posted
There was a post awhile back where someone asked if mycoplasma testing could have a false negative. I mentioned that my doctor wanted to do mycoplasma testing and gave me a kit for MDL but told me not to have it drawn until I was off abx for at least a month. Well that didn't happen and we put the blood work off for now.
As I was researching something for my children I ran across a resource on getting an accurate pcr test that I thought I would post that also lists not taking abx for a month prior to testing and suggests antibody testing as an alternative to pcr testing for those already on abx.
1. INDIVIDUAL: The most accurate of the PCR blood tests is the individual test for a specific species.
2. "MULTIPLEX": Multi-species ("3 in 1" or "4 in 1") mycoplasma PCR blood tests are less expensive but their accuracy rate may not be as high as individual species tests. Therefore, patients need to specifically ask the laboratories for the published accuracy rate of their "multiplex" tests. Additionally, some laboratories identify a combination of tests for one price as a "panel" when in fact they are performing a "multiplex" test.
3. ANTIBODY TEST: The least accurate of the blood tests. In the case of Mycoplasma fermentans (incognitus), antibodies are not produced until the patient is near death. However, antibodies to the other mycoplasma species are produced more readily.
4. CULTURE: Mycoplasmas are rarely successfully cultured, as they require specialized culture mediums and weeks of careful laboratory work. In some rare instances, culturing may be an alternative choice.
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* Recommendations - "HOW TO GET AN ACCURATE POLYMERASE CHAIN REACTION (PCR)BLOOD TEST FOR MYCOPLASMAS"
-- Do not perform the General (or Family) Mycoplasma species screening test. It is not as accurate as hoped. This test should never be used by physicians as a screening test for mycoplasmal infections in patients.
-- Have the blood drawn at the testing lab. If that is impractical, the second best solution is to have the blood delivered to the lab within 24 hours. Blood samples left at room temperature for longer than 24 hours cause half the mycoplasmas to die and disintegrate. After 72 hours at room temperature all the mycoplasmas will have died and disintegrated. Once they disintegrate, the specific genetic sequences needed for PCR amplification will have vanished, resulting in a false negative.
-- Have the blood sample drawn later in the day if you are shipping overnight. This shortens the hours before the sample is processed. Also, have the blood drawn early in the week rather than on a Friday so that the sample arrives on a day when the lab is open, rather than sitting unprocessed over the weekend.
-- Ship blood samples with small packs of blue ice which keeps the sample at a refrigerated temperature (not frozen). Place some packing material between the blood sample and the blue ice to prevent the blood from freezing, which causes coagulation, ruining the sample for testing.
-- Do not take any antibiotics at least one month or longer before a PCR blood test. The antibiotics will remove most of the infection from the blood, reducing the chances of amplifying the specific genetic sequences needed for an accurate result.
-- Do not take vitamins, herbs or supplements that boost the immune system and/or kill mycoplasmas. Examples would be colloidal silver, flax seed oil, fish oils, vitamin C, IP6, immune boosters, garlic, transfer factor, olive leaf extract, etc. Unfortunately, no research exists to guide patients on how long they should avoid these products before drawing blood.
-- The best time to have blood drawn is when the patient is symptomatic. Mycoplasmas can become dormant from time to time, so if a patient is feeling well it might not be the best time to test.
-- If patients receive a negative result, but are still symptomatic, they should consider being retested. Review our recommended testing procedures to see if they were followed correctly. Discuss the merits of retesting with your physician.
-- Patients should never begin antibiotic treatment before being tested for a mycoplasmal infection. Some patients start antibiotics before being tested to see if they will show improvement. If they improve, they often refuse to stop using antibiotics before taking a PCR test due to relapses. Unfortunately, once antibiotics are started, the risk increases for getting a false PCR result, even if the patient stops taking antibiotics later. This leaves patients unsure of their exact infection, preventing them from taking the most effective antibiotic. Without a positive test result, physicians often refuse to prescribe long term antibiotics.
-- Antibody Tests may be an alternative to PCR for patients already on antibiotics. Although traditional antibody tests are generally not as accurate as PCR, detection may be possible if a patient has developed mycoplasma antibodies.
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elle
-------------------- When I feel blue . . . . . . its time to take another breath Posts: 296 | From East Coast | Registered: Aug 2005
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cantgiveupyet
Frequent Contributor (1K+ posts)
Member # 8165
posted
thanks elle for the post.
My blood sat overnight...actually for about 7 days before it was sent out...i often wonder if this messed up some of the testing. Im negative for all coinfections. its amazing how delicate some of these tests are.
-------------------- "Say it straight simple and with a smile."
"Thus the task is, not so much to see what no one has seen yet, But to think what nobody has thought yet, About what everybody sees."
-Schopenhauer
pos babs, bart, igenex WB igm/igg Posts: 3156 | From Lyme limbo | Registered: Oct 2005
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bettyg
Unregistered
posted
hi Elle, wonderful, informative info you posted.
Please copy the link and post it on TREEPATROL'S NEWBIE LINKS. Ask Tree if he'd add your link to his; it's to good not to be in there especially the part of being OFF ABX 30 DAYS PRIOR TO PCR testing.
My new LLMD had me tested for PCR; I WAS NOT OFF ABX AT THIS TIME. My results for pcr I believe are posted on my 4-20-06 LLMD's summary and lab results post. I'll have to find it & look to see if my PCR was high; normal, or low.
Thanks; wished I'd known this 1 month ago...hindsight if I'd know she would perform 12-15 different labs of testings.
Mathias
Frequent Contributor (1K+ posts)
Member # 5298
posted
My personal experience with regard to mycoplasma testing:
1. Antibody Tests are unreliable and can cross react between species which could lead to improper treatment with inappropriate antibiotics. PCR testing the only reliable method.
2. I tested positive on a PCR test with only being off antibiotics for 3 days prior, not 30+ days.
3. Retesting is a must, my first test was negative.
4. PCR testing of spinal fluid for neurological symptoms is more reliable than what is typical for lyme disease. My PCR was positive on spinal fluid but negative on blood.
-------------------- Mathias Posts: 1250 | From New Jersey | Registered: Feb 2004
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