LABORATORY DIAGNOSIS OF MYCOPLASMA-PNEUMONIAE INFECTION .4. ANTIGEN CAPTURE AND PCR-GENE AMPLIFICATION FOR DETECTION OF THE MYCOPLASMA - PROBLEMS OF CLINICAL CORRELATION

被引:70
作者
WILLIAMSON, J
MARMION, BP
WORSWICK, DA
KOK, TW
TANNOCK, G
HERD, R
HARRIS, RJ
机构
[1] UNIV ADELAIDE,DEPT PATHOL,ADELAIDE,SA 5000,AUSTRALIA
[2] UNIV S AUSTRALIA,SCH PHARM,ADELAIDE,SA,AUSTRALIA
[3] INST MED & VET SCI,DIV MED VIROL,ADELAIDE,SA,AUSTRALIA
[4] UNIV NEWCASTLE,FAC MED,NEWCASTLE,NSW 2308,AUSTRALIA
[5] UNIV S AUSTRALIA,MED LAB SCI,ADELAIDE,SA,AUSTRALIA
关键词
D O I
10.1017/S0950268800050512
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Direct detection assays for Mycoplasma pneumoniae were established by PCR amplification of short sequences within the foot protein/adhesin (Pl) gene and the 168 ribosomal RNA gene. Specificity and sensitivity was excellent, no hybridization was observed with M. genitalium and other human Mycoplasma species. In nose and throat washings from subjects with respiratory infection a pattern of high counts (c.f u./ml) of M. pneumoniae (deduced from the amount of amplified PCR product), and a positive antigen capture assay, was found in 83% of subjects with serological evidence of current infection with M. pneumoniae. A small proportion of subjects with serological patterns suggesting infection in the more distant past had positive PCR assays. This was considered to represent either persistence of the organism from a previous infection or perhaps transient carriage during a reinfection, without substantial change in antibody response. PCR-based assay of M. pneumoniae offers a powerful, rapid, and sensitive substitute for culture of the mycoplasma. Antigen capture, while less sensitive than PCR, offers the advantage that it is more often positive with samples from current infection and requires less stringent laboratory organization to contain false positive results. We conclude however that the laboratory diagnosis of a chosen clinical episode should not rest on the PCR or Ag-EIA assays alone, but must also include antibody assays to confirm whether infection is current or represents persistence from past exposure.
引用
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页码:519 / 537
页数:19
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