Abstract | November 10, 2020

The Limited Use of Mycoplasma IgM Antibody Testing in a Rural Hospital

Presenting Author: Johnny Espinoza, MD, Internal Medicine Resident PGY2, Internal Medicine Department, Ballad Health, Norton, Virginia

Co-author: Mehak Gulati, MD, Internal Medicine Resident PGY3, Internal Medicine Department, Norton Community Hospital, Norton, VA

Learning Objectives

  1. Discuss recent guidelines and management of Mycoplasma pneumoniae and contrast the differences between Mycoplasma IgM antibody testing and PCR testing.

Background: There have been multiple instances where antibiotics have been used in the treatment of Mycoplasma pneumoniae based solely on IgM antibody testing. Studies suggest PCR testing has a higher sensitivity and specificity for detecting mycoplasma although mixed results exist.

Objective: In patients living in a rural community, determine the usefulness of IgM antibody testing when compared with a Respiratory Viral Panel (RVP) to diagnose and treat mycoplasma pneumonia.

Design: Conduct a retrospective chart review between 2017-2019 of patients who received both a mycoplasma IgM antibody test and respiratory viral panel to determine their concordance. Tests had to be performed within 24 hours of each other.

Setting: Rural hospital in Southwest Virginia (Norton Community Hospital)

Data sources: Soarian Electronic Health Record

Data extraction: Compiled by in-house lab department on excel. Data was reviewed, extrapolated and synthesized by authors.

Results: 672 respiratory viral panels with mycoplasma IgM antibody tests were performed between 2017-2019. 72 had positive IgM results with negative RVP results. One test was congruent with a positive RVP and IgM.

Limitations: Some patients had repeat testing throughout the 3-year span. Clinical presentation, demographics, and age were not taken into consideration.

Conclusions: Based on a 3-year data review, mycoplasma IgM antibody testing has a high discordance with mycoplasma PCR testing.

Implications: Mycoplasma IgM antibody testing may have limited utility in the diagnosis and treatment of Mycoplasma pneumoniae in the rural Southwest Virginia region.

Primary Funding: Norton Community Hospital Internal Medicine Residency Program. No outside funding sources.

Posted in: Medicine & Medical Specialties21