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Detection of Mycoplasma pneumoniae in different respiratory specimens

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Abstract

Mycoplasma pneumoniae (M. pneumoniae) is an important community-acquired pneumonia pathogen. Serological test and polymerase chain reaction (PCR) assay are the two main laboratory tests to detect M. pneumoniae now. Little information was compared about the sensitivity and specificity of PCR using different specimens including bronchoalveolar lavage (BAL) and nasopharyngeal aspirate (NPA). The aim of the present study was to evaluate diagnostic values of different specimens by fluorescence quantitative real-time PCR and to find clinical features helpful to diagnose M. pneumoniae pneumonia (MPP). Four hundred and six hospitalized pneumonia children were studied. M. pneumoniae DNA in NPA and BAL samples were detected by fluorescence quantitative real-time PCR. M. pneumoniae-specific IgM was tested by ELISA. MPP were diagnosed based on positive M. pneumoniae-specific IgM in 101 (24.9%) children. The median ages of MPP and non-MPP children were 4.1 and 2.4 years, respectively, with significant difference between them (p < 0.001). Laboratory results including leukocyte count, neutrophil percentage, immunoglobulins, except serum IgM, subgroups of T lymphocyte, and BAL cell count had no significant differences in MPP and non-MPP. BAL macrophage cell percentage was lower in BAL-PCR positive children (p = 0.003), while BAL neutrophil percentage was higher in BAL-PCR positive children (p = 0.007). PCR from NPA and BAL were similar in diagnostic parameters, including sensitivity, specificity, PPV, and NPV (78.6%, 63.4%, 39.8%, and 90.6% for NPA-PCR, respectively; 70.3%, 58.7%, 36.0%, and 85.6% for BAL-PCR, respectively). Conclusions: NPA is better than BAL as PCR sample in MPP diagnosis for similar performance in PCR assay, cheap, and less invasive. BAL is useful in defining local inflammatory condition. Age is the only prefigurative factor in MPP.

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Abbreviations

BAL:

Bronchoalveolar lavage

CAP:

Community-acquired pneumonia

ELISA:

Enzyme-linked immunosorbent assay

FOB:

Fiberoptic bronchoscopy

IL:

Interleukin

M. pneumoniae :

Mycoplasma pneumoniae

MPP:

M. pneumoniae pneumonia

Non-MPP:

Pneumonia not caused by M. pneumoniae

NPA:

Nasopharyngeal aspirate

NPV:

Negative prediction value

PCR:

Polymerase chain reaction

PPV:

Positive prediction value

ROC:

Relative operating characteristic

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Acknowledgments

The authors thank all patients and guardians involved in the study. We also thank all colleagues in central laboratory of our hospital and doctors who have enrolled patients. This study was partially supported by grants from the National Natural Science Foundation of China (nos. 30872798, 81070004, and 81000765).

Conflict of interest

There was no conflict of interest.

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Authors and Affiliations

  1. Department of Pulmonology, The Children’s Hospital of Zhejiang University School of Medicine, 57 Zhugan Xiang, Hangzhou, 310003, Zhejiang Province, People’s Republic of China

    Dan Xu, Shuxian Li & Zhimin Chen

  2. Department of Neonatology, The Children’s Hospital of Zhejiang University School of Medicine, 57 Zhugan Xiang, Hangzhou, 310003, Zhejiang Province, People’s Republic of China

    Lizhong Du

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  1. Dan Xu
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  2. Shuxian Li
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Correspondence to Zhimin Chen or Lizhong Du.

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Xu, D., Li, S., Chen, Z. et al. Detection of Mycoplasma pneumoniae in different respiratory specimens. Eur J Pediatr 170, 851–858 (2011). https://doi.org/10.1007/s00431-010-1360-y

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  • DOI: https://doi.org/10.1007/s00431-010-1360-y

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