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对Mycoplasma pneumoniae肺炎的非侵入性诊断测试的评估

Yongwei Fan¹, Zhenyun Tan¹, Zhenfa Wang¹

¹Department of Respiratory and Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China.

Frontiers in immunology

|October 16, 2025

概括

准确识别Mycoplasma pneumoniae肺炎 (MPP) 是一个挑战. 虽然使用鼻拭片核酸测试 (NAAT) 和血清IgM测试,但甲基因组下一代测序 (mNGS) 证明了MPP的优越诊断性能.

科学领域:

肺部医学肺部医学
传染性疾病传染性疾病
诊断微生物学诊断微生物学

背景情况:

准确及时诊断Mycoplasma pneumoniae肺炎 (MPP) 是一个重大的临床挑战.
目前的非侵入性诊断方法,包括鼻拭片核酸测试 (NAAT) 和血清IgM抗体测试,具有可变的诊断性能.
现实世界的临床环境需要对这些用于MPP识别的非侵入性测试进行严格的评估.

研究的目的:

以回顾评估NAAT和血清IgM抗体检测的敏感性和特异性,以诊断MPP.
为了将非侵入性测试的诊断性能与支气管洗液下一代代基因组测序 (BALF-mNGS) 的诊断性能进行比较.
评估NAAT或血清IgM抗体测定是否在诊断MPP时不劣于mNGS.

主要方法:

对住院患有社区获得性肺炎 (CAP) 的成年患者进行了回顾性研究.
作为参考标准,利用了支气管洗液的下一代代基因组测序 (BALF-mNGS).
计算了NAAT和血清IgM抗体测定对mNGS和临床判断决定的最终诊断的敏感性和特异性.

主要成果:

在594名患者中,60人被诊断患有MPP. NAAT显示74.1%的灵敏度和99.3%的特异性;血清IgM测试显示23.6%的灵敏度和98.0%的特异性.
在mNGS和两个非侵入性测试之间观察到统计学上显著的灵敏度差异 (P<0.05).
与mNGS相比,NAAT和血清IgM抗体测定都未能达到非劣势差距,表明灵敏度较低.

结论:

阳性NAAT或血清IgM结果可以支持MPP诊断,但负面结果不排除临床怀疑病例的MPP.
与非侵入性替代方法相比,甲基因组下一代测序 (mNGS) 是MPP的更有效的诊断方法.
可能需要进一步的研究来优化MPP的非侵入性诊断策略.

关键词:

在IgM抗体中,IgM抗体是最重要的.肺炎的神经质菌.在社区获得的肺炎.诊断的准确性诊断的准确性基因组下一代测序的测序.鼻口腔抽样核酸测试核酸测试

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