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Volume 40, Number 6, December 2007

Rapid diagnosis of Mycoplasma pneumoniae infection in children by polymerase chain reaction


Fang-Ching Liu, Po-Yen Chen, Fang-Liang Huang, Chi-Ren Tsai, Chun-Yi Lee, Li-Chung Wang
Department of Pediatrics, Jen-Ai Hospital, Taichung, 2Division of Pediatric Infectious Disease, Department of Pediatrics and 3Microbiology Section of Medical Laboratory Department, Taichung Veterans General Hospital, Taichung, Taiwan

Received: May 30, 2006    Revised: July 28, 2006    Accepted: August 10, 2006   

 

Corresponding author:

Dr. Po-Yen Chen, Department of Pediatrics, Taichung Veterans General Hospital, 160, Sec. 3, Chung-Kang Road, Taichung 40705, Taiwan. E-mail: Dr. Po-Yen Chen This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

 



 

Background and purpose: 

Endemic atypical pneumonia was noted in central Taiwan during 2005. The serological response to Mycoplasma pneumoniae infection was usually poor in its early course; convalescent serum was needed in most cases, which was sometimes difficult to obtain in children. Empiric antimicrobial therapy was usually initiated before serological testing. A rapid test would be useful to define the etiology and initiate appropriate management. We studied the usefulness of polymerase chain reaction (PCR) analysis for diagnosis in this setting.

 



 

Methods:

This 1-year prospective study conducted during 2005 in central Taiwan enrolled 307 hospitalized children (aged 3 months to 16 years) with respiratory tract infections, some complicated with systemic manifestations, such as encephalitis and skin rash. Fifty one patients were excluded due to unavailability of data or lack of consent. PCR analysis of samples using a primer set for the P1 gene of M. pneumoniae was compared to serological testing, including particle agglutinin test and enzyme-linked immunosorbent assay.

 



 

Results:

263 throat swabs from 256 patients were available for PCR tests, and serological tests were performed in 140 children (55%) with clinical suspicion of atypical pneumonia. Eighty two children (32%) were positive by the PCR method and 76 (30%) were serologically positive. Seventy one patients (87%) with duration of disease onset of 2 to 7 days had positive PCR results. The mean age of patients with M. pneumoniae infection was 5.2 years, with 27% of patients <2 years old and 73% of patients >2 years of age. The diagnoses were as follows: pneumonia (n = 44); pneumonia complicated with pleural effusion (n = 12); bronchitis and bronchopneumonia (n = 18); asthmatic bronchitis (n = 2); croup syndrome (n = 1); pharyngitis (n = 3); and herpangina (n = 2). Coinfection with bacteria or virus was found in 21% of patients with M. pneumoniae infection.

 



 

Conclusion:

The PCR method could provide earlier diagnosis of M. pneumoniae infection and was useful to identify variable clinical features of infection, especially in younger children.

 



 

Key words:

Child; Mycoplasma pneumoniae; Polymerase chain reaction; Respiratory tract infections; Taiwan


 



 

J Microbiol Immunol Infect. 2007;40:507-512.