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

Summary 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 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), rales ( 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.