Evaluation of Three Atypical Pathogen Detection Methods for Clinical Diagnosis of Community-Acquired Pneumonia in Adults
10.3969/j.issn.1671-7414.2025.04.035
- VernacularTitle:三种非典型病原体检测方法对成人社区获得性肺炎感染临床诊断的应用评价
- Author:
Qianqian ZHOU
1
;
Jianyu ZHAO
;
Mei WANG
;
Xinxin LU
Author Information
1. 北京回龙观医院检验科,北京大学回龙观临床医学院,北京 100096
- Publication Type:Journal Article
- Keywords:
community-acquired pneumonia in adults;
atypical pathogen;
multiplex polymerase chain reaction;
serum immunoglobulin M;
urinary Legionella pneumophila antigen detection
- From:
Journal of Modern Laboratory Medicine
2025;40(4):194-198,213
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the clinical value of multiplex polymerase chain reaction(mPCR),serum IgM and urinary Legionella pneumophila antigen detection in the diagnosis and treatment of adult community-acquired pneumonia(CAP)for Mycoplasma pneumoniae(MP),Chlamydia pneumoniae(CP)and Legionella pneumophila(LP).Methods A total of 275 inpatients diagnosed with CAP from October 2018 to January 2022 in Beijing Tongren Hospital were selected as the study objects.275 lower respiratory tract samples,195 serum samples and 50 urine samples were collected for sanger sequencing,mPCR,serum IgM and urinary LP antigen test,respectively.With the result of sanger sequencing as the reference standard,the clinical application value of the three detection methods was evaluated.Results The infection rate of atypical pathogens in adult patients with CAP was 26.5%(73/275).The infection rates of MP,CP and LP were 21.8%(60/275),2.2%(6/275)and 2.5%(7/275),respectively.The sensitivity of mPCR,serum IgM and urinary LP antigen test were 100%(72/72),31.0%(18/58),100%(7/7),and the specificity were 99.5%(202/203),76.6%(105/137),100%(43/43),respectively.The sensitivity of serum IgM was significantly decreased in patients with time≤7 days compared to patients with time>7 days from onset to sampling(41.9%vs 14.3%),the difference was statistically significant(χ2=5.483,P<0.05).The proportion of false negative for serum IgM was the highest in 25～<41 years old(57.5%),and the difference was statistically significant among all age groups(χ2=25.069,P<0.001).The proportion of false positive for serum IgM was the highest among 41～<66 years old(37.5%),and there was no significant difference among all age groups(χ2=6.404,P=0.171).The IgM cross-reactivity rate of the three atypical pathogens was 33.3%(13/39).Conclusion Serum IgM is not suitable for the diagnosis of atypical pathogen infection in adults alone,mPCR and urinary LP antigen test have obvious advantages in the early diagnosis of CAP in adults.
