Value of simultaneous amplification and testing in early diagnosis of Mycoplasma pneumoniae pneumonia and related influencing factors

Abstract:

Objective To investigate the value of simultaneous amplification and testing (SAT) in the early diagnosis of Mycoplasma pneumoniae pneumonia (MPP) in children and related influencing factors. Methods A total of 526 children with community-acquired pneumonia who were hospitalized between December 2016 and December 2017 were enrolled. Particle agglutination was used to measure serum Mycoplasma pneumoniae (MP) antibody (MP-Ab). The value of SAT in the diagnosis of MPP was evaluated based on these results. Results Based on the results of serum MP-Ab measurement, 165 children were diagnosed with MPP. MP-SAT had a sensitivity of 90.9% (150/165), a specificity of 97.9% (368/376), and high accuracy (Youden index=0.89) in the diagnosis of MPP, suggesting that there was good consistency between these two methods (Kappa=0.90). The diagnostic sensitivity of MP-SAT in children with a short course of disease was significantly higher than that in children with a long course of disease (P=0.031). The diagnostic sensitivity of MP-SAT was significantly higher than that of single serum MP-Ab measurement (P=0.018), with poor consistency between these two methods (Kappa=0.039). MP-SAT had good consistency with double serum MP-Ab measurement (Kappa=0.91). The multivariate logistic regression analysis showed that course of disease (≥ 7 days) and out-of-hospital macrolide treatment were the main factors influencing the results of MP-SAT (P < 0.05). Conclusions MP-SAT has high value in the early diagnosis of MPP and can effectively cover the shortage of single serum MP-Ab test in the acute stage and thus provide help for early clinical diagnosis. MP-SAT test should be performed in the early stage of the disease (< 7 days) and before the application of macrolide treatment.