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Updated: Jan 4, 2026
Antigen-Capture Enzyme-Linked Immunosorbent Assay for Specific Detection of Mycoplasma pneumoniae
Published on: February 24, 2023
Improved Diagnostics Help to Identify Clinical Features and Biomarkers That Predict Mycoplasma pneumoniae
Patrick M Meyer Sauteur1, Selina Krautter1, Lilliam Ambroggio2
1Division of Infectious Diseases and Hospital Epidemiology, University Children's Hospital Zurich, Zurich, Switzerland.
Background:
There are no reliable signs or symptoms that differentiate Mycoplasma pneumoniae (Mp) infection in community-acquired pneumonia (CAP) from other etiologies. Additionally, current diagnostic tests do not reliably distinguish between Mp infection and carriage. We previously determined that the measurement of Mp-specific immunoglobulin M antibody-secreting cells (ASCs) by enzyme-linked immunospot assay allowed for differentiation between infection and carriage. Using this new diagnostic test, we aimed to identify clinical and laboratory features associated with Mp infection.
Methods:
This is a prospective cohort study of children, 3-18 years of age, with CAP from 2016 to 2017. Clinical features and biomarkers were compared between Mp-positive and -negative groups by Mann-Whitney U test or Fisher exact test, as appropriate. Area under the receiver operating characteristic curve (AUC) differences and optimal thresholds were determined by using the DeLong test and Youden J statistic, respectively.
Results:
Of 63 CAP patients, 29 were Mp-positive (46%). Mp positivity was statistically associated with older age (median, 8.6 vs 4.7 years), no underlying disease, family with respiratory symptoms, prior antibiotic treatment, prolonged prodromal respiratory symptoms and fever, and extrapulmonary (skin) manifestations. Lower levels of C-reactive protein, white blood cell count, absolute neutrophil count, and procalcitonin (PCT), specifically PCT <0.25 μg/L, were statistically associated with Mp infection. A combination of age >5 years (AUC = 0.77), prodromal fever and respiratory symptoms >6 days (AUC = 0.79), and PCT <0.25 μg/L (AUC = 0.81) improved diagnostic performance (AUC = 0.90) (P = .05).
Conclusions:
A combination of clinical features and biomarkers may aid physicians in identifying patients at high risk for Mp CAP.
Insights
Identifying Mycoplasma pneumoniae (Mp) infection in community-acquired pneumonia (CAP) is challenging. A combination of older age, prolonged symptoms, and low procalcitonin levels can help physicians diagnose Mp CAP.
Area of Science:
- Pediatric infectious diseases
- Respiratory medicine
- Diagnostic microbiology
Background:
- Differentiating Mycoplasma pneumoniae (Mp) from other community-acquired pneumonia (CAP) causes is difficult due to overlapping symptoms.
- Current diagnostic methods struggle to distinguish between Mp infection and asymptomatic carriage.
- Previous research identified Mp-specific immunoglobulin M antibody-secreting cells (ASCs) as a reliable indicator of infection.
Purpose of the Study:
- To identify clinical and laboratory features associated with Mycoplasma pneumoniae (Mp) infection in children with community-acquired pneumonia (CAP).
- To develop a diagnostic approach for Mp CAP using clinical and biomarker data.
Main Methods:
- Prospective cohort study of 63 children (3-18 years) with CAP from 2016-2017.
- Comparison of clinical features and biomarkers between Mp-positive and Mp-negative groups using Mann-Whitney U and Fisher exact tests.
- Analysis of diagnostic performance using receiver operating characteristic (ROC) curves and Youden J statistic.
Main Results:
- Mycoplasma pneumoniae (Mp) positivity (46%) was associated with older age, absence of underlying disease, family respiratory symptoms, prior antibiotics, prolonged prodromal symptoms, and extrapulmonary manifestations.
- Lower levels of C-reactive protein, white blood cell count, absolute neutrophil count, and procalcitonin (PCT <0.25 μg/L) were linked to Mp infection.
- A combination of age >5 years, prodromal symptoms >6 days, and PCT <0.25 μg/L achieved high diagnostic performance (AUC = 0.90).
Conclusions:
- Clinical features and biomarkers can assist in identifying children at high risk for Mycoplasma pneumoniae (Mp) community-acquired pneumonia (CAP).
- The proposed combination of factors offers improved diagnostic accuracy for Mp CAP.
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