Sayan Murat, Kilinç Oğuz, Yüce Ayşe, Uçan Eyüp Sabri, Genç Sabahat
Dokuz Eylül Universitesi Tip Fakültesi, Mikrobiyoloji ve Klinik Mikrobiyoloji Anabilim Dali, Izmir.
Mikrobiyol Bul. 2003 Oct;37(4):247-53.
The aim of this study was to investigate the IgG and IgM antibody positivities against atypical pneumonia agents in patients with community-acquired pneumonia (CAP), and to compare the results with the controls. The serum samples which were collected from 53 adult patients and 20 healthy donors have been investigated by a commercial indirect immunofluorescent assay (IFA, Pneumo-slide, Vircell SL, Spain) in which nine different antigens were fixed onto a slide. In both of the study groups. IgG and IgM seropositivities were detected in different rates against one or more etiologic agents. In the patient group. IgG and IgM positivity rates for the agents were as follows, respectively; 22.6% and 28.3% for Legionella pneumophila, 9.4% and 5.6% for Mycoplasma pneumoniae, 30.1% and 7.5% for Coxiella burnetii, 33.9% and 3.7% for Chlamydia pneumoniae, 28.3% and 0 for adenovirus, 71.6% and 1.8% for respiratory syncytial virus, 30.1% and 24.5% for influenza A virus, 35.8% and 7.5% for influenza B virus, 71.6% and 1.8% for parainfluenza viruses type 1-3. The rates of IgG positivities in the control group varied between 5-55% for all of the agents except M. pneumoniae and 3 of these controls were positive for L. pneumophila IgM, 3 were positive for C. pneumoniae IgM and one was positive for influenza A virus IgM. According to the statistical evaluation, there were no significant differences for IgM seropositivities to any of the agents, between the patient and control groups (p > 0.05). These results could be attributed to one or more of the following; a) none of these microorganisms were the primary etiologic agents, b) IgM positivities were the result of reinfections with these agents, c) longer duration of IgM antibodies after the acute infections. In terms of IgG positivities between the patient and control groups, only C. burnetii showed statistically significant difference (p = 0.029). Since the type of the pathogens causing CAP are of crucial importance both for the epidemiological purposes and for planning the empirical treatment strategies, more detailed multicenter studies should be performed in our country.
本研究旨在调查社区获得性肺炎（CAP）患者针对非典型肺炎病原体的IgG和IgM抗体阳性情况，并将结果与对照组进行比较。采用商业间接免疫荧光法（IFA，Pneumo-slide，Vircell SL，西班牙）对从53例成年患者和20名健康供体采集的血清样本进行检测，该方法在载玻片上固定了9种不同抗原。在两个研究组中，针对一种或多种病原体均检测到不同比例的IgG和IgM血清阳性。在患者组中，各病原体的IgG和IgM阳性率分别如下：嗜肺军团菌为22.6%和28.3%，肺炎支原体为9.4%和5.6%，伯氏考克斯体为30.1%和7.5%，肺炎衣原体为33.9%和3.7%，腺病毒为28.3%和0，呼吸道合胞病毒为71.6%和1.8%，甲型流感病毒为30.1%和24.5%，乙型流感病毒为35.8%和7.5%，1-3型副流感病毒为71.6%和1.8%。对照组中，除肺炎支原体外，所有病原体的IgG阳性率在5%-55%之间，其中3名对照者嗜肺军团菌IgM阳性，3名对照者肺炎衣原体IgM阳性，1名对照者甲型流感病毒IgM阳性。根据统计学评估，患者组和对照组之间针对任何病原体的IgM血清阳性率均无显著差异（p>0.05）。这些结果可能归因于以下一种或多种情况：a）这些微生物均不是主要病原体；b）IgM阳性是这些病原体再次感染的结果；c）急性感染后IgM抗体持续时间较长。在患者组和对照组之间的IgG阳性方面，仅伯氏考克斯体显示出统计学显著差异（p=0.029）。由于引起CAP的病原体类型对于流行病学目的和制定经验性治疗策略都至关重要，我国应开展更详细的多中心研究。
