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聚合酶链反应(PCR)、培养及血清学检测在儿童社区获得性下呼吸道感染中诊断肺炎支原体的比较

Comparison of PCR, culture & serological tests for the diagnosis of Mycoplasma pneumoniae in community-acquired lower respiratory tract infections in children.

作者信息

Kashyap Bineeta, Kumar Surinder, Sethi G R, Das B C, Saigal S R

机构信息

Department of Microbiology, Maulana Azad Medical College, New Delhi, India.

出版信息

Indian J Med Res. 2008 Aug;128(2):134-9.

Abstract

BACKGROUND & OBJECTIVE: Mycoplasma pneumoniae is known to be a major cause of lower respiratory tract infections in children. A specific diagnosis is important to institute the appropriate treatment. Information on diagnostic methods used for M. pneumoniae in Indian paediatric population is scarce. The study was thus conducted to compare polymerase chain reaction (PCR), culture and serology for the diagnosis of M. pneumoniae in community-acquired lower respiratory tract infections in children.

METHODS

Seventy five children aged 6 months to 12 yr with signs of community-acquired lower respiratory tract infections were selected for the study. Culture of nasopharyngeal aspirates was done. The serum samples were analyzed for the detection of IgM and IgG antibodies to M. pneumoniae. A 543 base pairs (bp) region of P1 gene of M. pneumoniae was selected for amplification in PCR assay applied to nasopharyngeal aspirates.

RESULTS

M. pneumoniae was isolated in culture from 4 (5.33%) children. Serological evidence of M. pneumoniae infection was observed in 16(21.3%) children. All culture positive patients were also positive by serology. Overall, PCR for M. pneumoniae was positive in 13 (17.3%) patients. All four culture positive patients were also positive by PCR. In 11 out of 13 (84.62%) PCR positive patients, serological evidence was there. Culture and/or serology and/or PCR positive results diagnosed M. pneumoniae infection in 18 (24%) of 75 patients.

INTERPRETATION & CONCLUSION: A combination of culture, serology and PCR may provide diagnostic information on the aetiology of M. pneumoniae community-acquired lower respiratory tract infections in paediatric population.

摘要

背景与目的

已知肺炎支原体是儿童下呼吸道感染的主要病因。进行特异性诊断对于采取恰当治疗很重要。关于印度儿科人群中用于诊断肺炎支原体的方法的信息匮乏。因此开展本研究以比较聚合酶链反应(PCR)、培养和血清学检测在诊断儿童社区获得性下呼吸道感染中肺炎支原体的效果。

方法

选取75名年龄在6个月至12岁、有社区获得性下呼吸道感染体征的儿童进行研究。对鼻咽抽吸物进行培养。分析血清样本以检测肺炎支原体IgM和IgG抗体。在应用于鼻咽抽吸物的PCR检测中,选择肺炎支原体P1基因的一个543碱基对(bp)区域进行扩增。

结果

4名(5.33%)儿童的培养物中分离出肺炎支原体。16名(21.3%)儿童有肺炎支原体感染的血清学证据。所有培养阳性的患者血清学检测也呈阳性。总体而言,13名(17.3%)患者的肺炎支原体PCR检测呈阳性。所有培养阳性的4名患者PCR检测也呈阳性。13名PCR阳性患者中有11名(84.62%)有血清学证据。培养和/或血清学和/或PCR阳性结果确诊75名患者中有18名(24%)感染肺炎支原体。

解读与结论

培养、血清学和PCR相结合可为儿科人群中肺炎支原体社区获得性下呼吸道感染的病因提供诊断信息。

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