Petitjean J, Vabret A, Gouarin S, Freymuth F
Laboratoire de virologie humaine et moléculaire, hôpital universitaire, avenue G. Clémenceau, 14033, Caen,
Pathol Biol (Paris). 2002 Nov;50(9):530-7. doi: 10.1016/s0369-8114(02)00349-8.
The four following commercially available enzyme immunoassays (EIAs) were assessed and compared for their performance in detecting Mycoplasma pneumoniae specific IgG and IgM antibodies: EIA-Platelia, EIA-Bmd, EIA-Sorin and EIA-Biotest. Three groups of patients were investigated: 39 patients (27 children and 12 adults) with respiratory infections and a M. pneumoniae PCR-positive in respiratory specimens (group I; 52 sera), 61 healthy children and adults (group II; 61 sera) and 20 patients with rheumatoid factor, antinuclear antibodies or positive antiviral IgM (group III; 20 sera). In group III, the IgM specificity for the EIA-Platelia, EIA-Bmd, EIA-Biotest and EIA-Sorin was 100%, 90%, 65% and 25%, respectively. In the children from group I, the four EIAs had similar IgM sensitivity (89 to 92%) but a striking difference in IgM sensitivity was observed in adult patients: 16% EIA-Platelia and EIA-Bmd, 50% EIA-Biotest, 58% EIA-Sorin. The sensitivity for IgG was greater with EIA-Bmd and EIA-Biotest, especially in detection of IgG in acute-phase serum : 61% EIA-Bmd and EIA-Biotest, 15% EIA-Platelia and 31% EIA-Sorin. Discrepant and unexpected results were observed in IgM detection from control healthy patients using EIA-Sorin and EIA-Biotest, confirming the lack of specificity of these two EIA-tests and making them inaccurate for routine diagnosis. A high IgG seroprevalence were found in healthy adults by the four EIAs (43-70%). In healthy children, EIA-Bmd and EIA-Biotest gave a higher IgG seroprevalence than EIA-Sorin and EIA-Platelia (45% each for the former as 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 test used is specific. In adults, the difficult interpretation of EIA tests suggests that paired sera, combined with PCR detection on respiratory tract specimens collected on admission of patient, should be required for accurate diagnosis.
对以下四种市售酶免疫测定法（EIA）检测肺炎支原体特异性IgG和IgM抗体的性能进行了评估和比较：酶免疫测定法-普乐可复（EIA-Platelia）、酶免疫测定法-百麦德（EIA-Bmd）、酶免疫测定法-索林（EIA-Sorin）和酶免疫测定法-比奥泰（EIA-Biotest）。对三组患者进行了调查：39例呼吸道感染且呼吸道标本肺炎支原体PCR检测呈阳性的患者（第一组；52份血清），其中包括27名儿童和12名成人；61名健康儿童和成人（第二组；61份血清）；以及20例类风湿因子、抗核抗体或抗病毒IgM呈阳性的患者（第三组；20份血清）。在第三组中，酶免疫测定法-普乐可复、酶免疫测定法-百麦德、酶免疫测定法-比奥泰以及酶免疫测定法-索林的IgM特异性分别为100%、90%、65%和25%。在第一组儿童中，这四种酶免疫测定法的IgM敏感性相似（89%至92%），但在成年患者中观察到IgM敏感性存在显著差异：酶免疫测定法-普乐可复和酶免疫测定法-百麦德为16%，酶免疫测定法-比奥泰为50%，酶免疫测定法-索林为58%。酶免疫测定法-百麦德和酶免疫测定法-比奥泰对IgG的敏感性更高，尤其是在急性期血清中IgG的检测方面：酶免疫测定法-百麦德和酶免疫测定法-比奥泰为61%，酶免疫测定法-普乐可复为15%，酶免疫测定法-索林为31%。使用酶免疫测定法-索林和酶免疫测定法-比奥泰检测对照健康患者的IgM时，出现了不一致和意外的结果，证实了这两种酶免疫测定法缺乏特异性且使其不适用于常规诊断。四种酶免疫测定法在健康成年人中均发现高IgG血清阳性率（43% - 70%）。在健康儿童中，酶免疫测定法-百麦德和酶免疫测定法-比奥泰的IgG血清阳性率高于酶免疫测定法-索林和酶免疫测定法-普乐可复（前者各为45%，后者分别为17%和20%）。这些结果证实，只要所使用的酶免疫测定法具有特异性，IgM酶免疫血清学检测就是儿童肺炎支原体感染早期诊断的有价值工具。在成年人中，酶免疫测定法结果难以解释，这表明准确诊断需要配对血清，并结合患者入院时采集的呼吸道标本进行PCR检测。
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