Serological Diagnosis of Mycoplasma pneumoniae Infections: A Critical Review of Current Procedures

Abstract

Respiratory diseases due to Mycoplasma pneumoniae are still confirmed with serological methods, although during the acute phase of M. pneumoniae disease indicative parameters are frequently negative. This result is true not only for serodiagnosis based on tests for the presence of cold hemagglutinin (the first but unspecific acute-phase parameter; these are positive in only about 50% of cases) but also for serodiagnosis based on CF tests, particle agglutination tests, or even enzyme-linked immunoassays that test for "early" IgM antibodies. Whereas the sensitivity of the different tests is difficult to improve, advances in specificity were obtained with use of more defined protein antigen preparations of M. pneumoniae cells. Even more problematic than negative titers in the first serum samples and delayed positive titers in the convalescent-phase sera are false-negative results with sera from immunocompromised patients, which limit the value of serological approaches for diagnosis of M. pneumoniae infections in particular risk groups. This review summarizes the use and the limitations of various serological approaches but also refers to alternative methods that are suitable for diagnosis of acute-phase M. pneumoniae disease or cases in which seroconversion has not occurred.

Multiplex polymerase chain reaction for the simultaneous detection of Mycoplasma pneumoniae, Chlamydia pneumoniae, and Chlamydia psittaci in respiratory samples.

“…10 11 DiVerentiation between M pneumoniae and M genitalium, both of which can be isolated from respiratory samples, is not easy, 12 13 and the culture of C psittaci could be hazardous. 14 Frequently, insensitive and cross reacting serological techniques, [15][16][17] such as the complement fixation test, are being used as the main diagnostic test. As a result of these factors, and also of the timing of the research, conflicting prevalences of these atypical infections have been reported, ranging from 1% to 40%.…”

A Case of Acute Myopericarditis Associated with Mycoplasma pneumoniae Infection in a Korean Adult

“…There was no chest pain or dyspnea reported. The initial complete blood count revealed a white cell count of 16.8×10 worldwide; its sensitivity and specificity is 90% and 94%, respectively (16). Although the specificity of the PA test is inferior to that of the CFT, the sensitivity of it is similar to that of the CFT or ELISA (13,14,17).…”

Stevens-Johnson Syndrome, Mucositis, or Something Else?

“…The cold agglutinins test was performed at the bedside; the results were positive, which have been associated with M pneumoniae disease in 30% to 50% of cases. 6 Given the diffi culty in quickly and accurately diagnosing M pneumoniae with serology samples alone, Mycoplasma polymerase chain reaction analysis was requested as an adjunctive test; however, this test was not available at our laboratory.…”