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Evaluation of the performance of DiaSorin molecular Pneumocystis jirovecii-CMV multiplex real-time PCR assay from bronchoalveolar lavage samples.
J Mycol Med. 2020 Jun; 30(2):100936.JM

Abstract

The aim of this study was to evaluate the performance of the DiaSorin Molecular PJ-CMV multiplex real-time PCR (PJ-CMV PCR) assay (DiaSorin Molecular LLC, USA) in bronchoalveolar lavage (BAL) samples compared to direct immunofluorescence assay (IFA) for the detection of Pneumocystis jirovecii and assess CMV and P. jirovecii co-infection rate in immunosuppressed patients with suspected pneumonia. A total of 125 BAL samples from immunosuppressed patients submitted for PJP-IFA were tested. Surplus samples were saved and further tested by using the PJ-CMV PCR assay. Among the 125 samples, P. jirovecii was detected in 31.2% (39/125) and in 40% (50/125) of the specimens using IFA and PJ-CMV PCR respectively. Eleven of the PJ-CMV PCR positive samples were negative by direct IFA for P. jirovecii. All samples positive by direct IFA were also positive by PJ-CMV PCR. Using the direct IFA as a gold standard, the PJ-CMV PCR sensitivity, specificity, positive predictive value and negative predictive value for detection of P. jirovecii were 100%, 87.2%, 78% and 100%, respectively. However, after reviewing the clinical diagnosis, the specificity and PPV increased to 100%. Of the 50 P. jirovecii samples positive by PJ-CMV PCR, 18 (36%) were also positive for CMV by the PJ-CMV PCR. The co-infection rate was found to be 37.5% (6/16) and 35.2% (12/34) in HIV infected and non-HIV infected patients. This study indicated that the DiaSorin Molecular PJ-CMV multiplex real-time PCR assay has higher sensitivity than direct IFA for detection of P. jirovecii and provides rapid detection of PJ and CMV infection in BAL samples.

Links

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Authors+Show Affiliations

Kilic A
Department of Pathology, Wake Forest Baptist Medical Center, Medical Center Boulevard, Winston-Salem, NC 27157, USA.
Elliott S
Department of Pathology, Wake Forest Baptist Medical Center, Medical Center Boulevard, Winston-Salem, NC 27157, USA.
Hester L
Department of Pathology, Wake Forest Baptist Medical Center, Medical Center Boulevard, Winston-Salem, NC 27157, USA.
Palavecino E
Department of Pathology, Wake Forest Baptist Medical Center, Medical Center Boulevard, Winston-Salem, NC 27157, USA. Electronic address: epalave@wakehealth.edu.

MeSH

Bronchoalveolar LavageBronchoalveolar Lavage FluidCase-Control StudiesCytomegalovirusCytomegalovirus InfectionsDiagnosis, DifferentialHumansImmunocompromised HostMolecular Diagnostic TechniquesMultiplex Polymerase Chain ReactionMycological Typing TechniquesPneumocystis cariniiPneumoniaPneumonia, PneumocystisReal-Time Polymerase Chain ReactionSensitivity and SpecificityVirology

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

32044156

Citation

Kilic, A, et al. "Evaluation of the Performance of DiaSorin Molecular Pneumocystis jirovecii-CMV Multiplex Real-time PCR Assay From Bronchoalveolar Lavage Samples." Journal De Mycologie Medicale, vol. 30, no. 2, 2020, p. 100936.
Kilic A, Elliott S, Hester L, et al. Evaluation of the performance of DiaSorin molecular Pneumocystis jirovecii-CMV multiplex real-time PCR assay from bronchoalveolar lavage samples. J Mycol Med. 2020;30(2):100936.
Kilic, A., Elliott, S., Hester, L., & Palavecino, E. (2020). Evaluation of the performance of DiaSorin molecular Pneumocystis jirovecii-CMV multiplex real-time PCR assay from bronchoalveolar lavage samples. Journal De Mycologie Medicale, 30(2), 100936. https://doi.org/10.1016/j.mycmed.2020.100936
Kilic A, et al. Evaluation of the Performance of DiaSorin Molecular Pneumocystis jirovecii-CMV Multiplex Real-time PCR Assay From Bronchoalveolar Lavage Samples. J Mycol Med. 2020;30(2):100936. PubMed PMID: 32044156.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evaluation of the performance of DiaSorin molecular Pneumocystis jirovecii-CMV multiplex real-time PCR assay from bronchoalveolar lavage samples. AU - Kilic,A, AU - Elliott,S, AU - Hester,L, AU - Palavecino,E, Y1 - 2020/01/31/ PY - 2019/10/25/received PY - 2020/01/24/revised PY - 2020/01/28/accepted PY - 2020/2/12/pubmed PY - 2020/10/21/medline PY - 2020/2/12/entrez KW - CMV KW - DiaSorin Molecular PJ-CMV assay KW - Pneumocystis jirovecii KW - pneumonia KW - real-time PCR. SP - 100936 EP - 100936 JF - Journal de mycologie medicale JO - J Mycol Med VL - 30 IS - 2 N2 - The aim of this study was to evaluate the performance of the DiaSorin Molecular PJ-CMV multiplex real-time PCR (PJ-CMV PCR) assay (DiaSorin Molecular LLC, USA) in bronchoalveolar lavage (BAL) samples compared to direct immunofluorescence assay (IFA) for the detection of Pneumocystis jirovecii and assess CMV and P. jirovecii co-infection rate in immunosuppressed patients with suspected pneumonia. A total of 125 BAL samples from immunosuppressed patients submitted for PJP-IFA were tested. Surplus samples were saved and further tested by using the PJ-CMV PCR assay. Among the 125 samples, P. jirovecii was detected in 31.2% (39/125) and in 40% (50/125) of the specimens using IFA and PJ-CMV PCR respectively. Eleven of the PJ-CMV PCR positive samples were negative by direct IFA for P. jirovecii. All samples positive by direct IFA were also positive by PJ-CMV PCR. Using the direct IFA as a gold standard, the PJ-CMV PCR sensitivity, specificity, positive predictive value and negative predictive value for detection of P. jirovecii were 100%, 87.2%, 78% and 100%, respectively. However, after reviewing the clinical diagnosis, the specificity and PPV increased to 100%. Of the 50 P. jirovecii samples positive by PJ-CMV PCR, 18 (36%) were also positive for CMV by the PJ-CMV PCR. The co-infection rate was found to be 37.5% (6/16) and 35.2% (12/34) in HIV infected and non-HIV infected patients. This study indicated that the DiaSorin Molecular PJ-CMV multiplex real-time PCR assay has higher sensitivity than direct IFA for detection of P. jirovecii and provides rapid detection of PJ and CMV infection in BAL samples. SN - 1773-0449 UR - https://www.unboundmedicine.com/medline/citation/32044156/Evaluation_of_the_performance_of_DiaSorin_molecular_Pneumocystis_jirovecii_CMV_multiplex_real_time_PCR_assay_from_bronchoalveolar_lavage_samples_ DB - PRIME DP - Unbound Medicine ER -
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