Serodiagnosis of Mycobacterium avium complex pulmonary disease in the USA

Eur Respir J. 2013 Aug;42(2):454-60. doi: 10.1183/09031936.00098212. Epub 2012 Oct 25.

Abstract

Diagnosis of Mycobacterium avium complex pulmonary disease (MAC-PD) can be difficult. A previous study from Japan reported the usefulness of a serodiagnostic test for MAC-PD. The objective of this study was to evaluate the usefulness of the test in similar patients in the USA. 100 patients with known or suspected MAC-PD and 52 healthy volunteers were enrolled into the study at National Jewish Health, Denver, CO, USA. Serum glycopeptidolipid core immunoglobulin A antibody levels were measured with an enzyme immunoassay (EIA) kit and routine clinical evaluations were performed. The patients were divided into two groups based on clinical evaluation: 87 patients with MAC-PD that met American Thoracic Society criteria, and 13 who did not meet the criteria. The sensitivity and specificity (cut-off point 0.3 U·mL(-1)) of the serodiagnostic test for diagnosing MAC-PD were 70.1% and 93.9%, respectively. Among the 44 patients in the MAC-PD group with two or more positive sputum cultures within the previous 6 months, sensitivity was 81.8%. The EIA kit demonstrated good sensitivity and specificity for the identification of MAC-PD, particularly in patients with two or more positive cultures, and may be useful for rapid MAC-PD diagnosis.

MeSH terms

  • Adult
  • Aged
  • Antibodies, Bacterial / blood
  • Antigens, Bacterial / immunology
  • Diagnostic Tests, Routine
  • Female
  • Glycolipids / blood
  • Humans
  • Immunoenzyme Techniques
  • Immunoglobulin A / blood
  • Lung Diseases / epidemiology*
  • Lung Diseases / microbiology*
  • Male
  • Middle Aged
  • Mycobacterium avium Complex / isolation & purification*
  • ROC Curve
  • Sensitivity and Specificity
  • Serologic Tests / methods*
  • Serologic Tests / standards
  • Tomography, X-Ray Computed
  • United States / epidemiology

Substances

  • Antibodies, Bacterial
  • Antigens, Bacterial
  • Glycolipids
  • Immunoglobulin A