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Serum IgM and Molecular Tests for Mycoplasma pneumoniae Detection: A Review of Diagnostic Test Accuracy, Clinical Effectiveness, Cost-Effectiveness, and Guidelines

Last updated: November 9, 2015
Project Number: RC0725-000
Product Line: Rapid Response
Research Type: Other Diagnostics
Report Type: Summary with Critical Appraisal
Result type: Report

Question

  1. What is the diagnostic test accuracy of the serum IgM test compared with molecular tests for the detection of Mycoplasma pneumoniae in patients with respiratory infections?
  2. What is the clinical effectiveness of the serum IgM test compared with molecular tests for the detection of Mycoplasma pneumoniae in patients with respiratory infections?
  3. What is the cost-effectiveness of the serum IgM test compared with molecular tests for the detection of Mycoplasma pneumoniae in patients with respiratory infections?
  4. What are the evidence-based guidelines regarding the use of the serum IgM test and molecular tests for the detection of Mycoplasma pneumoniae in patients with respiratory infections?

Key Message

Six diagnostic test accuracy studies and one evidence-based guideline regarding the use of serum IgM tests and molecular tests for the detection of Mycoplasma pneumoniae in patients with respiratory infections were identified. The diagnostic performances of IgM and molecular tests were variable among the six studies and may have been affected by choice of reference standard and specific index test, patient age, and time of specimen collection after disease onset. Four of the six studies concluded that IgM and PCR tests should be performed in combination. One evidence-based guideline recommends acute and convalescent serology for the diagnosis of Mycoplasma pneumoniae in children with severe pneumonia. No literature regarding the clinical utility or cost-effectiveness of serum IgM tests or molecular tests was identified.