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Accuracy of a routine real-time PCR assay for the diagnosis of Pneumocystis jirovecii pneumonia.
J Microbiol Methods. 2008 Oct; 75(2):258-61.JM

Abstract

Pneumocystis jirovecii is a common cause of life-threatening pneumonia among immunocompromised patients. Using 400 fresh bronchoalveolar lavage samples, we compared prospectively routine direct immunofluorescence assay (DFA) and a real-time PCR assay, performed on a LightCycler system, for the detection of P. jirovecii. Among the 66 PCR positive samples, 31 were positive by DFA. No patient was found as having the pattern "PCR--ve/DFA+ve". The semi-quantification of the P. jirovecii DNA was represented by the cycle threshold (Ct). Using DFA as the gold standard, the sensitivity of the PCR was 100% for Ct > or = 28 and the specificity was 100% for Ct < 22. Between these two points, the results could be discrepant. The patients of the "22 < or = Ct < 28" group presented more frequently with a radiological interstitial syndrome than the "Ct > or = 28" group, and presented less frequently with HIV-infection and elevated lactate dehydrogenase (LDH) assay than in the "Ct < 22" group. A negative PCR allowed us to exclude the P. jirovecii pneumonia. The real-time PCR assay seems to be an accurate diagnosis method and could replace the DFA. The semi-quantitative results should be helpful to distinguish colonized, subclinically infected and P. jirovecii pneumonia patients.

Authors+Show Affiliations

Department of Parasitology and Mycology, Toulouse University Hospitals, France. fillaux@cict.frNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

18606198

Citation

Fillaux, Judith, et al. "Accuracy of a Routine Real-time PCR Assay for the Diagnosis of Pneumocystis Jirovecii Pneumonia." Journal of Microbiological Methods, vol. 75, no. 2, 2008, pp. 258-61.
Fillaux J, Malvy S, Alvarez M, et al. Accuracy of a routine real-time PCR assay for the diagnosis of Pneumocystis jirovecii pneumonia. J Microbiol Methods. 2008;75(2):258-61.
Fillaux, J., Malvy, S., Alvarez, M., Fabre, R., Cassaing, S., Marchou, B., Linas, M. D., & Berry, A. (2008). Accuracy of a routine real-time PCR assay for the diagnosis of Pneumocystis jirovecii pneumonia. Journal of Microbiological Methods, 75(2), 258-61. https://doi.org/10.1016/j.mimet.2008.06.009
Fillaux J, et al. Accuracy of a Routine Real-time PCR Assay for the Diagnosis of Pneumocystis Jirovecii Pneumonia. J Microbiol Methods. 2008;75(2):258-61. PubMed PMID: 18606198.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Accuracy of a routine real-time PCR assay for the diagnosis of Pneumocystis jirovecii pneumonia. AU - Fillaux,Judith, AU - Malvy,Sonia, AU - Alvarez,Muriel, AU - Fabre,Richard, AU - Cassaing,Sophie, AU - Marchou,Bruno, AU - Linas,Marie-Denise, AU - Berry,Antoine, Y1 - 2008/06/21/ PY - 2008/01/15/received PY - 2008/06/07/revised PY - 2008/06/17/accepted PY - 2008/7/9/pubmed PY - 2008/12/17/medline PY - 2008/7/9/entrez SP - 258 EP - 61 JF - Journal of microbiological methods JO - J Microbiol Methods VL - 75 IS - 2 N2 - Pneumocystis jirovecii is a common cause of life-threatening pneumonia among immunocompromised patients. Using 400 fresh bronchoalveolar lavage samples, we compared prospectively routine direct immunofluorescence assay (DFA) and a real-time PCR assay, performed on a LightCycler system, for the detection of P. jirovecii. Among the 66 PCR positive samples, 31 were positive by DFA. No patient was found as having the pattern "PCR--ve/DFA+ve". The semi-quantification of the P. jirovecii DNA was represented by the cycle threshold (Ct). Using DFA as the gold standard, the sensitivity of the PCR was 100% for Ct > or = 28 and the specificity was 100% for Ct < 22. Between these two points, the results could be discrepant. The patients of the "22 < or = Ct < 28" group presented more frequently with a radiological interstitial syndrome than the "Ct > or = 28" group, and presented less frequently with HIV-infection and elevated lactate dehydrogenase (LDH) assay than in the "Ct < 22" group. A negative PCR allowed us to exclude the P. jirovecii pneumonia. The real-time PCR assay seems to be an accurate diagnosis method and could replace the DFA. The semi-quantitative results should be helpful to distinguish colonized, subclinically infected and P. jirovecii pneumonia patients. SN - 0167-7012 UR - https://www.unboundmedicine.com/medline/citation/18606198/Accuracy_of_a_routine_real_time_PCR_assay_for_the_diagnosis_of_Pneumocystis_jirovecii_pneumonia_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0167-7012(08)00236-4 DB - PRIME DP - Unbound Medicine ER -