Objective To investigate clinical value of real-time simultaneous amplification and testing(SAT)in the early diagnosis of pediatric mycoplasma pneumoniae pneumonia(MPP)and its role in evaluating MPP outcomes and assessing drug efficacy.Methods A total of 451 hospital-ized children with community-acquired pneumonia(CAP)were selected.Serum samples were col-lected and tested with passive agglutination method for mycoplasma pneumoniae(MP)-specific antibodies[MP antibody test(MP-Ab)]and pharyngeal swab samples were also collected for MP-RNA(MP-SAT method)within 24 hours of admission.MP-Ab and MP-RNA were re-tested at the completion of the first course of treatment with macrolides and the third course of treatment with macrolides for MPP children.They were categorized into the MPP group(n=183)and the non-MPP group(n=268)according to the diagnostic criteria for MPP.The accuracy(sensitivity,speci-ficity,positive predictive value,negative predictive value)of MP-SAT and MP-Ab in diagnosing MPP was compared.Dynamic observation was conducted on MPP patients with a disease course of less than 7 days,who did not use macrolide drugs before admission,to investigate the positive rates of MP-SAT and MP-Ab at different time points(admission,completion of the first and third treatment courses)when macrolide drugs(azithromycin)were used to treat MP,as well as the changes in clinical and imaging manifestations(cough,fever,lung signs,and CT manifestations)of the patients.Results There was no statistically significant difference in the accuracy of diagnosing MPP between MP-SAT and MP-Ab(P＞0.05);the sensitivity,specificity,positive predictive val-ue,and negative predictive value of MP-SAT in diagnosing MPP in the group of patients with a disease course of less than 7 days were all better than those of MP-Ab(P＜0.001 or P＜0.05 or P＜0.01).42 MPP children who were not treated with macrolide drugs before admission with a disease course of less than 7 days had a positive rate of 88.09％(37/42),88.09％(37/42),and 9.52％(4/42)for MP-SAT at the time of admission,completion of the first course of azithromycin treatment,and completion of the third course of azithromycin treatment;the positive rate of MP-Ab was 26.19％(11/42),100.00％(42/42),and 100.00％(42/42),respectively.There are statisti-cally significant differences in the positive rates of MP-SAT and MP-Ab at different time points(P＜0.001,P＜0.05,P＜0.001).The positive rate of MP-SAT in this group of children at the completion of the 3rd course of treatment was significantly lower than that at the time of admis-sion(P＜0.001),and the clinical symptoms(cough,fever),pulmonary signs and pulmonary CT manifestations were significantly better than those at the time of admission(all P＜0.001),and the MP-SAT results were consistent with the trend of changes in clinical symptoms,pulmonary signs and pulmonary imaging manifestations.Conclusion The detection of MP-RNA with SAT can serve as an early diagnostic basis for pediatric MPP,as well as an indicator for evaluating the outcome of MPP and assessing the efficacy of clinical treatment.
mycoplasma pneumoniaepneumoniachildreal-time simultaneous amplification and testingdiagnosis
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