However, it should be noted that the use of an NP specimen for the detection of M. pneumoniae may be suboptimal, particularly when diagnosing lower-respiratory-tract infection (20,21). For B. pertussis, discrepancies between the QIAstat-Dx RP and the comparator method were not unexpected, as the QIAstat-Dx RP targets the multicopy insertion sequence (IS481) that is present in several Bordetella species (B. pertussis, B. holmesii, and B. bronchiseptica), whereas the comparator targets the single-copy promoter region of the pertussis toxin gene and is designed to be specific to the detection of B. pertussis.…”

Section: Discussionmentioning

confidence: 99%

Multicenter Evaluation of the QIAstat-Dx Respiratory Panel for Detection of Viruses and Bacteria in Nasopharyngeal Swab Specimens

et al. 2020

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The QIAstat-Dx Respiratory Panel (QIAstat-Dx RP) is a multiplex in vitro diagnostic test for the qualitative detection of 20 pathogens directly from nasopharyngeal swab (NPS) specimens. The assay is performed using a simple sample-toanswer platform with results available in approximately 69 min. The pathogens identified are adenovirus, coronavirus 229E, coronavirus HKU1, coronavirus NL63, coronavirus OC43, human metapneumovirus A and B, influenza A, influenza A H1, influenza A H3, influenza A H1N1/2009, influenza B, parainfluenza virus 1, parainfluenza virus 2, parainfluenza virus 3, parainfluenza virus 4, rhinovirus/enterovirus, respiratory syncytial virus A and B, Bordetella pertussis, Chlamydophila pneumoniae, and Mycoplasma pneumoniae. This multicenter evaluation provides data obtained from 1,994 prospectively collected and 310 retrospectively collected (archived) NPS specimens with performance compared to that of the BioFire FilmArray Respiratory Panel, version 1.7. The overall percent agreement between QIAstat-Dx RP and the comparator testing was 99.5%. In the prospective cohort, the QIAstat-Dx RP demonstrated a positive percent agreement of 94.0% or greater for the detection of all but four analytes: coronaviruses 229E, NL63, and OC43 and rhinovirus/enterovirus. The test also demonstrated a negative percent agreement of Ն97.9% for all analytes. The QIAstat-Dx RP is a robust and accurate assay for rapid, comprehensive testing for respiratory pathogens.

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Section: Discussionmentioning

confidence: 99%

Multicenter Evaluation of the QIAstat-Dx Respiratory Panel for Detection of Viruses and Bacteria in Nasopharyngeal Swab Specimens

et al. 2020

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“…Four of the 13 studies were excluded as two studies did not provide sufficient data for generation of a 2 × 2 contingency table and the other two studies did not use PCR or microbial cultures as reference standards. Of the nine studies not excluded, several evaluated more than one reference method [28] and different patient groups [48], brand of index test [36], and type of specimen [49]. Each dataset from these studies was considered separately.…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

“…All the studies were conducted in Asia (2 in China [29,61], 10 in Japan [28,30,36,[47][48][49], and 1 in Korea [50]). Seven studies (53.8%) included both adults and children [28,36,47,48] while the remaining six studies (46.2%) included only children [29,30,49,50,61]. No studies specifically evaluated adult populations (� 18 years of age).…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

“…No studies specifically evaluated adult populations (� 18 years of age). Among the ICTs used in the studies included in our meta-analysis, Ribotest Mycoplasma 1 (Asahi Kasei Pharma Co., Tokyo, Japan) was the most frequently assessed with eight (57.6%) of the studies evaluating this ICT [30, 36,[47][48][49][50]. PCR was used as the reference standard in 11 (84.6%) of the studies [28-30, 36, 47-49, 61] and microbial culturing was used in two (15.4%) of the studies [28,50].…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

“…In addition, the pooled estimates of sensitivity and accuracy for studies using PCR reference standards were higher than those using microbial culturing (Table 3). Among the 13 studies included in our current analysis, eight of the studies consisting of 1,287 samples used the Ribotest Mycoplasma 1 brand of ICT [30, 36,[47][48][49][50]. The pooled sensitivity, specificity, positive LR, negative LR, and DOR of Ribotest Mycoplasma 1 for M. pneumoniae infection were 0.66 (95% CI, 0.60-0.71), 0.89 (95% CI, 0.85-0.92), 6.00 (95% CI, 4.55-7.88), 0.39 (95% CI, 0.33-0.45) and 15.70 (95% CI, 11.00-21.40), respectively (S4 Table).…”

Section: Subgroup Analysismentioning

confidence: 99%

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Immunochromatography for the diagnosis of Mycoplasma pneumoniae infection: A systematic review and meta-analysis

2020

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The aim of this study was to evaluate the diagnostic performance of immunochromatographic tests (ICTs) for the detection of Mycoplasma pneumoniae. Medline/Pubmed, Embase, the Cochrane Library, and ISI Web of Science were searched through June 12, 2019 for relevant studies that used ICTs for the detection of M. pneumoniae infection with polymerase chain reaction (PCR) or microbial culturing as reference standards. Pooled diagnostic accuracy with 95% confidence interval (CI) was calculated using a bivariate random effects model. We also constructed summary receiver operating characteristic curves and calculated the area under the curve (AUC). Statistical heterogeneity was evaluated by χ 2 test or Cochrane's Q test. Thirteen studies including 2,235 samples were included in the metaanalysis. The pooled sensitivity and specificity for diagnosing M. pneumoniae infection were 0.70 (95% CI: 0.59-0.79) and 0.92 (95% CI: 0.87-0.95), respectively. The positive likelihood ratio (LR) was 8.94 (95% CI: 4.90-14.80), negative LR 0.33 (95% CI: 0.22-0.46), diagnostic odds ratio 29.20 (95% CI: 10.70-64.20), and AUC 0.904. In subgroup analysis, ICTs demonstrated similar pooled sensitivities and specificities in populations of children only and mixed populations (children + adults). Specimens obtained from oropharyngeal swabs exhibited a higher sensitivity and specificity than those of nasopharyngeal swab. Moreover, pooled estimates of sensitivity and accuracy for studies using PCR as a reference standard were higher than those using culture. The pooled sensitivity and specificity of Ribotest Mycoplasma ® , the commercial kit most commonly used in the included studies, were 0.66 and 0.89, respectively. Overall, ICT is a rapid user-friendly method for diagnosing M. pneumoniae infection with moderate sensitivity, high specificity, and high accuracy. This suggests that ICT may be useful in the diagnostic workup of M. pneumoniae infection; however, additional studies are needed for evaluating the potential impact of ICT in clinical practice.

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Primary symptoms of severe mycoplasma pneumoniae pneumonia with acute abdomen, scrotal swelling and pain, and fever: A case report

Lei,

Wang,

Xiong

et al. 2023

Immunity Inflam & Disease

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Background IntroductionIn recent years, there has been an increase in the number of patients diagnosed with pediatric diseases who have severe Mycoplasma pneumoniae (MP) pneumonia, and there has also been an increased attention to serious extrapulmonary complications. However, cases with abdominal pain, acute abdomen, scrotal swelling and pain, and fever as the primary symptoms have been rarely reported.Case DescriptionA 3‐years‐and‐8‐months‐old male patient diagnosed with pediatric disease was reported with abdominal pain, scrotal swelling and pain, and fever as the primary symptoms in the present study. No respiratory symptoms were observed throughout the disease. Through computed tomography (CT) scanning, the patient was diagnosed with severe MP pneumonia based on the symptoms of abdominal pain and fever, as well as pulmonary infection, pleural effusion, and retroperitoneal exudation. Laboratory tests supported the diagnosis of MP infection, and the diagnosis was confirmed by severe MP pneumonia. The therapeutic effects of azithromycin were poor, and the symptoms were quickly alleviated with the addition of gamma globulin and methylprednisolone. After discharge, azithromycin sequential therapy was administered. The chest CT was normal at the follow‐up 1‐month later.ConclusionSevere MP pneumonia in patients with pediatric diseases may include abdominal pain, scrotal swelling and pain, and fever as the primary symptoms. Care should be taken to avoid missed diagnoses and misdiagnoses in clinical practice.

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Comparison of Oropharyngeal and Nasopharyngeal Swab Specimens for the Detection of Mycoplasma pneumoniae in Children with Lower Respiratory Tract Infection

Cited by 14 publications

References 17 publications

Multicenter Evaluation of the QIAstat-Dx Respiratory Panel for Detection of Viruses and Bacteria in Nasopharyngeal Swab Specimens

Multicenter Evaluation of the QIAstat-Dx Respiratory Panel for Detection of Viruses and Bacteria in Nasopharyngeal Swab Specimens

Immunochromatography for the diagnosis of Mycoplasma pneumoniae infection: A systematic review and meta-analysis

Primary symptoms of severe mycoplasma pneumoniae pneumonia with acute abdomen, scrotal swelling and pain, and fever: A case report

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