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Chlamydophila pneumoniae serology: cross-reaction with Mycoplasma pneumoniae infection

  • Original Article
  • Published:
Journal of Infection and Chemotherapy

Abstract

Atypical pathogens Mycoplasma pneumoniae and Chlamydophila pneumoniae play an important role in community-acquired pneumonia. However, it has been pointed out that positive enzyme-linked immunosorbent assay (ELISA, Hitazyme C. pneumoniae) IgM reactivity is frequent among M. pneumoniae pneumonia patients. To clarify the reactivity of ELISA IgM in M. pneumoniae pneumonia, findings were compared with immunoblotting, ELNAS Plate C. pneumoniae (ELNAS) and the micro-immunofluorescence (MIF) test. Ninety-eight serologically confirmed cases with M. pneumoniae pneumonia and 10 cases with C. pneumoniae pneumonia were enrolled in this study. C. pneumoniae IgM-positive cases measured by the ELISA were observed in 30 (30 %) patients with M. pneumoniae pneumonia. However, there were no positive cases by immunoblotting, ELNAS, or MIF test. These cases determined to be IgM positive only in the ELISA were all negative by another serological test, recombinant enzyme immunoassay (rEIA), and these positive results in the ELISA were considered to be false-positive reactions. In contrast, IgM-positive findings in patients with C. pneumoniae pneumonia did not show any positive reaction in M. pneumoniae antibody titer. ELISA showed a high frequency of false-positive findings in patients with M. pneumoniae pneumonia, which included false-positive cases with a high titer for IgM. To accurately diagnose C. pneumoniae infection in various studies, including respiratory infections, researchers should consider the IgM false-positive reaction with ELISA in patients with suspected atypical pneumonia.

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References

  1. Arnold FW, Summersgill JT, Lajoie AS, Peyrani P, Marrie TJ, Rossi P, et al. A worldwide perspective of atypical pathogens in community-acquired pneumonia. Am J Respir Crit Care Med. 2007;175:1086–93.

    Article  PubMed  Google Scholar 

  2. The committee for the Japanese Respiratory Society guidelines in management of respiratory infections. The Japanese Respiratory Society guideline for the management of community-acquired pneumonia in adults. Respirology 2006;11:S79–S133.

    Google Scholar 

  3. Morozumi M, Takahashi T, Ubukata K. Macrolide-resistant Mycoplasma pneumoniae: characteristics of isolates and clinical aspects of community-acquired pneumonia. J Infect Chemother. 2010;16:78–86.

    Article  PubMed  Google Scholar 

  4. Miyashita N, Kawai Y, Akaike H, Ouchi K, Hayashi T, Kurihara T, et al. Macrolide-resistant Mycoplasma pneumoniae in adolescents with community-acquired pneumonia. BMC Infect Dis. 2012;12:126.

    Article  PubMed  CAS  Google Scholar 

  5. Cao B, Zhao CJ, Yin YD, Zhao F, Song SF, Bai L, et al. High prevalence of macrolide resistance in Mycoplasma pneumoniae isolates from adult and adolescent patients with respiratory tract infection in China. Clin Infect Dis. 2010;51:189–94.

    Article  PubMed  CAS  Google Scholar 

  6. Kishimoto T, Ando S, Numazaki K, Ouchi K, Yamazaki T, Nakahama C. Assay of Chlamydia pneumoniae-specific IgM antibodies by ELISA method: reduction of non-specific reaction and resetting of serological criteria by measuring IgM antibodies. Jpn J Infect Dis. 2009;62:260–4.

    PubMed  Google Scholar 

  7. Miyashita N, Kawai Y, Yamaguchi T, Ouchi K, Kobashi Y, Oka M. Evaluation of false-positive reaction with ELISA for the detection of Chlamydophila pneumoniae-specific IgM antibody in adults. Jpn J Infect Dis. 2010;63:150–1.

    PubMed  CAS  Google Scholar 

  8. Miyashita N, Ouchi K, Kawasaki K, Komura H, Kawai Y, Tsumura N, et al. Comparison of serological tests for detection of immunoglobulin M antibodies to Chlamydophila pneumoniae. Respirology. 2008;13:427–31.

    Article  PubMed  Google Scholar 

  9. Miyashita N, Kawai Y, Yamaguchi T, Ouchi K, Oka M, the Atypical Pathogen Study Group. Clinical potential of diagnostic methods for the rapid diagnosis of Mycoplasma pneumoniae pneumonia in adults. Eur J Clin Microbiol Infect Dis. 2011;30:439–46.

    Article  PubMed  CAS  Google Scholar 

  10. Dowell SF, Peeling RW, Boman J, Carlone GM, Fields BS, Guarner J, et al. Standardizing Chlamydia pneumoniae assays: recommendations from the Centers for Disease Control and Prevention (USA) and the Laboratory Centre for Disease Control (Canada). Clin Infect Dis. 2001;33:492–503.

    Article  PubMed  CAS  Google Scholar 

  11. Ramirez JA, Ahkee S, Tolentino A, Miller RD, Summersgill JT. Diagnosis of Legionella pneumophila, Mycoplasma pneumoniae, or Chlamydia pneumoniae lower respiratory infection using the polymerase chain reaction on a single throat swab specimen. Diagn Microbiol Infect Dis. 1996;24:7–14.

    Article  PubMed  CAS  Google Scholar 

  12. Persson K, Haidl S. Evaluation of commercial test for antibodies to the chlamydial lipopolysaccharide (Medac) for serodiagnosis of acute infections by Chlamydia pneumoniae (TWAR) and Chlamydia psittaci. APMIS. 2000;108:131–8.

    Article  PubMed  CAS  Google Scholar 

  13. National Institute of Health. Infectious Disease Surveillance Center. Mycoplasma pneumoniae pneumonia. http://idsc.nih.go.jp/idwr/kanja/weeklygraph/18myco.html.

  14. Verkooyen RP, Hazenberg MA, Van Haaren GH, Van Dean B, Snijder RJ, Van Helden HP, et al. Age-related interference with Chlamydia pneumoniae microimmunofluorescence serology due to circulating rheumatoid factor. J Clin Microbiol. 1992;30:1287–90.

    PubMed  CAS  Google Scholar 

  15. Miyashita N, Obase Y, Fukuda M, Shouji H, Mouri K, Yagi S, et al. Evaluation of serological tests detecting Chlamydophila pneumoniae-specific immunoglobulin M antibody. Intern Med. 2006;45:1127–31.

    Article  PubMed  Google Scholar 

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Acknowledgments

We thank the members of the Atypical Pathogen Study Group: Takaya Maruyama (Mie University Graduate School of Medicine), Chikara Nakahama (Nakahama Clinic), Hirohide Yoneyama (Kasaoka Daiichi Hospital), Masayasu Kawanishi (Kaneda Hospital), Makoto Kimura (Kimura Clinic), Toshiharu Matsushima (Kurashiki Daiichi Hospital), Masao Kuwabara (Kenritsu Hiroshima Hospital), Kouji Hashiguchi (Nagasaki Genbaku Hospital), and Yasuhiro Nagatomo (University of Miyazaki). This work was supported by MEXT KAKENHI (19591190 and 21591304) and Project Research Grants from Kawasaki Medical School (13-401, 14-402, 15-405A, 16-405M, 17-402M, 18-401, 19-402M, 20-4030).

Conflict of interest

The authors have no conflicting interests.

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Authors and Affiliations

  1. Department of Internal Medicine I, Kawasaki Medical School, 2-1-80 Nakasange, Kita-ku, Okayama, 700-8505, Japan

    Naoyuki Miyashita, Tadashi Kato, Toshikiyo Hayashi & Niro Okimoto

  2. Department of Pediatrics, Kawasaki Medical School, Okayama, Japan

    Hiroto Akaike, Hideto Teranishi, Yasuhiro Kawai & Kazunobu Ouchi

Authors
  1. Naoyuki Miyashita
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  2. Hiroto Akaike
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  3. Hideto Teranishi
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  4. Yasuhiro Kawai
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  5. Kazunobu Ouchi
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  6. Tadashi Kato
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  7. Toshikiyo Hayashi
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  8. Niro Okimoto
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Atypical Pathogen Study Group

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Correspondence to Naoyuki Miyashita.

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Miyashita, N., Akaike, H., Teranishi, H. et al. Chlamydophila pneumoniae serology: cross-reaction with Mycoplasma pneumoniae infection. J Infect Chemother 19, 256–260 (2013). https://doi.org/10.1007/s10156-012-0494-4

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  • DOI: https://doi.org/10.1007/s10156-012-0494-4

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