First Department of Internal Medicine, Division of Respiratory Medicine, Infectious Disease and Allergology, Kansai Medical University, Japan.
First Department of Internal Medicine, Division of Respiratory Medicine, Infectious Disease and Allergology, Kansai Medical University, Japan.
J Infect Chemother. 2020 Jun;26(6):527-530. doi: 10.1016/j.jiac.2019.12.021. Epub 2020 Apr 7.
To prevent an increase in the frequency of antimicrobial resistance (AMR), the specific and rapid diagnosis of causative pathogens is important, as the results can be used to initiate appropriate antibiotics treatment. Recently, the highly sensitive rapid immunochromatographic assay of silver amplification technology was developed for the detection of Mycoplasma pneumoniae. We investigated the sensitivity and specificity of the silver amplification immunochromatographic assay in adolescent and adult patients. A total of 767 patients with respiratory tract infection (RTI) and 605 with pneumonia were assessed by the silver amplification assay and real-time polymerase chain reaction (PCR). M. pneumoniae was identified by PCR in 95 patients with RTI and in 30 patients with community-acquired pneumonia (CAP), but it was not identified in patients with nursing- and healthcare-associated pneumonia. Eighteen of the 95 RTI patients and 7 of the 30 CAP patients with PCR-positive M. pneumoniae were found to be infected with macrolide-resistant M. pneumoniae. When PCR was used as the control test, the sensitivity, specificity, and overall agreement with the silver amplification assay were 90.5%, 99.0%, and 97.9%, respectively, in RTI patients and 90.0%, 99.1%, and 98.7%, respectively, in pneumonia patients. Our results show that the silver amplification assay has excellent sensitivity and specificity compared with PCR despite being a rapid diagnostic method. The silver amplification assay may be helpful for initiating appropriate antibiotic treatment and preventing AMR.
为了防止抗菌药物耐药性（AMR）的增加，明确和快速诊断病原体非常重要，因为这样可以及时开始使用合适的抗生素治疗。最近，开发了一种基于银增强放大技术的高度敏感的快速免疫层析检测方法，用于检测肺炎支原体。我们调查了该银增强免疫层析检测法在青少年和成年患者中的敏感性和特异性。共有 767 例呼吸道感染（RTI）和 605 例肺炎患者接受了银增强检测和实时聚合酶链反应（PCR）检测。95 例 RTI 患者和 30 例社区获得性肺炎（CAP）患者通过 PCR 鉴定出肺炎支原体，但在护理相关性肺炎和医疗保健相关性肺炎患者中未鉴定出肺炎支原体。18 例 RTI 患者和 30 例 CAP 患者中 PCR 阳性的肺炎支原体中，有 18 例为大环内酯类耐药肺炎支原体感染。当 PCR 作为对照试验时，银增强检测在 RTI 患者中的敏感性、特异性和总符合率分别为 90.5%、99.0%和 97.9%，在肺炎患者中的敏感性、特异性和总符合率分别为 90.0%、99.1%和 98.7%。与 PCR 相比，尽管该银增强检测法是一种快速诊断方法，但它的敏感性和特异性都非常出色。该银增强检测法可能有助于及时开始使用合适的抗生素治疗和预防 AMR。
