Kenny G E, Kaiser G G, Cooney M K, Foy H M
Department of Pathobiology, School of Public Health and Community Medicine, University of Washington, Seattle 98195.
J Clin Microbiol. 1990 Sep;28(9):2087-93. doi: 10.1128/jcm.28.9.2087-2093.1990.
The sensitivities and specificities of isolation and serology for detection of Mycoplasma pneumoniae infections were determined for 3,546 pneumonia patients for whom both isolation and serological data were available. Soy peptone, fresh yeast extract, horse serum-supplemented agar, and diphasic medium were employed for isolation, and the lipid antigen of M. pneumoniae was used for serodiagnosis by complement fixation. The number of M. pneumoniae colonies most frequently detected was 200 to 600 per throat swab, with a range of less than or equal to 60 to greater than or equal to 2,000. The use of diphasic medium increased the number of isolates by 26% compared with direct isolation on agar plates. The organism was isolated from 360 of 525 patients who showed fourfold or greater antibody increases in their paired sera, resulting in a sensitivity of culture of 68%. When persons with titers of greater than or equal to 32 but no fourfold increase were used as the reference, the sensitivity of culture was 58%. The combined sensitivity of the culture method for persons with serological evidence of infection (fourfold increase and titer of greater than or equal to 32) was 64%. The specificity of the culture method was 97% for the 2,527 serologically negative persons. Fourfold antibody increases were found in 360 of 674 persons with isolates of the organism, resulting in a sensitivity of 53%. An additional 247 persons showed titers of greater than or equal to 32 (without a fourfold increase), resulting in a combined sensitivity of 90% for serology with the lipid antigen for the detection of antibodies in culture-positive persons. Fourfold antibody increases were found in 6% of culture-negative persons, resulting in a specificity of 94%. The quantitative culture results provide important base-line data for the development of rapid diagnostic tests for M. pneumoniae infection.
对于3546例同时有分离培养和血清学数据的肺炎患者，测定了分离培养和血清学检测肺炎支原体感染的敏感性和特异性。采用大豆蛋白胨、新鲜酵母提取物、补充马血清的琼脂和双相培养基进行分离培养，并用肺炎支原体的脂抗原通过补体结合试验进行血清学诊断。每支咽拭子最常检测到的肺炎支原体菌落数为200至600个，范围为小于或等于60至大于或等于2000个。与在琼脂平板上直接分离相比，使用双相培养基使分离株数量增加了26%。在525例配对血清抗体升高四倍或更多的患者中，有360例分离出该病原体，培养的敏感性为68%。当以滴度大于或等于32但无四倍升高的患者作为对照时，培养的敏感性为58%。对于有感染血清学证据（四倍升高且滴度大于或等于32）的患者，培养方法的综合敏感性为64%。对于2527例血清学阴性的患者，培养方法的特异性为97%。在674例分离出该病原体的患者中，有360例抗体升高四倍，敏感性为53%。另外247例患者的滴度大于或等于32（无四倍升高），对于培养阳性患者，脂抗原血清学检测抗体的综合敏感性为90%。在培养阴性的患者中，有6%的患者抗体升高四倍，则特异性为94%。定量培养结果为开发肺炎支原体感染的快速诊断试验提供了重要的基线数据。
