Evaluation of Four Commercial Immunoglobulin G (IgG)- and IgM-Specific Enzyme Immunoassays for Diagnosis of Mycoplasma pneumoniae Infections

Abstract

routine diagnosis. A good concordance of IgG seroprevalence in healthy adults was found between the four EIAs (66 to 70%), though this concordance was lower with EIA-Platelia (43%). In healthy children, EIA-BMD and EIA-Biotest gave a higher IgG seroprevalence than EIA-Sorin and EIA-Platelia (45% each for the former compared to 17 and 20%, respectively, for the latter). These results confirm that the IgM EIA serology test is a valuable tool for the early diagnosis of M. pneumoniae infections in children, as long as the EIA used is specific. In adults, the difficult interpretation of EIAs suggests that paired sera, combined with PCR detection on respiratory tract specimens collected on admission of patient, should be required for accurate diagnosis.Mycoplasma pneumoniae is a common respiratory pathogen responsible for mild acute respiratory infections such as sore throats, pharyngitis, and tracheobronchitis in younger children. It is the most common cause of primary atypical pneumonia resistant to ␤-lactam antibiotics in older children and young adults (5,10,15). M. pneumoniae can also be associated with severe extrapulmonary complications (9, 21, 24). The standard laboratory methods for the specific diagnosis of M. pneumoniae infection have been isolation in culture and serological methods. Culture is time-consuming and relatively insensitive. The conventional complement fixation test (CFT) using a glycolipid antigen gives unspecific reactions and lacks sensitivity (16,19). Alternative tests have recently been developed to obtain moreaccurate and prompt diagnosis: indirect enzyme immunoassay (EIA) measuring separately immunoglobulin G (IgG) and IgM class antibodies (8,14,27,33,35) and PCR for rapid and sensitive detection of M. pneumoniae in respiratory tract specimens (1,4,6,31,32,36). The objective of this retrospective study was to compare the performance of four commercially available EIAs for the detection of specific M. pneumoniae IgG and IgM antibodies in assessing the antibody response of suspected M. pneumoniae patients on the basis of PCR-positive results for M. pneumoniae in respiratory samples. Furthermore, we evaluated the ability of the serological tests to accurately establish an earlier serodiagnosis of M. pneumoniae infections. MATERIALS AND METHODSPatients and controls. For a 4-year period, January 1997 through December 2000, 39 patients (group I: 27 children and 12 adults), admitted to Caen's hospital with clinical features of upper or lower respiratory tract infection consistent with M. pneumoniae infection, were retrospectively selected on the basis of a specific M. pneumoniae-positive PCR in respiratory tract samples. Serum specimens and respiratory tract specimens were obtained on admission from all 39 patients. In addition, serum specimens were obtained 5 to 22 days later from 13 patients. Upon their receipt, the 52 serum samples were serologically investigated for M. pneumonia-specific IgM and IgG antibodies by the Platelia EIAs IgG and IgM (Diagnostica Pasteur Sanofi) (referred to herein...

Guidelines for the management of adult lower respiratory tract infections

“…Some commercialised assays lack both sensitivity and specificity, emphasising the need for more validation and quality control [117].…”

Persistence of Community-Acquired Respiratory Distress Syndrome Toxin-Producing Mycoplasma pneumoniae in Refractory Asthma

“…This lack of antibody response to Mp has been reported by others. In a study by Petitjean et al 22 comparing four commercial Mp ELISAs in hospitalized subjects with upper or lower respiratory tract infections, 22% to 48% of children and 17% to 25% responses were characterized by the rapid expression of cytokines and chemokines with the concurrent development of an intense lymphocytic infl ammatory response. Additionally, signifi cant increases in both airway obstruction and airway hyperreactivity correlated with the degree of peribronchiolar and perivascular airway infl ammation.…”

Comparison and Evaluation of Real-Time PCR, Real-Time Nucleic Acid Sequence-Based Amplification, Conventional PCR, and Serology for Diagnosis of Mycoplasma pneumoniae

“…An accurate diagnosis with convalescentphase samples is often made many days after the onset of disease (28). Sensitivity and specificity values are between 55 and 100%, depending on the serological method used and the patient population tested (1,4,8,10,15,18,25). PCR has been shown to offer the potential of increased sensitivity and rapidity compared to other diagnostic tests.…”