Pediatric allergy and respiratory disease (소아알레르기 및 호흡기학회지)

The Korean Academy of Pediatric Allergy and Respiratory Diseasse (대한소아알레르기호흡기학회)
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Diagnostic Availability of PCR and ELISA in Mycoplasma pneumoniae Pneumonia

마이코플라즈마 폐렴에서 중합 효소 연쇄반응과 효소면역측정법의 진단적 유용성

신윤호;이병철;송태원;김경원;이경은;김은수;박미연;류정우;장욱;손명현;김규언

  • Published : 20060000
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Abstract

Purpose : Mycoplasma pneumoniae is a common respiratory pathogen responsible for acute respiratory infections in young children. The standard laboratory methods for the specific diagnosis of M. pneumoniae infection have been isolation in culture and serological methods. The objective of this study was to compare the performance of enzyme-linked immunosorbent assays (ELISA) for the detection of M. pneumoniae specific IgG and IgM antibodies and polymerase chain reaction (PCR) in diagnosis of M. pneumoniae pneumonia. Methods : For a 1-year period, 111 patients admitted to Severance Hospital and Yongdong Severance Hospital with clinical features of pneumonia and radiographically defined pneumonia were included. Serum specimens and throat swab specimens were obtained at the time of admission. Patients who showed M. pneumoniae antibody titer 1 : 320 or greater or a fourfold increase in M. pneumoniae antibody titer between acute and convalescent sera obtained 5 days to 3 weeks after the onset of illness were diagnosed as having M. pneumoniae pneumonia. PCR and ELISA were also performed. Results : The sensitivity, specificity, false positivity, and false negativity of PCR were 40.6 percent, 63.3 percent, 69.1 percent, and 27.5 percent, respectively. The sensitivity, specificity, false positivity, and false negativity of ELISA IgM were 9.4 percent, 100 percent, 0 percent, and 26.9 percent, respectively. The sensitivity, specificity, false positivity, and false negativity of the use of PCR and ELISA in combination were 46.9 percent, 63.3 percent, 65.9 percent, and 25.4 percent, respectively. Conclusion : These observations suggest that the use of PCR and ELISA in addition to the detection of serum antibody to Mycoplasma pneumoniae using microparticle agglutination would allow the maximal number of diagnoses to be made at a very early phase of infection.

목 적 : Mycoplasma pneumoniae 폐렴은 소아 및 청소년기에 주로 호흡기 질환을 일으키는 주요 원인이다. M. pneumoniae 폐렴을 진단하기 위해서는 한랭응집소 검출반응, 마이코플라즈마 특이 항체 측정법, 배양 검사 등의 방법이 이용되고 있으나 초기 진단에는 효용성이 떨어진다. 본 연구는 중합 효소 연쇄반응과 효소면역측정법을 이용한 M. pneumoniae 폐렴의 진단적 유용성에 대해 평가하고자 하였다.방 법 : 연세대학교 의과대학 부속 세브란스병원 및 영동세브란스병원 소아과에 입원한 환자 중 입원 당시 시행한 흉부 X-선 검사 및 흉부 청진상 폐렴 소견을 보인 환아 111명의 임상 검체를 대상으로 M. pneumoniae를 분리, 동정하였다. 마이코플라즈마 특이항체가 1 : 320 이상이거나 추적 관찰 시 4배 이상 역가가 증가하는 경우를 M. pneumoniae 폐렴으로 진단하였고 이를 기준으로 중합 효소 연쇄반응과 효소면역측정법을 수행하였다. 결 과 : 중합 효소 연쇄반응의 민감도는 40.6 %, 특이도 63.3%, 위양성률 69.1%, 위음성률 27.5%로 나타났고, 효소면역측정법에서 M. pneumoniae 특이 IgM은 민감도 9.4%, 특이도 100%, 위양성률 0%, 위음성률 26.9%를 나타내었다. 중합 효소 연쇄반응과 효소면역측정법을 조합한 결과는 민감도 46.9%, 특이도 63.3%, 위양성률 65.9%, 위음성률 25.4%로 나타났다.

Keywords

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