Department of Microbiology, University Hospital Antwerp, Antwerp, Belgium.
Mycoplasma pneumoniae (M. pneumoniae) is recognized as common cause of respiratory tract infections occurring worldwide both in children and in adults.
Prevalences of M. pneumoniae infection range from 0% to 50%, influenced by age and geographic location of the patients, the stage of the disease but also with the diagnostic methods applied. Correct and rapid diagnosis of M. pneumoniae infections is however critical to initiate appropriate antibiotic treatment.
Because of the widespread availability of commercial tests, and the ease of obtaining a serum specimen, serological methods still play a predominant role in clinical practice to diagnose M. pneumoniae infections. However, the performances of these tests depend on several factors resulting in a poor agreement between different tests. Consequently, the choice of the serological test has important implications when performing seroepidemiological studies and when using these tests for the management of individual patients.
Over the past few years, nucleic acid amplification techniques (NAATs), especially real-time PCR, have provided significant improvements in the diagnosis of RTI, resulting from both improved sensitivity and specificity, and the production of very rapid results. However, as for serology, lack of standardization has resulted in a wide variation of interlaboratory test performances. The availability of the very sensitive NAATs has in recent years also put the serological tests in their right perspective.
Data from recent studies using PCR based methods and serology published during the last 5 years in different patient populations from around the world are summarized and the role of both techniques will be discussed.