[Usefulness of PCR test for the management of a Mycoplasma pneumoniae outbreak in Bethune Hospital (Pas-de-Calais, France)].
METHODS
Molecular amplification (PCR) provides adequate rapid and specific diagnosis of Mycoplasma pneumoniae infection (first agent responsible for community-wide bacterial pneumonia in children above 5 years of age).


METHODS
Positive (Chlamylège(®), Argène) PCR in nasopharyngeal aspirate, respiratory samples and nasopharyngeal swab and/or positive serological test (ELISA).


RESULTS
Diagnosis of M. pneumoniae infection in 39 cases: 31 between September and December 2008 (30 children and one adult) and eight since June 2009 (three adults and five children). Children (mean age: 3.6years) were hospitalized in 88.6% of cases, mean hospitalization duration was 2.9 days for respiratory tract infections, mainly due to lack of response to β-lactamines therapy (65.7%). Four adults (mean age: 29.5 years) presented a pneumonia, with hospitalization for three of them with one in intensive care unit. Twenty-eight PCR have proved positive (87%): without associated serology (13), eight negative serologies, IgG and IgM positive (five), and IgG alone (two). Seven patients had only serological test for diagnosis: IgM±IgG. For two children, IgM positive only in isolation, with a PCR probably false negative.


CONCLUSIONS
The sensitivity of the serology in the diagnosis of mycoplasma infection is limited: IgM, which appear traditionally 1 week after clinical signs are mostly inexistent for adults and IgG rise at a later stage. Early diagnosis of child pneumoniae by PCR helped rapidly characterize this epidemic phenomenon and adapt the treatment.
Dekeyser
S
S
Laboratoire, centre hospitalier de Béthune, rue Delbecque, 62408 Béthune, France. sdekeyser@ch-bethune.fr
Bonnel
C
C
Martinet
A
A
Descamps
D
D
D018829:Adhesins, Bacterial / Q000235:genetics; D000293:Adolescent; D000328:Adult; D000907:Antibodies, Bacterial / Q000097:blood; D002648:Child; D002675:Child, Preschool; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology*; D004269:DNA, Bacterial / Q000235:genetics; D004196:Disease Outbreaks; D042241:Early Diagnosis; D004797:Enzyme-Linked Immunosorbent Assay; D005602:France / Q000453:epidemiology; D006786:Hospitals, Urban; D006801:Humans; D007124:Immunoenzyme Techniques; D007074:Immunoglobulin G / Q000097:blood / Q000276:immunology; D007075:Immunoglobulin M / Q000097:blood / Q000276:immunology; D007223:Infant; D009177:Mycoplasma pneumoniae / Q000235:genetics* / Q000276:immunology / Q000302:isolation & purification; D009305:Nasopharynx / Q000382:microbiology; D011019:Pneumonia, Mycoplasma / Q000453:epidemiology / Q000382:microbiology*; D016133:Polymerase Chain Reaction / Q000379:methods*; D011237:Predictive Value of Tests; D055815:Young Adult
D018829:Adhesins, Bacterial; D000907:Antibodies, Bacterial; D004269:DNA, Bacterial; D007074:Immunoglobulin G; D007075:Immunoglobulin M; C035471:adhesin, Mycoplasma pneumoniae
Pathol Biol (Paris). 2006 Dec;54(10):603-11
17030455
Med Mal Infect. 2011 May;41(5):221-8
21106313