Abstract：OBJECTIVE: To study the value of fluorescence quantitative polymerase chain reaction (FQ-PCR) for detecting Mycoplasma pneumoniae (MP)-DNA in bronchoalveolar lavage fluid (BALF) in the early diagnosis of Mycoplasma pneumoniae pneumonia (MPP). METHODS: FQ-PCR was used to detect MP-DNA in BALF obtained by fiberoptic bronchoscopy from 61 children with MPP, and the sensitivity and the specificity of FQ-PCR were compared with the traditional serological test. RESULTS: The sensitivity and the specificity of BALF FQ-PCR for detecting MP-DNA were 94% and 100% respectively. The accuracy of BALF FQ-PCR assay for detecting MP-DNA was higher than that of the serological test at the early stage of the disease (1-7 days) (P<0.01). In the children with refractory MPP, BALF FQ-PCR assay also showed higher accuracy for detecting MP-DNA than the serological test (P<0.01). The copies of MP-DNA in children with refractory MPP were significant higher than those in children with common MPP (P<0.05). The copies of MP-DNA were positively correlated with CRP values (r=0.845, P<0.01). CONCLUSIONS: FQ-PCR assay of BALF for detecting MP-DNA in BALF is superior to the serological test. It is a reliable method for the early diagnosis of MPP, especially refractory MPP. The copies of MP-DNA can be used as an index for evaluation of the treatment outcome of refractory MPP.
ZHONG Li-Li,PENG Li,HUANG Han et al. Value of fluorescence quantitative PCR assay of bronchoalveolar lavage fluid samples in the diagnosis of Mycoplasma pneumoniae pneumonia in children[J]. CJCP, 2011, 13(3): 191-194.
［1］Yang E, Altes T, Anupindi SA. Early Mycoplasma pneumoniae infection presenting as multiple pulmonary masses: an unusual presentation in a child［J］. Pediatr Radiol, 2008, 38(4): 477-480.
［2］Nagalingam NA, Adesiyun AA, Swanston WH, Bartholomew M. Prevalence of Mycoplasma pneumoniae and Chlamydia pneumoniae in pneumonia patients in four major hospitals in Trinidad［J］. New Microbiol, 2004, 27(4): 345-351.
［3］Gaillat J, Flahault A, de Barbeyrac B, Orfila J, Portier H, Ducroix JP, et al. Community epidemiology of Chlamydia and Mycoplasma pneumoniae in LRTI in France over 29 months［J］. Eur J Epidemiol, 2005, 20(7): 643-651.
［4］Tamura A, Matsubara K, Tanaka T, Nigami H, Yura K, Fukaya T. Methylprednisolone pulse therapy for refractory Mycoplasma pneumoniae pneumonia in children［J］. J Infect, 2008, 57(3): 223-228.
［5］Kenri T, Okazaki N, Yamazaki T, Narita M, Izumikawa K, Matsuoka M, et al. Genotyping analysis of Mycoplasma pneumoniae clinical strains in Japan between 1995 and 2005: type shift phenomenon of M.pneumoniae clinical strains［J］. J Med Microbiol, 2008, 57(Pt 4): 469-475.
［9］Verloet LA, Marguet C, Camargos PA. Infetion by Mycoplasma pneumoniae and its importance as an etiological agent in childhood community-acquired pneumonias［J］. Braz J Infect Dis, 2007, 11(5): 507-514.
［10］Yamazaki T, Narita M, Sasaki N, Kenri T, Arakawa Y, Sasaki T. Comparison of PCR for sputum samples obtained by induced cough and serological tests for diagnosis of Mycoplasma pneumoniae infection of children［J］. Clin Vaccine Immunol, 2006, 13(6): 708-710.
［11］Matas Andreu L, Molinos Abos S, Fernandez Rivas G, Gonzalez Soler V, Ausina Ruiz V. Serologic diagnosis of Mycoplasma pneumoniae infections［J］. Enferm Infecc Microbiol Clin, 2006, 24(Suppl 1):19-23.
［12］Lam WY, Yeung AC, Tang JW, Ip M, Chan EW, Hui M, et al. Rapid multiplex nested PCR for detection of respiratory viruses［J］. J Clin Microbiol. 2007, 45(11): 3631-3640.
［14］Michelow IC, Olsen K, Lozano J, Duffy LB, McCracken GH, Hardy RD. Diagnostic utility and clinical significance of nasoand oropharyngeal samples used in a PCR assay to diagnose Mycoplasma pneumoniae infection in children with community-acquired pneumonia［J］. J Clin Microbiol, 2004, 42(7): 3339-3341.
［15］Raty R, RonkkoE, Kleemola M. Sample type is crucial to the diagnosis of Mycoplasma pneumoniae pneumonia by PCR［J］. J Med Microbiol, 2005, 54(Pt 3): 287-291.
［16］Stelmach I, Podsiadlowicz-Borzecka M, Grzelewski T, Majak P, Stelmach W, Jerzyńska J, et al. Humoral and cellular immunity in children with Mycoplasma pneumoniae infection: a 1oyear prospective study［J］. Clin Diagn Lab Immunol, 2005, 12(10): 1246o1250.
［17］Pitcher D, Chalker VJ, Sheppard C, George RC, Harrison TG. Realotime detection of Mycoplasma pneumoniae in respiratory samples with an internal processing control［J］. J Med Microbiol, 2006, 55(Pt 2): 149o155.
［18］Nilsson AC, Bjorkman P, Welinder-Olsson C, Widell A, Persson K. Clinical severity of Mycoplasma pneumoniae (MP) infection is associated with bacterial load in oropharyngeal secretions but not with MP genotype［J］. BMC Infect Dis, 2010, 10: 39.
