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KMID : 0605820130200020071
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Korean Journal of Pediatric Infectious Diseases
2013 Volume.20 No. 2 p.71 ~ p.80
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Indirect Particle Agglutination Antibody Testing for Early Diagnosis of Mycoplasma pneumoniae pneumonia in Children
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Kim Jin-Soo
Ko Jeong-Hee
Oh Sung-Hee
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Abstract
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Objectives: Outbreaks of pneumonia caused by Mycoplasma pneumoniae (MP) occur every 3-4 years in Korea, most recently
in 2011. The aim of our study was to determine the optimal time to perform indirect particle agglutination antibody
assays to improve early diagnosis of MP pneumonia in children.
Methods: A database of 206 pediatric patients treated for pneumonia at the Hanyang University Hospital from June to October
2011 was analyzed retrospectively for demographic characteristics and laboratory test results.
Results: Among the 206 patients treated for pneumonia during the study period, there were 160 children (mean age, 5.44
years) diagnosed with MP pneumonia, who were studied further. The mean age of these MP pneumonia patients was 5.44
years. Antibody titers increased with increasing time between symptom onset and the collection of serum collection: MP
titers were <1:640 for sera collected after 5.44 days and titers 1:640 for those collected ≥ after 8.58 days; P<0.001). Antibody
titers were considered positive when they reached ≥1:640. In 42 MP pneumonia patients in whom there was a four-fold
or greater increase in titer between successive serum samples, the optimal cut-off time-point for distinguishing between
the initial and second titer groups was 7.5 days after the onset of symptoms (sensitivity, 90.5%; specificity, 92.9%).
Conclusions: Negative MP antibody titers earlier than 8 days after the onset of symptoms in children with pneumonia may
require repeating to confirm the diagnosis. This finding could optimize diagnosis and result in better therapeutic outcomes
of MP pneumonia in children.
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KEYWORD
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Mycoplasma pneumoniae, Pneumonia, Diagnosis, Serology, Children
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