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J Med Microbiol 57 (2008), 1491-1495; DOI: 10.1099/jmm.0.2008/003814-0
© 2008 Society for General Microbiology
ISSN 0022-2615

Detection of Mycoplasma pneumoniae in adult community-acquired pneumonia by PCR and serology

María A. Martínez1, Mauricio Ruiz2, Enna Zunino3, Vivian Luchsinger4 and Luis F. Avendaño4

1 Programa de Microbiología, Facultad de Medicina, Universidad de Chile, Av. Independencia 1027, Santiago de Chile, Chile

2 Hospital Clínico Universidad de Chile, Santiago de Chile, Chile

3 Hospital de Infecciosos Dr Lucio Córdova, Santiago de Chile, Chile

4 Programa de Virología, Facultad de Medicina, Universidad de Chile, Santiago de Chile, Chile

Correspondence
María A. Martínez
mamartin{at}med.uchile.cl

Received May 23, 2008
Accepted August 11, 2008

Diagnosis of pneumonia caused by Mycoplasma pneumoniae in adults is hampered by a lack of rapid and standardized tests for detection. This prospective study was conducted to compare the diagnostic values of an indirect immunofluorescence assay and a 16S rRNA gene PCR for the diagnosis of M. pneumoniae pneumonia in adults. From February 2005 to January 2008, 357 patients (53.8 % males, median age 63 years, range 18–94) admitted for community-acquired pneumonia (CAP) to two hospitals in Santiago, Chile, were enrolled in the study. Thirty-two patients (9.0 %) met the criteria of current or recent M. pneumoniae infection, and laboratory diagnosis was definitive in 26 cases (81.2 %) and presumptive in six cases (18.8 %). Among the 32 M. pneumoniae infections, the PCR assay was positive in 23 (71.9 %) and the serology in 27 (84.4 %) of the cases. IgM was positive in acute-phase serum specimens in 13 cases (40.6 %) of M. pneumoniae infections. Using serology as the gold standard, the sensitivity, specificity, and positive and negative predictive values of the PCR were 66.7, 98.5, 78.3 and 97.3 %, respectively, whereas the global agreement of the methods was 343/357 (96.1 %). The frequency of M. pneumoniae CAP cases declined significantly during the second year of study, suggesting the end of an epidemic period. In conclusion, although good global agreement was found between PCR and serology, the lower sensitivity of the PCR leads us to recommend the use of both procedures in parallel to confirm M. pneumoniae in CAP in adults.

Abbreviations: CAP, community-acquired pneumonia; IFA, immunofluorescence assay.






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