Detection of pulmonary Mycoplasma pneumoniae infections in HIV-infected subjects using culture and serology

Objective: The true prevalence of Mycoplasma pneumoniae infections involving the respiratory tracts of HIV-infected individuals is still unclear. This study examined the prevalence of M. pneumoniae in 100 HIV-infected individuals at an AIDS care center in Chennai, India, using conventional laboratory techniques and interpretation criteria. Methods: Diagnosis was based on culture, cold agglutination test, and commercial enzyme-linked immunosorbent assay (ELISA) for the qualitative determination of IgM antibodies against M. pneumoniae. The efficacies of the different diagnostic procedures used in the study were analyzed. Results: The prevalence of I M. pneumoniae was 31 % by culture and 21 % by IgM ELISA. Cough (p = 0.03, OR 3.8, 95% CI 1-17.8), myalgia (p = 0.04, OR 2.5, 95% CI 1-6.6), rates (p = 0.04, OR 2.4, 95% CI 1-6.6), and cervical adenopathy (p = 0.03, OR 2.7, 95% CI 1-7. 1) were the symptoms that significantly corroborated culture positivity. Patients positive for M. pneumoniae by culture or IgM antibody had significantly greater CD4+ T-cell depletion and anemia than those without any evidence of infection. Conclusions: This study provides the means to diagnose M. pneumoniae infection and information on the prevalence of the pathogen in HIV-infected individuals in resource constrained settings. Although modern molecular techniques may provide more insight into the prevalence of M. pneumoniae in HIV-infected individuals, conventional methods can still be used in diagnosis. (C) 2006 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.