[Evaluation of four commercial immunoglobulin G (IgG)- and IgM- specific enzyme immunoassays for diagnosis of Mycoplasma pneumoniae infections].
The four following commercially available enzyme immunoassays (EIAs) were assessed and compared for their performance in detecting Mycoplasma pneumoniae specific IgG and IgM antibodies: EIA-Platelia, EIA-Bmd, EIA-Sorin and EIA-Biotest. Three groups of patients were investigated: 39 patients (27 children and 12 adults) with respiratory infections and a M. pneumoniae PCR-positive in respiratory specimens (group I; 52 sera), 61 healthy children and adults (group II; 61 sera) and 20 patients with rheumatoid factor, antinuclear antibodies or positive antiviral IgM (group III; 20 sera). In group III, the IgM specificity for the EIA-Platelia, EIA-Bmd, EIA-Biotest and EIA-Sorin was 100%, 90%, 65% and 25%, respectively. In the children from group I, the four EIAs had similar IgM sensitivity (89 to 92%) but a striking difference in IgM sensitivity was observed in adult patients: 16% EIA-Platelia and EIA-Bmd, 50% EIA-Biotest, 58% EIA-Sorin. The sensitivity for IgG was greater with EIA-Bmd and EIA-Biotest, especially in detection of IgG in acute-phase serum : 61% EIA-Bmd and EIA-Biotest, 15% EIA-Platelia and 31% EIA-Sorin. Discrepant and unexpected results were observed in IgM detection from control healthy patients using EIA-Sorin and EIA-Biotest, confirming the lack of specificity of these two EIA-tests and making them inaccurate for routine diagnosis. A high IgG seroprevalence were found in healthy adults by the four EIAs (43-70%). In healthy children, EIA-Bmd and EIA-Biotest gave a higher IgG seroprevalence than EIA-Sorin and EIA-Platelia (45% each for the former as compared to 17% and 20%, respectively, for the latter).These results confirm that the IgM EIA serology test is a valuable tool for the early diagnosis of M. pneumoniae infections in children, as long as the EIA test used is specific. In adults, the difficult interpretation of EIA tests suggests that paired sera, combined with PCR detection on respiratory tract specimens collected on admission of patient, should be required for accurate diagnosis.
Petitjean
J
J
Laboratoire de virologie humaine et moléculaire, hôpital universitaire, avenue G. Clémenceau, 14033, Caen, France.petitjean-j@chu-caen.fr
Vabret
A
A
Gouarin
S
S
Freymuth
F
F
D000328:Adult; D015415:Biomarkers / Q000097:blood; D001992:Bronchoalveolar Lavage Fluid / Q000382:microbiology*; D002648:Child; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D007075:Immunoglobulin M / Q000097:blood*; D009177:Mycoplasma pneumoniae / Q000302:isolation & purification*; D011019:Pneumonia, Mycoplasma / Q000097:blood / Q000175:diagnosis* / Q000276:immunology; D011933:Reagent Kits, Diagnostic; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
D015415:Biomarkers; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D011933:Reagent Kits, Diagnostic