三种方法对儿童肺炎支原体感染诊断的动态评价

目的评价荧光定量PCR(FQ-PCR)检测肺炎支原体(MP)-DNA(MP-DNA),酶联免疫吸附试验(ELISA)检测MP-IgM,以及MP快速培养三种方法对儿童MP感染诊断的临床价值。方法对经临床和实验室诊断MP感染的患儿同时进行三种方法检测。并分别在病程1、3个月时重复检测。结果 MP感染患儿共153例。入院时首次检测,FQ-PCR阳性率为96%,ELISA为71%,MP快速培养法为24%。其中MP快速培养法的检出率在≤3岁组明显高于>3岁组,差异有统计学意义(P<0.05)。随访至1个月时,MP-DNA检测结果仍有50%以上阳性,而MP-IgM则保持较高的阳性率,此时仍然有44例(29%)患儿存在咳嗽,其中28例(64%)MP-DNA和MP-IgM均为阳性。随访至3个月时有4例(3%)患儿仍存在咳嗽,2例(50%)MP-DNA和MP-IgM均为阳性。结论在三种诊断儿童MP感染的方法中,FQ-PCR检测MP-DNA最敏感,其次为ELISA检测MP-IgM抗体,MP快速培养敏感性最低。MP-IgM检测阳性率至3个月时仍然维持较高水平。

Dynamical evaluation of three methods for diagnosis of Mycoplasma pneumoniae infection in children

Objective To evaluate the diagnostic value dynamically of fluorescent quantization PCR(FQ-PCR)for MP-DNA,enzyme-linked immunosorbent assay(ELISA)for MP-IgM antibodies,and rapid culture for MP in children with Mycoplasma pneumoniae infection.Methods The pediatric patients with confirmed MP infection by clinical and laboratory diagnosis were tested for MP-DNA,MP-IgM,and MP at admission,one month and three months after admission.Results A total of 153 MP infected pediatric patients were enrolled.At admission,the detection rate of FQ-PCR,ELISA and MP rapid culture were 96%,71% and 24% respectively.The detection rate of rapid culture method was significantly higher in ≤ 3 years old than that in > 3 years old group(P < 0.05).At one month,the detection rate of MP-DNA was > 50%,and the detection rate of MP-IgM was still higher.Forty-four patients(29%)had cough at one month,among whom 28(64%)patients were both MP-DNA and MP-IgM positive.At 3 months,4(3%)patients had cough,among whom 2 patients were both MP-DNA and MP-IgM positive.Conclusions In three kinds of methods,FQ-PCR assay for detecting MP-DNA was the most sensitive method for diagnosing MP infection,followed by the ELISA assay for detecting MP-IgM and rapid culture for MP.The detection rate of MP-IgM remained a high level when follow-up to 3 months.