Department of Respiratory Medicine, Kawasaki Medical School, Kurashiki, Okayama, Japan.
Eur J Clin Microbiol Infect Dis. 2011 Mar;30(3):439-46. doi: 10.1007/s10096-010-1107-8.
The purpose of the present study was to evaluate the accuracy and usefulness of three rapid diagnostic methods, ImmunoCard Mycoplasma kit, chest high-resolution computed tomography (HRCT) findings, and the Japanese Respiratory Society (JRS) scoring system (including six parameters), for the early presumptive diagnosis of Mycoplasma pneumoniae pneumonia in adults. We performed three rapid diagnostic methods at the same time in four pneumonia groups: 68 cases with M. pneumoniae pneumonia, 133 cases with Streptococcus pneumoniae pneumonia, 30 cases with Haemophilus influenzae pneumonia, and 20 cases with Legionella pneumonia. The sensitivity and specificity were 35% and 68% for ImmunoCard, 73% and 85% with HRCT, and 83% and 90% with the JRS scoring system, respectively. Among the three rapid diagnostic methods, the JRS scoring system was the most useful tool for initiating the administration of adequate antibiotic therapy for probable M. pneumoniae pneumonia. We suggest that M. pneumoniae pneumonia should be suspected when there is a correlation of more than five parameters in the JRS scoring system (99% specificity). If there is a correlation of three or four parameters in the JRS scoring system, chest computed tomography (CT) findings are helpful for the presumptive diagnosis of M. pneumoniae pneumonia.
本研究旨在评估三种快速诊断方法（免疫层析法检测肺炎支原体试剂盒、胸部高分辨率计算机断层扫描[HRCT]结果和日本呼吸学会[JRS]评分系统[包含六个参数]）在成人肺炎支原体肺炎早期疑似诊断中的准确性和实用性。我们在四个肺炎组中同时进行了三种快速诊断方法：68 例肺炎支原体肺炎、133 例肺炎链球菌肺炎、30 例流感嗜血杆菌肺炎和 20 例军团菌肺炎。免疫层析法的敏感性和特异性分别为 35%和 68%，HRCT 为 73%和 85%，JRS 评分系统为 83%和 90%。在这三种快速诊断方法中，JRS 评分系统是启动可能的肺炎支原体肺炎适当抗生素治疗的最有用工具。我们建议当 JRS 评分系统中有五个以上参数相关时，应怀疑肺炎支原体肺炎（特异性为 99%）。如果 JRS 评分系统中有三个或四个参数相关，则胸部计算机断层扫描（CT）结果有助于对肺炎支原体肺炎进行疑似诊断。
