32(02) 133-138 
| Comparison of Sputum and Nasopharyngeal Swab Specimens for Molecular Diagnosis of Mycoplasma pneumoniae, Chlamydophila pneumoniae, and Legionella pneumophila |
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| Min-Chul Cho, M.D.1, Hyewon Kim, M.D.1, Dongheui An, M.D.1, Miyoung Lee, M.T.1, Shin-Ae Noh, M.T.1, Mi-Na Kim, M.D.1,
Young Pil Chong, M.D.2, and Jun Hee Woo, M.D.2 | | Department of Laboratory Medicine1, Division of Infectious Disease2, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea | |
| 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. |
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2012 Mar; 32(02) 133-138 |
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| DOI : http://dx.doi.org/10.3343/alm.2012.32.2.133 |
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| Keyword : Atypical pneumonia, Mycoplasma pneumoniae, Chlamydophila pneumoniae,
Legionella pneumophila, Polymerase chain reaction, Nasopharyngeal swab, Sputum |
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