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Laboratory diagnosis of Mycoplasma pneumoniae infection. 4. Antigen capture and PCR-gene amplification for detection of the mycoplasma: problems of clinical correlation

Published online by Cambridge University Press:  15 May 2009

J. Williamson ,
B. P. Marmion ,
D. A. Worswick ,
T. -W. Kok ,
G. Tannock ,
R. Herd  and
R. J. Harris
J. Williamson
Affiliation:
School of Pharmacy and Medical Laboratory Science, University of South Australia, Adelaide, South Australia
B. P. Marmion*
Affiliation:
Department of Pathology, University of Adelaide, South Australia Division of Medical Virology, Institute of Medical and Veterinary Science, Adelaide, South Australia
D. A. Worswick
Affiliation:
Division of Medical Virology, Institute of Medical and Veterinary Science, Adelaide, South Australia
T. -W. Kok
Affiliation:
Division of Medical Virology, Institute of Medical and Veterinary Science, Adelaide, South Australia
G. Tannock
Affiliation:
Faculty of Medicine, The University of Newcastle, Newcastle, New South Wales
R. Herd
Affiliation:
Faculty of Medicine, The University of Newcastle, Newcastle, New South Wales
R. J. Harris
Affiliation:
School of Pharmacy and Medical Laboratory Science, University of South Australia, Adelaide, South Australia
*
*Please address correspondence and reprint requests to: Professor B. P. Marmion, Department of Pathology, University of Adelaide, North Terrace, Adelaide, South Australia 5000.
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Direct detection assays for Mycoplasma pneumoniae were established by PCR amplification of short sequences within the foot protein/adhesin (P1) gene and the 16S 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.

Type
Research Article
Information
Epidemiology & Infection , Volume 109 , Issue 3 , December 1992 , pp. 519 - 537
Copyright
Copyright © Cambridge University Press 1992

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