title: PCR versus serology for diagnosing Mycoplasma pneumoniae infection: a systematic review & meta-analysis.
abstract: OBJECTIVE
  Diagnosis for Mycoplasma pneumoniae usually relies on serological tests. PCR technology has some advantages but also limitations. The optimal selection for these tests still needs discussion. This paper reviews the overall diagnostic accuracy of PCR versus serological assays for diagnosis of M. pneumoniae infections and to identify factors associated with heterogeneity of results.
  
  
  METHODS
  MEDLINE and Embase databases were searched. Articles meeting the selection criteria were retrieved for data collection and analysis. Studies were assessed for methodological quality using QUADAS. Hierarchial summary receiver operating characteristic (HSROC) model was used to estimate summary ROC curve.
  
  
  RESULTS
  Initial meta-analysis showed a summary estimate of sensitivity (SEN) 0.62 (95% CI, 0.45-0.76), and specificity (SPE) 0.96 (95% CI, 0.93-0.98). Subgroup analyses were performed to identify factors associated with heterogeneity. For different gene targets, reference standards, subjects (children or adults) and different PCR types, these aspects can generate results of heterogeneity. The 16s rDNA target and adult subjects and real-time PCR may have better test results for PCR.
  
  
  CONCLUSIONS
  Commercial PCR tests generated consistent results with high specificity but a lower and more variable sensitivity. The findings suggest commercial PCR tests having superiorities in diagnosing M. pneumoniae infections but still cannot replace serology. PCR plus serology could be good screening tests for reliable and accurate diagnosis of M. pneumoniae.
authors: Center of Infectious Disease, West China Hospital, Sichuan University, Sichuan, PR China.
authors: Lei
authors: L
authors: Zhang
authors: Zhi-Yong
authors: ZY
authors: Zong
authors: Yan-Bin
authors: YB
authors: Liu
authors: Hui
authors: H
authors: Ye
authors: Xiao-Ju
authors: XJ
authors: Lv
mesh_terms: D000328:Adult; D002648:Child; D006801:Humans; D016239:MEDLINE; D009177:Mycoplasma pneumoniae / Q000235:genetics*; D011019:Pneumonia, Mycoplasma / Q000175:diagnosis*; D016133:Polymerase Chain Reaction / Q000379:methods*; D012336:RNA, Ribosomal, 16S / Q000235:genetics; D012372:ROC Curve; D012680:Sensitivity and Specificity; D012699:Serology / Q000379:methods*
chemical_list: D012336:RNA, Ribosomal, 16S