Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea.
Ann Lab Med. 2012 Mar;32(2):133-8. doi: 10.3343/alm.2012.32.2.133. Epub 2012 Feb 23.
Differentiation of atypical pathogens is important for community-acquired pneumonia (CAP). In this study, we compared sputum and nasopharyngeal swabs (NPS) for use in detection of Mycoplasma pneumoniae (MP), Chlamydophila pneumoniae (CP), and Legionella pneumophila (LP), using Seeplex PneumoBacter ACE Detection Assay (PneumoBacter; Seegene).
Sputum and NPS specimens were collected from patients in 15 hospitals. DNA was extracted from sputum using QIAamp DNA Stool Mini Kit (Qiagen) and from NPS using easyMAG (bioMérieux). Both types of specimens were evaluated by multiplex PCR using PneumoBacter. To determine the diagnostic performance of this assay, sputum samples were also tested using BD ProbeTec ET Atypical Pneumonia Assay (APA; Becton Dickinson).
Among 217 sputum and NPS, 20 (9.2%), 2 (0.9%), and 0 sputum were positive for MP, LP, and CP, respectively, whereas 8 (3.7%) NPS were positive for MP. The sputum APA test yielded 186, 206, and 204 interpretable results for MP, LP, and CP, respectively. Of these, 21 (11.3%) were positive for MP, 2 (1.0%) were positive for LP, and 0 samples were positive for CP. Compared to APA, the sensitivity and specificity of the sputum assay for MP were 95.2% and 100.0%, respectively, whereas for the NPS assay, these were 38.1% and 93.9%. Sputum testing was more sensitive than NPS testing (P=0.002). For LP and CP diagnosis, PneumoBacter and APA tests agreed 100%.
Specimen type is crucial and sputum is preferred over NPS for simultaneous detection of MP, LP, and CP using multiplex PCR in CAP.
区分非典型病原体对于社区获得性肺炎（CAP）的诊断很重要。在这项研究中，我们使用 Seeplex PneumoBacter ACE Detection Assay（PneumoBacter；Seegene）比较了痰和鼻咽拭子（NPS）在检测肺炎支原体（MP）、肺炎衣原体（CP）和嗜肺军团菌（LP）中的应用。
从 15 家医院的患者中采集痰和 NPS 标本。使用 QIAamp DNA Stool Mini Kit（Qiagen）从痰中提取 DNA，使用 easyMAG（bioMérieux）从 NPS 中提取 DNA。使用 PneumoBacter 通过多重 PCR 对两种类型的标本进行评估。为了确定该检测方法的诊断性能，还使用 BD ProbeTec ET 非典型性肺炎检测试剂盒（APA；Becton Dickinson）对痰标本进行了检测。
在 217 份痰和 NPS 标本中，分别有 20（9.2%）、2（0.9%）和 0 份标本检测出 MP、LP 和 CP 阳性，而 8（3.7%）份 NPS 标本检测出 MP 阳性。APA 检测对 MP、LP 和 CP 的可解释结果分别为 186、206 和 204 个。其中，21（11.3%）份标本 MP 阳性，2（1.0%）份标本 LP 阳性，0 份标本 CP 阳性。与 APA 相比，痰标本检测对 MP 的敏感性和特异性分别为 95.2%和 100.0%，而 NPS 标本检测的敏感性和特异性分别为 38.1%和 93.9%。痰标本检测比 NPS 检测更敏感（P=0.002）。对于 LP 和 CP 的诊断，PneumoBacter 和 APA 检测结果完全一致。
标本类型很重要，在 CAP 中使用多重 PCR 同时检测 MP、LP 和 CP 时，痰标本优于 NPS。
