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CORRESPONDENCE
Year : 2014  |  Volume : 32  |  Issue : 4  |  Page : 458-459
 

Role of cold agglutination test in the diagnosis Mycoplasma pneumoniae infection in HIV infected children


1 Department of Microbiology, Raichur Institute of Medical Sciences, Raichur, Karnataka, India
2 Department of Microbiology, Karnataka Institute of Medical Sciences, Hubli, Karnataka, India

Date of Submission30-Jul-2013
Date of Acceptance22-Jan-2014
Date of Web Publication4-Oct-2014

Correspondence Address:
A K Bahadur
Department of Microbiology, Raichur Institute of Medical Sciences, Raichur, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0255-0857.142234

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How to cite this article:
Bahadur A K, Nadagir S D, Peerapur B V. Role of cold agglutination test in the diagnosis Mycoplasma pneumoniae infection in HIV infected children . Indian J Med Microbiol 2014;32:458-9

How to cite this URL:
Bahadur A K, Nadagir S D, Peerapur B V. Role of cold agglutination test in the diagnosis Mycoplasma pneumoniae infection in HIV infected children . Indian J Med Microbiol [serial online] 2014 [cited 2020 Nov 26];32:458-9. Available from: https://www.ijmm.org/text.asp?2014/32/4/458/142234


Dear Editor,

Studies have shown that CD4 depletion may enhance M. pneumoniae infection in human immunodeficiency virus (HIV)-infected patient. [1] Diagnosis of M. pneumoniae infection is mostly based on serology as isolation of bacterium in sputum is insensitive, whereas polymerase chain reaction (PCR) lacks clinical relevance. Cold agglutination test is convenient and inexpensive serological test for this purpose.

We have evaluated the reliability of Quantitative cold agglutination test and Rapid bed side cold agglutination test in diagnosis of M. pneumoniae infection in HIV-infected children. Serum samples of 90 HIV proven children presenting with recent pulmonary complaints were subjected to Quantitative cold agglutination test, Rapid cold agglutination test using the standard procedure. [5] M. pneumoniae IgM Enzyme Linked Immunosorbant Assay (IgM ELISA) was performed as the gold standard test and the results were compared.

Of the total 90 cases tested, 29 (32.2%) were tested positive by Quantitative cold agglutination test of which 19 (65.5%) correlated with positive IgM ELISA test. Among positive cases, titres of ≥1:64 were observed in 21 (72.4%) and 1:32 in 8 (27.5%). Rapid bed side cold agglutination test was found positive among 28 (31%) of which 15 (53.5%) correlated with positive IgM ELISA. A total of 29 (32.2%) cases tested were positive for IgM ELISA. Results concerning Reliability of cold agglutination test when compare to IgM- ElSA is given in [Table 1].
Table 1: Reliability of cold agglutination tests in diagnosis of M. pneumoniae infection in HIV infected children (Compare to IgM ELISA as gold standard)

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Shankar et al. reported sensitivity, specificity, positive and negative predictive values of 100%, 84%, 62% and 100%, respectively, for Quantitative cold agglutination test compared with IgM ELISA in HIV-infected patients. [3] Ching YT et al. reported sensitivity and specificity of 78.3% and 41.3% and positive and negative predictive values of 43.4% and 76.7%, respectively, for Rapid cold agglutination test when compared with IgM ELISA in asthmatic children . [4] Kwan et al. reported sensitivity and specificity of 46% and 95% for Conventional Quantitative cold agglutination test . [5] According to the results obtained in our study, Cold agglutination test lacks sensitivity and specificity, hence IgM ELISA should be considered in diagnosis of M. pneumoniae infection in case of HIV-infected children.


 ~ Acknowledgement Top


Mr. Kiran B and Mr. Rajesh M Technicians KIMS Hubli for their overwhelming technical support.

 
 ~ References Top

1.Shankar EM, Kumarasamy N, Balakrishnan P, Soloman S, Devaleenol B, Rao A. Incidence of Mycoplasma pneumoniae in HIV infected patients with underlying upper and lower respiratory complaints and correlation with various immunological and hematological findings. Retrovirology 2005;2:S97.  Back to cited text no. 1
    
2.Mandell GL, Bennet JE, Dolin R, Baum SG. Mycoplasma pneumoniae and atypical pneumonia. In: Principles and Practice of Infectious Disease. 16 th ed. Amsterdam: Elsevier publication; 2008. p. 2271-9.  Back to cited text no. 2
    
3.Shanker EM, Kumarasamy N, Balakrishnan P, Soloman S, Lijith R, Vengatesan A, et al. Serosurveillance of acute Mycoplasma pneumoniae infection among HIV infected patients with pulmonary complaints in Chennai, South India. J Infect 2006;53:325-30.  Back to cited text no. 3
    
4.Ching YT, Yang YH, Chiang BL. The significance of rapid cold hemagglutination test for detecting M. pneumoniae infection in children with asthma exacerbation. J Microbiol Immunol Infect 2006;39:28-32.  Back to cited text no. 4
    
5.Kwan YS, Dong IW, Min HC. Flow Cytometric Measurement of Cold Agglutinins for Diagnosing Mycoplasma pneumoniae Pneumonia. Lab Med 2012;43:68-73.  Back to cited text no. 5
    



 
 
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