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Clinical and Diagnostic Laboratory Immunology, September 2004, p. 862-867, Vol. 11, No. 5
1071-412X/04/$08.00+0     DOI: 10.1128/CDLI.11.5.862-867.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.

Analysis of Eight Commercial Enzyme Immunoassay Tests for Detection of Antibodies to Mycoplasma pneumoniae in Human Serum

Deborah F. Talkington,1* Susan Shott,2 Michael T. Fallon,3 Stephanie B. Schwartz,1 and W. Lanier Thacker1

Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention,1 Research Service, Atlanta VA Medical Center, Decatur, and Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia,3 Biostatistics Unit, Department of Medicine, Rush University Medical Center, Chicago, Illinois2

Received 21 October 2003/ Returned for modification 18 December 2003/ Accepted 17 May 2004

Mycoplasma pneumoniae is an important etiologic agent of primary atypical pneumonia in children and adults. The diagnosis of M. pneumoniae infection is commonly confirmed through serologic testing. In this study, we used paired sera from 51 patients (all with confirmed M. pneumoniae infection and positive complement fixation [CF] titers) to compare the results of eight enzyme immunoassays (EIAs) available commercially in the United States. We compared two single-use EIAs and six plate-type EIAs. Results from acute-phase sera ranged from only 7 (14%) positive by ImmunoWELL (GenBio) immunoglobulin M (IgM) EIA to 23 (45%) positive by Zeus IgG EIA. When both the acute-phase and convalescent-phase serum samples were examined, positive results ranged from 20 (39%) by the ImmunoWELL (GenBio) IgM assay to 45 (88%) positive by the Remel IgG-IgM EIA. In this study, the single-use EIAs by Remel and Meridian were more reliable than were the plate-type EIAs. Among the plate-type EIAs, the Zeus and DiaSorin assays (which detect antibodies to protein antigens) were more sensitive than the ImmunoWELL assay (which detects antibodies to glycolipid antigens). In general, IgG EIAs on convalescent-phase sera were more concordant with one another than were IgM EIAs with one another. Scatter plot analysis of convalescent-phase sera showed that, as the CF titer dropped, the IgM assays identified fewer positive convalescent-phase sera. In contrast, the IgG assays provided fairly consistent positive results for convalescent-phase sera with CF titers of 64 and above. Results of individual tests and overall limitations of serodiagnostics for M. pneumoniae infections are discussed.

* Corresponding author. Mailing address: Bldg. 5-312, Mailstop G03, 1600 Clifton Rd., NE, Centers for Disease Control and Prevention, Atlanta, GA 30333. Phone: (404) 639-3563. Fax: (404) 639-4215. E-mail: dft1{at}cdc.gov.

Clinical and Diagnostic Laboratory Immunology, September 2004, p. 862-867, Vol. 11, No. 5
1071-412X/04/$08.00+0     DOI: 10.1128/CDLI.11.5.862-867.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.



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