Retrospective Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Infect Dis. Nov 25, 2016; 6(4): 67-72
Published online Nov 25, 2016. doi: 10.5495/wjcid.v6.i4.67
Can the detection of IgA anti-Mycoplasma pneumoniae added to IgM increase diagnostic accuracy in patients with infections of the lower respiratory airways?
Massimo De Paschale, Teresa Cerulli, Debora Cagnin, Alessia Paganini, Maria Teresa Manco, Luisa Belvisi, Cristina Morazzoni, Laura Marinoni, Carlo Agrappi, Paola Mirri, Pierangelo Clerici
Massimo De Paschale, Teresa Cerulli, Debora Cagnin, Alessia Paganini, Maria Teresa Manco, Luisa Belvisi, Cristina Morazzoni, Laura Marinoni, Carlo Agrappi, Paola Mirri, Pierangelo Clerici, Microbiology Unit, ASST-Ovest Milanese, Hospital of Legnano, 20025 Legnano, Italy
Author contributions: All authors equally contributed to this paper with the concept and design of the study, literature review and analysis, drafting and critical revision and editing, and final approval of the final version.
Institutional review board statement: The study was approved by the Technical-Scientific Committee of ASST-Ovest Milanese, Hospital of Legnano.
Informed consent statement: All study participants, or their legal guardians, provided informed verbal consent prior to study enrollment; in all cases data handling and analyses were performed in order to safeguard patient privacy, and identity.
Conflict-of-interest statement: No potential conflicts of interest. No financial support.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Massimo De Paschale, Microbiology Unit, ASST-Ovest Milanese, Hospital of Legnano, Via Papa Giovanni Paolo II, 20025 Legnano, Italy. massimo.depaschale@asst-ovestmi.it
Telephone: +39-0331-449319 Fax: +39-0331-449578
Received: June 14, 2016
Peer-review started: June 17, 2016
First decision: July 27, 2016
Revised: August 13, 2016
Accepted: October 25, 2016
Article in press: October 27, 2016
Published online: November 25, 2016
Abstract
AIM

To evaluate the increase in diagnostic yield, by using IgA in addition to IgM, instead of IgM alone, in relation to the age of the patients.

METHODS

The study considered 1067 blood samples from patients with clinical signs of lower respiratory tract infections, tested for anti-Mycoplasma IgG, IgM and IgA antibody.

RESULTS

The increase in diagnostic yield with IgA, compared to IgM detection alone was of 3.5% with statistically significant differences between age groups (0.8% for those equal/under 50 years of age and 4.3% for those over 50).

CONCLUSION

Our findings demonstrate that IgA detection lead to a twofold increase in the number of diagnoses among the older age groups, but it did not result in relevant increase among the younger age groups.

Keywords: Community-acquired infections, Diagnostic yield, Elderly patients, IgA, Mycoplasma pneumoniae

Core tip: Diagnosis of Mycoplasma pneumoniae infection relies on IgM detection but also IgA can be searched. There are few data on the range of increase of diagnosis adding the search for the IgA. Detection of IgA (without IgM) increases diagnosis of 3.5% compared to the detection of IgM alone. The greater increase is for the patients older than 50 years. Detection of IgA antibodies could be included in laboratory routine only in older patients.