본문 바로가기
KERD
논문KCI 등재

Comparison of Sputum and Nasopharyngeal Swab Specimens for Molecular Diagnosis of Mycoplasma pneumoniae, Chlamydophila pneumoniae, and Legionella pneumophila

2

조회

0

다운로드

3

인용

0

참고문헌

키워드

주제분류병리학

초록

Background: Differentiation of atypical pathogens is important for community-acquired pneumonia (CAP). In this study, we compared sputum and nasopharyngeal swabs (NPS) for use in detection of Mycoplasma pneumoniae (MP), Chlamydophila pneumoniae (CP), and Legionella pneumophila (LP), using Seeplex PneumoBacter ACE Detection Assay (PneumoBacter; Seegene). Methods: Sputum and NPS specimens were collected from patients in 15 hospitals. DNA was extracted from sputum using QIAamp DNA Stool Mini Kit (Qiagen) and from NPS using easyMAG (bioMérieux). Both types of specimens were evaluated by multiplex PCR using PneumoBacter. To determine the diagnostic performance of this assay, sputum samples were also tested using BD ProbeTec ET Atypical Pneumonia Assay (APA; Becton Dickinson). Results: Among 217 sputum and NPS, 20 (9.2%), 2 (0.9%), and 0 sputum were positive for MP, LP, and CP, respectively, whereas 8 (3.7%) NPS were positive for MP. The sputum APA test yielded 186, 206, and 204 interpretable results for MP, LP, and CP, respectively. Of these, 21 (11.3%) were positive for MP, 2 (1.0%) were positive for LP, and 0 samples were positive for CP. Compared to APA, the sensitivity and specificity of the sputum assay for MP were 95.2% and 100.0%, respectively, whereas for the NPS assay, these were 38.1% and 93.9%. Sputum testing was more sensitive than NPS testing (P =0.002). For LP and CP diagnosis, PneumoBacter and APA tests agreed 100%. Conclusions: Specimen type is crucial and sputum is preferred over NPS for simultaneous detection of MP, LP, and CP using multiplex PCR in CAP.

Abstract

Background: Differentiation of atypical pathogens is important for community-acquired pneumonia (CAP). In this study, we compared sputum and nasopharyngeal swabs (NPS) for use in detection of Mycoplasma pneumoniae (MP), Chlamydophila pneumoniae (CP), and Legionella pneumophila (LP), using Seeplex PneumoBacter ACE Detection Assay (PneumoBacter; Seegene). Methods: Sputum and NPS specimens were collected from patients in 15 hospitals. DNA was extracted from sputum using QIAamp DNA Stool Mini Kit (Qiagen) and from NPS using easyMAG (bioMérieux). Both types of specimens were evaluated by multiplex PCR using PneumoBacter. To determine the diagnostic performance of this assay, sputum samples were also tested using BD ProbeTec ET Atypical Pneumonia Assay (APA; Becton Dickinson). Results: Among 217 sputum and NPS, 20 (9.2%), 2 (0.9%), and 0 sputum were positive for MP, LP, and CP, respectively, whereas 8 (3.7%) NPS were positive for MP. The sputum APA test yielded 186, 206, and 204 interpretable results for MP, LP, and CP, respectively. Of these, 21 (11.3%) were positive for MP, 2 (1.0%) were positive for LP, and 0 samples were positive for CP. Compared to APA, the sensitivity and specificity of the sputum assay for MP were 95.2% and 100.0%, respectively, whereas for the NPS assay, these were 38.1% and 93.9%. Sputum testing was more sensitive than NPS testing (P =0.002). For LP and CP diagnosis, PneumoBacter and APA tests agreed 100%. Conclusions: Specimen type is crucial and sputum is preferred over NPS for simultaneous detection of MP, LP, and CP using multiplex PCR in CAP.

참고문헌 (32)

  1. Blasi F., "Atypical pathogens and respiratory tract infections", Eur Respir J, 24, pp.171~181 (2004)
  2. Cunha BA, "The atypical pneumonias: clinical diagnosis and importance", Clin Microbiol Infect, 12(S3), pp.S12~S24 (2006)
  3. 정용필, "지역사회획득 폐렴의 원인 미생물에 대한 전향적 다기관 연구: 세균성 폐렴의 원인균 분석", Infection and Chemotherapy, 42(6), pp.397~403 (2010), 대한감염학회
  4. Lim WS, "BTS guidelines for the management of community acquired pneumonia in adults: update 2009", Thorax, 64(S3), pp.iii1~55 (2009)
  5. Mandell LA, "Infectious Diseases Society of America", American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults, 2007, pp.44(S2), S27~S72
  6. Thurman KA, "Detection of Mycoplasma pneumoniae, Chlamydia pneumoniae, and Legionella spp. in clinical specimens using a single-tube multiplex real-time PCR assay", Diagn Microbiol Infect Dis, 70, pp.1~9 (2011)
  7. Socan M, "Microbial aetiology of community-acquired pneumonia in hospitalised patients", Eur J Clin Microbiol Infect Dis, 18, pp.777~782 (1999)
  8. Templeton KE, "Improved diagnosis of the etiology of community-acquired pneumonia with real-time polymerase chain reaction", Clin Infect Dis, 41, pp.345~351 (2005)
  9. Räty R, "Sample type is crucial to the diagnosis of Mycoplasma pneumoniae pneumonia by PCR", J Med Microbiol, 54, pp.287~291 (2005)
  10. Murdoch DR, "Molecular genetic methods in the diagnosis of lower respiratory tract infections", APMIS, 112, pp.713~727 (2004)
  11. Strålin K, "Design of a multiplex PCR for Streptococcus pneumoniae, Haemophilus influenzae, Mycoplasma pneumoniae and Chlamydophila pneumoniae to be used on sputum samples", APMIS, 113, pp.99~111 (2005)
  12. Loens K, "Development of real-time multiplex nucleic acid sequence-based amplification for detection of Mycoplasma pneumoniae, Chlamydophila pneumoniae, and Legionella spp. in respiratory specimens", J Clin Microbiol, 46, pp.185~191 (2008)
  13. Loens K, "Optimal sampling sites and methods for detection of pathogens possibly causing community-acquired lower respiratory tract infections", J Clin Microbiol, 47, pp.21~31 (2009)
  14. Reznikov M, "Comparison of nasopharyngeal aspirates and throat swab specimens in a polymerase chain reaction-based test for Mycoplasma pneumoniae", Eur J Clin Microbiol Infect Dis, 14, pp.58~61 (1995)
  15. Baron EJ, "Manual of clinical microbiology. 10th ed", pp.255~256 (2011), ASM press
  16. Dorigo-Zetsma JW, "Molecular detection of Mycoplasma pneumoniae in adults with community-acquired pneumonia requiring hospitalization", J Clin Microbiol, 39, pp.1184~1186 (2001)
  17. Kleemola SR, "Rapid diagnosis of Mycoplasma pneumoniae infection: clinical evaluation of a commercial probe test", J Infect Dis, 162, pp.70~75 (1990)
  18. Loens K, "Evaluation of different nucleic acid amplification techniques for the detection of M. pneumoniae, C. pneumoniae and Legionella spp. in respiratory specimens from patients with community-acquired pneumonia", J Microbiol Methods, 73, pp.257~262 (2008)
  19. Honda J, "Clinical use of capillary PCR to diagnose Mycoplasma pneumoniae.", J Clin Microbiol, 38, pp.1382~1384 (2000)
  20. Brunner H, "Microbial surface components and toxins in relation to pathogenesis", pp.81~89 (1991), Plenum
  21. Dorigo-Zetsma JW, "Demonstration by a nested PCR for Mycoplasma pneumoniae that M. pneumoniae load in the throat is higher in patients hospitalised for M. pneumoniae infection than in non-hospitalised subjects", J Med Microbiol, 48, pp.1115~1122 (1999)
  22. Kenny GE, "Diagnosis of Mycoplasma pneumoniae pneumonia: sensitivities and specificities of serology with lipid antigen and isolation of the organism on soy peptone medium for identification of infections", J Clin Microbiol, 28, pp.2087~2093 (1990)
  23. Bencini MA, "Multicenter comparison of molecular methods for detection of Legionella spp. in sputum samples", J Clin Microbiol, 45, pp.3390~3392 (2007)
  24. Hernes SS, "Swabbing for respiratory viral infections in older patients: a comparison of rayon and nylon flocked swabs", Eur J Clin Microbiol Infect Dis, 30, pp.159~165 (2011)
  25. Edelstein PH., "Manual of Clinical Microbiology. 10th ed", pp.774~775 (2011), ASM press
  26. Den Boer JW, "Diagnosis of Legionella infection in Legionnaires’ disease", Eur J Clin Microbiol Infect Dis, 23, pp.871~878 (2004)
  27. McDonough EA, "A cluster of Legionella-associated pneumonia cases in a population of military recruits", J Clin Microbiol, 45, pp.2075~2077 (2007)
  28. Ramirez JA, "Diagnosis of Legionella pneumophila, Mycoplasma pneumoniae, or Chlamydia pneumoniae lower respiratory infection using the polymerase chain reaction on a single throat swab specimen", Diagn Microbiol Infect Dis, 24, pp.7~14 (1996)
  29. Diederen BM, "Are oropharyngeal swabs suitable as samples for Legionella-specific PCR testing?", J Clin Microbiol, 45, pp.3482~3483 (2007)
  30. Gaydos C, "Manual of Clinical Microbiology. 10th ed", pp.990~991 (2011), ASM press
  31. Boman J, "Rapid diagnosis of respiratory Chlamydia pneumoniae infection by nested touchdown polymerase chain reaction compared with culture and antigen detection by EIA", J Infect Dis, 175, pp.1523~1526 (1997)
  32. Kuoppa Y, "Quantitative detection of respiratory Chlamydia pneumoniae infection by realtime PCR", J Clin Microbiol, 40, pp.2273~2274 (2002)

관련 논문AI추천

호흡기 검체에서 Mycoplasma pneumoniae, Chlamydophila pneumoniae, Legionella pneumophila 검출을 위한 EuDxTM-PN MLC Detection 키트의 평가성흥섭, 이미경, 조아라, 지현영대한임상미생물학회 · Annals of Clinical Microbiology2017 · 제20권 제4호호흡기 검체에서 폐렴의 세균성 원인균 검출을 위한 다중 PCR 검사의 임상적 평가이미애, 정채림, 정화순대한임상미생물학회 · Annals of Clinical Microbiology2010 · 제13권 제1호Multiplex Real-time PCR Assay for the Detection of all Chlamydia Species and Simultaneous Differentiation of C. psittaci and C. pneumoniae in Human Clinical SpecimensChande Aroon T., Conley Andrew B., Diaz Maureen H., Gaines Anna, Norris Emily, Rishishwar Lavanya, Winchell Jonas M., Wolff Bernard J., Yang Eungi대한진단검사의학회 · Annals of Laboratory Medicine2023 · 제43권 제4호Macrolide Resistance of Mycoplasma pneumoniae and Its Detection Rate by Real-Time PCR in Primary and Tertiary Care Hospitals어영, 김주원, 박순덕, 오기진, 윤갑준, 이진아, 이환종, 조현미, 최은화, 홍주희대한진단검사의학회 · Annals of Laboratory Medicine2013 · 제33권 제6호소아의 세균성 호흡기감염의 진단을 위한 SeeplexTM Pneumobacter Multiplex PCR 키트의 평가김재경, 김종완, 박주원, 임인수대한진단검사의학회 · Annals of Laboratory Medicine2009 · 제29권 제4호Comparison of Multiplex Real-Time Polymerase Chain Reaction Assays for Detection of Respiratory Viruses in Nasopharyngeal Specimens김대원, 김민경, 변정현, 용동은, Jean Damascene Uwizeyimana대한임상미생물학회 · Annals of Clinical Microbiology2019 · 제22권 제2호

이 간행물의 다른 논문 (11건)