Serologiczna diagnostyka objawowych zakażeń wywoływanych w Polsce w latach 1970-2010 przez Mycoplasma pneumoniae
[Serodiagnosis of clinical infections caused by Mycoplasma pneumoniae in Poland in 1970-2010]

Streszczenie

Przedmiotem badań była próba retrospektywnej analizy wiarygodności serologicznej diagnostyki mykoplazmozy w następstwie wprowadzenia w Polsce metody ELISA w miejsce klasycznych metod diagnostycznych, jak odczyn wiązania dopełniacza i odczyn immunoelektroprecypitacji. Analizą objęto wyniki badań przeprowadzonych w latach 1970-2010 u ponad 300 tysięcy osób z zakażeniami układu oddechowego.

Abstract

The aim of the study was evaluation of the reliability of serodiagnosis of mycoplasmosis in Poland after replaced of classical assays, as complement fixation test (CFT) and immunoelectroprecipitation test (IEPT), by the ELISA method. The data were obtained from National Public Health Institute in Warsaw (NPHI), which receives quarterly reports of serologically confirmed infection from Sanitary and Epidemiological Stations through the country. Previously, from the 1970 to 1999 the serodiagnosis in Poland was performed only by uniform CFT using the same M. pneumoniae FH antigen prepared
at the Mycoplasma Laboratory of NPHI. The first data of M. pneumoniae serological investigation performed by commercial ELISA, mainly Virotech, which gradually replaced the CFT, were obtained in 2000. In the studied period 1970-2010 a total of over 300 thousand patients with respiratory tract infections (85% were children below 18 years old) were tested. During these studies five epidemics of mycoplasmosis were noted in Poland before 2000. However, after introduction of ELISA for serodiagnosis this characteristic distinct difference in epidemic and endemic occurrence of M. pneumoniae
infections have not been seen. In our opinion it may be caused by changes in the epidemiological pattern of M. pneumoniae infections in Poland as well as, paradoxical, by the decrease of sensitivity and specificity of serological investigation performed by ELISA since 2000. First of all, for the economical reasons 98% of the patients were tested by ELISA only once, secondly, the mycoplasmosis in many laboratories was confirmed only on the basis of the presence of IgG antibodies. The results of our analysis showed also usefulness in the serodiagnosis of mycoplasmosis, mainly during the first 2 weeks of the disease, of IEPT, which detect only specific IgM antibodies to M. pneumoniae antigens.