Rapid diagnostic method for the identification of Mycoplasma pneumoniae respiratory tract infection.

Abstract

Rapid diagnostic tests are useful tools in the early diagnosis of respiratory tract infections (RTIs) caused by a specific pathogens. We investigated the sensitivity and specificity of a rapid and simple antigen test for the detection of Mycoplasma pneumoniae, Ribotest Mycoplasma(®) in adolescent and adult patients with RTIs. In addition, we evaluated the accuracy of clinical and laboratory findings for the early presumptive diagnosis of M.pneumoniae RTI. We compared 55 cases with laboratory-confirmed M.pneumoniae infection using serology, culture, and polymerase chain reaction (PCR) and 346 cases without laboratory-confirmed M.pneumoniae infection. Pneumonia cases were excluded in this study. Among patients with M.pneumoniae infection, the incidences of cough, sore throat, and sputum production were high, with rates of 98%, 61%, and 67%, respectively, but the specificity was low. The prevalence of nasal symptoms was significantly lower in patients with M.pneumoniae infection (9%) than in non-M.pneumoniae infection (70%; p<0.0001). When PCR was used as the control test, the sensitivity, specificity, and overall agreement rates with Ribotest(®) were 71%, 89%, and 87%, respectively. Clinical symptoms and laboratory data were of limited value in making the diagnosis of M.pneumoniae RTI in adolescent and adult patients. Our results suggested that Ribotest(®) may be helpful in distinguishing M.pneumoniae RTI patients from those without the disease. Physicians should consider the use of Ribotest(®) when patients have a persistent cough without nasal symptoms.