Jeon Ha Eun, Kang Hyun Mi, Yang Eun Ae, Han Hye Young, Han Seung Beom, Rhim Jung Woo, Lee Kyung-Yil
Department of Pediatrics, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul 06591, Korea.
Department of Pediatrics, The Catholic University of Korea, Daejeon St. Mary's Hospital, 64 Daeheung-ro, Jung-gu, Daejeon 34943, Korea.
Diagnostics (Basel). 2021 Feb 20;11(2):353. doi: 10.3390/diagnostics11020353.
The aim of the present study is to re-evaluate the clinical application of two-times serologic immunoglobulin M (IgM) tests using microparticle agglutination assay (MAA), an enzyme-linked immunosorbent assay (ELISA), and polymerase chain reaction (PCR) assay in diagnosing (MP) infection. A retrospective analysis of 62 children with MP pneumonia during a recent epidemic (2019-2020) was conducted. The MAA and ELISA immunoglobulin M (IgM) and IgG measurements were conducted twice at admission and around discharge, and MP PCR once at presentation. Diagnostic rates in each test were calculated at presentation and at discharge. The seroconverters were 39% (24/62) of patients tested by MAA and 29% (18/62) by ELISA. At presentation, the diagnostic positive rates of MAA, ELISA, and PCR tests were 61%, 71%, and 52%, respectively. After the second examination, the rates were 100% in both serologic tests. There were positive correlations between the titers of MAA and the IgM values of ELISA. The single serologic IgM or PCR tests had limitations to select patients infected with MP in the early stage. The short-term, paired IgM serologic tests during hospitalization can reduce patient-selection bias in MP infection studies.
本研究的目的是重新评估使用微粒凝集试验(MAA)、酶联免疫吸附测定(ELISA)和聚合酶链反应(PCR)测定进行两次血清学免疫球蛋白M(IgM)检测在诊断支原体肺炎(MP)感染中的临床应用。对近期一次流行期间(2019 - 2020年)62例MP肺炎患儿进行了回顾性分析。在入院时和出院前后分别进行两次MAA和ELISA免疫球蛋白M(IgM)及IgG检测,就诊时进行一次MP PCR检测。计算每次检测在就诊时和出院时的诊断率。通过MAA检测的患者血清转化率为39%(24/62),通过ELISA检测的为29%(18/62)。就诊时,MAA、ELISA和PCR检测的诊断阳性率分别为61%、71%和52%。第二次检测后,两种血清学检测的阳性率均为100%。MAA滴度与ELISA的IgM值之间存在正相关。单次血清学IgM或PCR检测在早期选择MP感染患者方面存在局限性。住院期间短期、配对的IgM血清学检测可减少MP感染研究中的患者选择偏倚。