Evaluation of ELISA Kits for Detection of Mycoplasma pneumoniae-Specific IgG, IgA, IgM Antibodies on the Diagnosis of Mycoplasma pneumoniae Infection in Children
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概要
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A retrospective study was conducted to evaluate the utility of <I>Mycoplasma pneumoniae</I> IgG (quantitative), IgA (quantitative), IgM (qualitative) ELISA kits (Medac Diagnostika, Germany) forthe diagnosis of <I>M. pneumoniae</I> pneumonia in children under 16 years of age. This study included a to-tal of 159 serum samples from 113 patients with acute respiratory diseases such as bronchitis, pneu-monia, which were classified into three groups according to the results of a particle agglutination (PA) test as a reference method, that is, Group I (<I>Mycoplasma</I>-definite cases): Group I-a (paired 52samples from 26 cases); a four-fold or greater rise of antibody from an acute phase PA titer of =/<1: 80, Group I-b (paired 12 samples from 6 cases); a four-fold or greater rise of antibody from aacute phase PA titer of =/ >1: 160, Group I-c (48 samples from 38 cases); a single high PA titerof =/>1: 640 either or both in acute or convalescent serum, Group II (<I>Mycoplasma</I>-probable cases, 18samples from 17 cases): a PA titer of 1: 160 or 320 was observed either or both in acute or conva-lescent serum, but the above serological criteria for Group I were not fulfilled, Group III (non-cases, 29samples from 26 cases): a PA titer of any sample was =/< 1: 80. The ELISA tests were performedaccording to the supplier's recommendations, and the results were classified according to the interpretation provided by the supplier: Early stage of infection (category 1, 2), Acute-(3, 4, 5), Current-(6), Past-(7), and No-infection (8). The day of onset of fever (defined as a body temperature of =/>37.5 degrees Celsius) was denoted as day O. As a result from Group I, the category initially observedfollowing the onset of fever was category 8 (triple negative), and the predominance of category 8 wasreplaced by category 1 (IgM solely positive) after day 4, followed by a shift of predominance to cate-gory 4 (1gM and IgG double positive) or 5 (triple positive) after day 10 or later. Specifically, category1 was rather exclusively observed before day 21 following the onset of fever. These results suggestthat category 1, when observed, is a useful marker of acute infection by <I>Mycoplasma pneumoniae</I> inchildren because it appears early in the acute phase and no longer observed beyond the convalescentphase. On the other hand, significance of detecting IgA antibody, which must be important for adults, was not remarkable in our study. Five samples in group II and 3 samples in group III fell into cate-gory 1. Whether or not such cases, in the absence of significant PA titers, can be taken actually asmycoplasmal infection remains to be clear. This study validated the utility of this ELISA methodol-ogy in terms of the acute phase diagnosis using a single point serum sample for <I>Mycoplasma pneumoniae</I> infection specifically in children.
- The Japanese Association for Infectious Diseasesの論文
The Japanese Association for Infectious Diseases | 論文
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