Evaluation of 10 serological assays for diagnosing Mycoplasma pneumoniae infection.

Abstract In this study, the performance of 10 serological assaysfor the diagnosis of Mycoplasma pneumoniaeinfection was evaluated. A total of 145 sera from 120 patients were tested. They were obtained from patients who were serologicallypositive for M. pneumoniaeinfection as well as from patients who were infected with micro-organisms that may cause interstitial pneumonia. The following assayswere utilized: SeroMP IgM and IgG, SeroMP recombinant IgM, IgA and IgG, Liaison M. pneumoniaeIgM and IgG and M. pneumoniaeIgM, IgA and IgG ELISA Medac. The SeroMP Recombinant and Liaison assaysboth showed low IgM specificity, and crossreactivity was mainly observed in groups of patients with acute cytomegalovirus and Epstein-Barr virus infections. For IgA, the Medac assaywas less specific than the SeroMP Recombinant assay. Discrepancies between the four tests were observed in IgG analyses, and due to the lack of a gold standard, 22 results were removed prior to determining the sensitivity and specificity. Therefore, the overall performance of IgG assaysmay be overstated; nevertheless, the SeroMP assaydemonstrated a lack of sensitivity. The seroprevalence of IgG appears to be very low, raising concerns regarding whether the serologicaltechniques can detect IgG levels over time. Serologyremains a biological tool of choice for diagnosing M. pneumoniaeinfection, but improvement and standardization of the assaysare needed, particularly for the determination of IgG.