Research progress on laboratory diagnostic methods for Mycoplasma pneumonia

doi:10.3969/j.issn.1673-8640.2026.03.015

Abstract

Abstract:

Mycoplasma pneumoniae（MP）is one of the main pathogens causing respiratory tract infections，with a relatively high incidence of community-acquired pneumonia（CAP）among children and adolescents. Laboratory determination methods for MP mainly include etiological determination，serological determination and molecular biological determination，each with its own advantages and disadvantages. MP isolation and culture is time-consuming and has low specificity，and it is rarely routinely performed in clinical laboratories. Currently，the main methods used are MP-specific antigen，antibody and polymerase chain reaction（PCR）for MP. In recent years，new determination technologies such as loop-mediated isothermal amplification（LAMP），clustered regularly interspaced short palindromic repeat/associated protein（CRISPR/Cas）and nanobiosensors have made significant progress in the field of MP diagnosis，providing more options for clinical practice. This review focuses on the current status，advantages and disadvantages and application value of common MP determination methods and new laboratory diagnostic technologies，aiming to provide references for the clinical diagnosis and application of MP.

Key words: Mycoplasma pneumoniae, Clinical laboratory, Diagnosis, Etiology, Immunology, Molecular biology, Gene sequencing, Loop-mediated isothermal amplification, Clustered regularly interspaced short palindromic repeat, Nanobiosensor

CLC Number:

R375

CHEN Tian, CAI Qinzhen, TAO Yuxuan, WANG Jun, SHANG Yu, WU Mo, TUO Wenbin, YUAN Chunhui, XIANG Yun. Research progress on laboratory diagnostic methods for Mycoplasma pneumonia[J]. Laboratory Medicine, 2026, 41(3): 299-306.

Figures/Tables 2

References 48

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方法	目标	优点	缺点	样本类型	参考文献
ICA	核糖体蛋白L7/L12、	经济、快速、操作简便	不同检测方法之间敏感性差异较大（62.5%~97.4%）、易与其他呼吸道病原体产生交叉反应	咽拭子	[4]
	P1黏附蛋白、			咽拭子/痰	[3]
	GroES分子伴侣蛋白			MP分离株/GroES重组蛋白	[10]
CFT	IgM	成本低、适用范围广、特异性较高（97.0%）	操作复杂、敏感性较低（58.8%）、无法区分抗体类型	血清	[11]
PA	IgM/IgG	快速、操作相对简便、无需专业仪器	易受非特异性凝集干扰、不同抗体滴度条件下的诊断灵敏度和特异性存在差异、主观判读易产生误差	血清	[8,12]
ELISA	IgA/IgM/IgG	经济、特异性较高（74.8%~ 96.0%），可区分抗体类型，可定量分析，通量高	不同品牌试剂盒灵敏度差异大（57.9%~91%）、耗时较长、对仪器性能和操作人员的熟练度要求高	血清	[5,7,13-14]
CLIA	IgM/IgG	自动化检测、检测线性范围广，敏感性（62.1%~74.3%）和特异性（72.9%~87.0%）较高	设备成本高、未被临床大量验证	血清	[15-16]
ELISpot	Mp-IgM-ASC	可以区分携带和感染	灵敏度低、耗时长	全血	[9]

方法	目标	优点	缺点	样本类型	参考文献
ICA	核糖体蛋白L7/L12、	经济、快速、操作简便	不同检测方法之间敏感性差异较大（62.5%~97.4%）、易与其他呼吸道病原体产生交叉反应	咽拭子	[4]
	P1黏附蛋白、			咽拭子/痰	[3]
	GroES分子伴侣蛋白			MP分离株/GroES重组蛋白	[10]
CFT	IgM	成本低、适用范围广、特异性较高（97.0%）	操作复杂、敏感性较低（58.8%）、无法区分抗体类型	血清	[11]
PA	IgM/IgG	快速、操作相对简便、无需专业仪器	易受非特异性凝集干扰、不同抗体滴度条件下的诊断灵敏度和特异性存在差异、主观判读易产生误差	血清	[8,12]
ELISA	IgA/IgM/IgG	经济、特异性较高（74.8%~ 96.0%），可区分抗体类型，可定量分析，通量高	不同品牌试剂盒灵敏度差异大（57.9%~91%）、耗时较长、对仪器性能和操作人员的熟练度要求高	血清	[5,7,13-14]
CLIA	IgM/IgG	自动化检测、检测线性范围广，敏感性（62.1%~74.3%）和特异性（72.9%~87.0%）较高	设备成本高、未被临床大量验证	血清	[15-16]
ELISpot	Mp-IgM-ASC	可以区分携带和感染	灵敏度低、耗时长	全血	[9]

方法类型	信号策略	系统名称	效应蛋白	信号放大方式	目标分子	灵敏度	单碱基分辨率	检测周期	参考文献
CRISPR/Cas+等温扩增	可视化/荧光	ERA^①/CRISPR-Cas12a双系统	LbCas12a	ERA^①	DNA	100 拷贝·mL^-1，1 拷贝·mL^-1	是	30.0 min	[35]
	荧光	LAMP-CRISPR/Cas12b	Cas12b	LAMP	DNA	33.7 拷贝·tesP分离培养耗时较长	是		[36]
	荧光	RPA^②-CRISPR/Cas12a	Cas12a	RPA^②	DNA	2 拷贝·test^-1	是	<1 h	[37]
	荧光	RPA^②-CRISPR	Cas12b	RPA^②	DNA	5 fg	是		[38]
CRISPR/Cas+等温扩增+生物传感器	荧光	CHAMP系统	Cas12b	LAMP	DNA	0.5 拷贝·μL^-1	是	23.5 min	[39]
	可视化	CRISPR/Cas9-LFB	Cas9	RPA^②	DNA	3 拷贝	是	30.0 min	[40]
	荧光	PDTCTR	Cas12f_ge4.1	RPA^②	DNA	10 拷贝·μL^-1	是	50.0 min	[41]
	质谱	CRISPR/ Cas12a增强型DNA纳米机	Cas12a		DNA	38 amol	是		[42]

方法类型	信号策略	系统名称	效应蛋白	信号放大方式	目标分子	灵敏度	单碱基分辨率	检测周期	参考文献
CRISPR/Cas+等温扩增	可视化/荧光	ERA^①/CRISPR-Cas12a双系统	LbCas12a	ERA^①	DNA	100 拷贝·mL^-1，1 拷贝·mL^-1	是	30.0 min	[35]
	荧光	LAMP-CRISPR/Cas12b	Cas12b	LAMP	DNA	33.7 拷贝·tesP分离培养耗时较长	是		[36]
	荧光	RPA^②-CRISPR/Cas12a	Cas12a	RPA^②	DNA	2 拷贝·test^-1	是	<1 h	[37]
	荧光	RPA^②-CRISPR	Cas12b	RPA^②	DNA	5 fg	是		[38]
CRISPR/Cas+等温扩增+生物传感器	荧光	CHAMP系统	Cas12b	LAMP	DNA	0.5 拷贝·μL^-1	是	23.5 min	[39]
	可视化	CRISPR/Cas9-LFB	Cas9	RPA^②	DNA	3 拷贝	是	30.0 min	[40]
	荧光	PDTCTR	Cas12f_ge4.1	RPA^②	DNA	10 拷贝·μL^-1	是	50.0 min	[41]
	质谱	CRISPR/ Cas12a增强型DNA纳米机	Cas12a		DNA	38 amol	是		[42]