1887

Abstract

Purpose. Respiratory tract infections are a major cause of global morbidity and mortality. Pneumonia is the ninth leading cause of mortality in Sri Lanka. Atypical pathogens cause about one-fifth of community-acquired pneumonia, while Mycoplasma pneumoniae accounts for about 50 %. This study aimed to determine the seroprevalence of M. pneumoniae respiratory tract infections in Sri Lanka while attempting to understand the relationships between the serology and PCR.

Methodology. Paired sera from 418 adult patients (pneumonia, n=97; bronchitis, n=183; pharyngitis, n=138) and 87 healthy controls were studied. IgM, IgG and IgA antibodies were tested by M. pneumoniae enzyme-linked immunosorbent assay (ELISA). Positive IgM and or IgG seroconversion was considered to be seropositive. M. pneumoniae DNA were tested by PCR in age and gender-matched seropositives and seronegatives.

Results. M. pneumoniae IgG was in 14.4 % (14/97), 6.0 % (11/183) and 1.5 % (2/138) of pneumonia, bronchitis and pharyngitis patients, respectively, whilst IgM was in 6.2 % (6/97), 1.1 % (2/183) and 0 % (0/138), respectively. Amongst the pneumonia seropositives, 64.7 % (11/17) showed IgG alone, 17.5 % (3/17) showed IgM alone and 17.5 % (3/17) showed IgM and IgG. Amongst the bronchitis seropositives, 84.6 % (11/13) had IgG alone and 15.4 % (2/13) had IgM alone. In the pharyngitis seropositives, only IgG was detected 100 % (2/2). M. pneumoniae DNA was in 52.2 % (12/23) of seropositives and 15.4 % (4/26) of seronegatives. In pneumonia or bronchitis patients, specific DNA was in 77.8 % (7/10) and 50 % (6/12) of patients, respectively. M. pneumoniae DNA was not found in pharyngitis patients. Of the seropositive PCR-negative pneumonia patients, 66.7 % (2/3) showed IgG alone and 33.3 % (1/3)showed IgM alone. In bronchitis patients, 83.3 % (5/6) showed IgG alone and 16.7 % (1/6) showed IgM alone. Of the seronegative PCR-positive patients, 16.7 % (2/12) had pneumonia and 18.2 % (2/11) had bronchitis.

Conclusion.The serological evidence for M. pneumoniae infection in Sri Lanka comprised the following prevalences: 17.5 % (17/97), 7.1 % (13/183) and 1.4 % (2/138) in adults with pneumonia, bronchitis or pharyngitis, respectively. M. pneumoniae DNA was in 52.2 % (12/23) of seropositives and 15.4 % (4/26) of seronegatives. IgG was predominant in PCR positives and negatives.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.000813
2018-08-03
2024-03-28
Loading full text...

Full text loading...

/deliver/fulltext/jmm/67/9/1232.html?itemId=/content/journal/jmm/10.1099/jmm.0.000813&mimeType=html&fmt=ahah

References

  1. World Health Organization 2015 Available from www.who.int/gho/mortality_burden_disease/causes_death/top_10/en/
  2. World Health Organization 2016; Pneumonia. Available from www.who.int/mediacentre/factsheets/fs331/en/
  3. Department of Health Services, Sri Lanka 2015 www.health.gov.lk/moh_final/english/others.php?pid=110 3.2.2.1 leading cause of hospital deaths
  4. Atkinson TP, Balish MF, Waites KB. Epidemiology, clinical manifestations, pathogenesis and laboratory detection of Mycoplasma pneumoniae infections. FEMS Microbiol Rev 2008; 32:956–973 [View Article][PubMed]
    [Google Scholar]
  5. Gallagher JR. Acute pneumonitis: a report of 87 cases among adolescents. Yale J Biol Med 1941; 13:663[PubMed]
    [Google Scholar]
  6. Gallagher JR. Bronchopneumonia in adolescence. Yale J Biol Med 1934; 7:23[PubMed]
    [Google Scholar]
  7. Eaton MD, Meiklejohn G, van Herick W, Corey M. Studies on the etiology of primary atypical pneumonia : II. properties of the virus isolated and propagated in chick embryos. J Exp Med 1945; 82:317–328 [View Article][PubMed]
    [Google Scholar]
  8. Marmion BP, Goodburn GM. Effect of an organic gold salt on Eaton's primary atypical pneumonia agent and other observations. Nature 1961; 189:247–248 [View Article][PubMed]
    [Google Scholar]
  9. Sánchez-Vargas FM, Gómez-Duarte OG. Mycoplasma pneumoniae-an emerging extra-pulmonary pathogen. Clin Microbiol Infect 2008; 14:105–115 [View Article][PubMed]
    [Google Scholar]
  10. Murray HW, Masur H, Senterfit LB, Roberts RB. The protean manifestations of Mycoplasma pneumoniae infection in adults. Am J Med 1975; 58:229–242 [View Article][PubMed]
    [Google Scholar]
  11. Wijesooriya WRPLI, Sunil-Chandra NP, Perera J. Reliability of cold agglutinin test (CAT) for the detection of patients with Mycoplasma pneumoniae pneumonia. SLJID 2016; 28:6
    [Google Scholar]
  12. Song JH, Jung SI, Ko KS, Kim NY, Son JS et al. High prevalence of antimicrobial resistance among clinical Streptococcus pneumoniae isolates in Asia (an ANSORP study). Antimicrob Agents Chemother 2004; 48:2101–2107 [View Article][PubMed]
    [Google Scholar]
  13. World Health Organization 2017; WHO publishes list of bacteria for which new antibiotics are urgently needed. www.who.int/mediacentre/news/releases/2017/bacteria-antibiotics-needed/en/
  14. Sri Lanka College of Microbiologists slmicrobiology.net/antibiotic-guidelines-2016/Empirical and Prophylactic Use of Antimicrobials, National Guidelines; 2016
  15. McPhee SJ, Papadakis MA, Rabow MW. Current Medical Diagnosis and Treatment, 56th ed. New York: The McGraw-Hill; 2017
    [Google Scholar]
  16. Gunawardhana CB, Sakeena MHF, Sivayoganthan C. Awareness of rational medication use and antibiotic self- medication practices among undergraduate students in a University in Sri Lanka. Trop J Pharm Res 2015; 14:723–729 [View Article]
    [Google Scholar]
  17. Koneman EW, Stephen DA, Janda WM, Schreckenberger PC, Winn WC et al. Colour Atlas and Textbook of Diagnostic Microbiology, 5th ed. Philadelphia: Lippincott Williams and Wilkins; 1997
    [Google Scholar]
  18. Williamson J, Marmion BP, Worswick DA, Kok TW, Tannock G et al. Laboratory diagnosis of Mycoplasma pneumoniae infection. 4. Antigen capture and PCR-gene amplification for detection of the Mycoplasma: problems of clinical correlation. Epidemiol Infect 1992; 109:519–537 [View Article][PubMed]
    [Google Scholar]
  19. Marmion BP, Williamson J, Worswick DA, Kok TW, Harris RJ. Experience with newer techniques for the laboratory detection of Mycoplasma pneumoniae infection: Adelaide, 1978–1992. Clin Infect Dis 1993; 17:S90–S99 [View Article][PubMed]
    [Google Scholar]
  20. Cimolai N, Bryan LE, To M, Woods DE. Immunological cross-reactivity of a Mycoplasma pneumoniae membrane-associated protein antigen with Mycoplasma genitalium and Acholeplasma laidlawii. J Clin Microbiol 1987; 25:2136–2139[PubMed]
    [Google Scholar]
  21. Inamine JM, Denny TP, Loechel S, Schaper U, Huang CH et al. Nucleotide sequence of the P1 attachment-protein gene of Mycoplasma pneumoniae. Gene 1988; 64:217–229 [View Article][PubMed]
    [Google Scholar]
  22. Razin S, Yogev D, Naot Y. Molecular biology and pathogenicity of mycoplasmas. Microbiol Mol Biol Rev 1998; 62:1094–1156[PubMed]
    [Google Scholar]
  23. Thacker WL, Talkington DF. Analysis of complement fixation and commercial enzyme immunoassays for detection of antibodies to Mycoplasma pneumoniae in human serum. Clin Diagn Lab Immunol 2000; 7:778–780 [View Article][PubMed]
    [Google Scholar]
  24. Ayyez HN, Naher HS, Alsaadi MA. Serological and molecular detection of Mycoplasma pneumonia. Int J Curr Microbiol Appl Sci 2014; 3:1201–1206
    [Google Scholar]
  25. Loens K, Ieven M. Mycoplasma pneumoniae: current knowledge on nucleic acid amplification techniques and serological diagnostics. Front Microbiol 2016; 7:448 [View Article][PubMed]
    [Google Scholar]
  26. Foy HM, Kenny GE, Cooney MK, Allan ID. Long-term epidemiology of infections with Mycoplasma pneumoniae. J Infect Dis 1979; 139:681–687 [View Article][PubMed]
    [Google Scholar]
  27. Drasbek M, Nielsen PK, Persson K, Birkelund S, Christiansen G. Immune response to Mycoplasma pneumoniae P1 and P116 in patients with atypical pneumonia analyzed by ELISA. BMC Microbiol 2004; 4:7 [View Article][PubMed]
    [Google Scholar]
  28. Chang HY, Chang LY, Shao PL, Lee PI, Chen JM et al. Comparison of real-time polymerase chain reaction and serological tests for the confirmation of Mycoplasma pneumoniae infection in children with clinical diagnosis of atypical pneumonia. J Microbiol Immunol Infect 2014; 47:137–144 [View Article][PubMed]
    [Google Scholar]
  29. Lee WJ, Huang EY, Tsai CM, Kuo KC, Huang YC et al. The role of serum Mycoplasma pneumoniae IgA, IgM, and IgG for the diagnosis of Mycoplasma pneumonia-related pneumonia in school-age children and adolescents. Clin Vaccine Immunol 2016; 19:CVI-00471
    [Google Scholar]
  30. Spuesens EB, Fraaij PL, Visser EG, Hoogenboezem T, Hop WC et al. Carriage of Mycoplasma pneumoniae in the upper respiratory tract of symptomatic and asymptomatic children: an observational study. PLoS Med 2013; 10:e1001444 [View Article][PubMed]
    [Google Scholar]
  31. Kok TW, Varkanis G, Marmion BP, Martin J, Esterman A. Laboratory diagnosis of Mycoplasma pneumoniae infection. 1. Direct detection of antigen in respiratory exudates by enzyme immunoassay. Epidemiol Infect 1988; 101:669–684 [View Article][PubMed]
    [Google Scholar]
  32. Nilsson AC, Björkman P, Persson K. Polymerase chain reaction is superior to serology for the diagnosis of acute Mycoplasma pneumoniae infection and reveals a high rate of persistent infection. BMC Microbiol 2008; 8:93 [View Article][PubMed]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/jmm.0.000813
Loading
/content/journal/jmm/10.1099/jmm.0.000813
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error