Li Jieqiong, Sun Lin, Wu Xirong, Guo Yan, Jiao Weiwei, Xiao Jing, Xu Baoping, Shen Adong
Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, National Key Discipline of Pediatrics (Capital Medical University), Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
Department of Respiratory Diseases, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, Beijing, China.
Front Pediatr. 2019 Oct 25;7:441. doi: 10.3389/fped.2019.00441. eCollection 2019.
The effective diagnosis of (MP) pneumonia (MPP) in children has been hampered by the difficulty of achieving an early diagnosis. The simultaneous amplification and testing (SAT) has the potential for early diagnosis of MP in children. Of the 1,180 children enrolled in this study, 169 were MPP antibody (Ab) seroconversion positive, 641 showed MPP positivity with a single Ab test, and 370 were MPP negative. Sera and pharyngeal swabs were collected for antibody testing and SAT detection, respectively, on admission. When the samples were Ab negative, the paired -Ab test was requested for MP 7 days later. Using the Ab results as the diagnostic standard, the sensitivity, specificity, positive predictive values (PPV), and negative predictive values (NPV) for SAT were 72.8, 95.1, 97.0, and 61.5%, respectively. SAT had superior diagnostic value in the MPP group who had undergone Ab seroconversion (sensitivity: 82.2%; NPV: 92.1%) and in the short-course group also (sensitivity: 81.0%; NPV: 81.3%). Good agreement was observed between SAT and the paired-Ab results (kappa value = 0.79; < 0.001), but there was a lack of consistency between SAT and the single-Ab test results on admission (kappa value = 0.54, < 0.001). SAT is a rapid, sensitive, and specific method for MP diagnosis in pediatric patients. Our results indicate its value as an effective diagnostic tool for detecting MPP at the initial stage of an infection.
儿童支原体(MP)肺炎(MPP)的早期诊断困难,这阻碍了其有效诊断。同时扩增检测(SAT)有潜力对儿童MP进行早期诊断。在本研究纳入的1180名儿童中,169名MPP抗体(Ab)血清学转换呈阳性,641名单次Ab检测显示MPP阳性,370名MPP阴性。入院时分别采集血清和咽拭子用于抗体检测和SAT检测。当样本Ab为阴性时,7天后要求进行MP的双份Ab检测。以Ab结果作为诊断标准,SAT的敏感性、特异性、阳性预测值(PPV)和阴性预测值(NPV)分别为72.8%、95.1%、97.0%和61.5%。SAT在经历Ab血清学转换的MPP组(敏感性:82.2%;NPV:92.1%)以及短疗程组(敏感性:81.0%;NPV:81.3%)中具有更高的诊断价值。SAT与双份Ab结果之间观察到良好的一致性(kappa值 = 0.79;P < 0.001),但SAT与入院时单次Ab检测结果之间缺乏一致性(kappa值 = 0.54,P < 0.001)。SAT是儿科患者MP诊断的一种快速、敏感且特异的方法。我们的结果表明其作为在感染初期检测MPP的有效诊断工具的价值。