Damiani, Céline;
Le Gal, Solène;
Da Costa, Cécilia;
Virmaux, Michèle;
Nevez, Gilles;
Totet, Anne
Combined Quantification of Pulmonary Pneumocystis jirovecii DNA and Serum (1→3)-β- d -Glucan for Differential Diagnosis of Pneumocystis Pneumonia and Pneumocystis Colonization
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Medientyp:
E-Artikel
Titel:
Combined Quantification of Pulmonary Pneumocystis jirovecii DNA and Serum (1→3)-β- d -Glucan for Differential Diagnosis of Pneumocystis Pneumonia and Pneumocystis Colonization
Beteiligte:
Damiani, Céline;
Le Gal, Solène;
Da Costa, Cécilia;
Virmaux, Michèle;
Nevez, Gilles;
Totet, Anne
Erschienen:
American Society for Microbiology, 2013
Beschreibung:
<jats:title>ABSTRACT</jats:title>
<jats:p>
This study assessed a quantitative PCR (qPCR) assay for
<jats:named-content content-type="genus-species">Pneumocystis jirovecii</jats:named-content>
quantification in bronchoalveolar lavage (BAL) fluid samples combined with serum (1→3)-β-
<jats:sc>d</jats:sc>
-glucan (BG) level detection to distinguish
<jats:named-content content-type="genus-species">Pneumocystis</jats:named-content>
pneumonia (PCP) from pulmonary colonization with
<jats:named-content content-type="genus-species">P. jirovecii</jats:named-content>
. Forty-six patients for whom
<jats:named-content content-type="genus-species">P. jirovecii</jats:named-content>
was initially detected in BAL fluid samples were retrospectively enrolled. Based on clinical data and results of
<jats:named-content content-type="genus-species">P. jirovecii</jats:named-content>
detection, 17 and 29 patients were diagnosed with PCP and colonization, respectively. BAL fluid samples were reassayed using a qPCR assay targeting the mitochondrial large subunit rRNA gene. qPCR results and serum BG levels (from a Fungitell kit) were analyzed conjointly.
<jats:named-content content-type="genus-species">P. jirovecii</jats:named-content>
DNA copy numbers were significantly higher in the PCP group than in the colonization group (1.3 × 10
<jats:sup>7</jats:sup>
versus 3.4 × 10
<jats:sup>3</jats:sup>
copies/μl,
<jats:italic>P</jats:italic>
< 0.05). A lower cutoff value (1.6 × 10
<jats:sup>3</jats:sup>
copies/μl) achieving 100% sensitivity for PCP diagnosis and an upper cutoff value (2 × 10
<jats:sup>4</jats:sup>
copies/μl) achieving 100% specificity were determined. Applying these two values, 13/17 PCP patients and 19/29 colonized patients were correctly assigned to their patient groups. For the remaining 14 patients with
<jats:named-content content-type="genus-species">P. jirovecii</jats:named-content>
DNA copy numbers between the cutoff values, PCP and colonization could not be distinguished on the basis of qPCR results. Four of these patients who were initially assigned to the PCP group presented BG levels of ≥100 pg/ml. The other 10 patients, who were initially assigned to the colonization group, presented BG levels of <100 pg/ml. These results suggest that the combination of the qPCR assay, applying cutoff values of 1.6 × 10
<jats:sup>3</jats:sup>
and 2 × 10
<jats:sup>4</jats:sup>
copies/μl, and serum BG detection, applying a 100 pg/ml threshold, can differentiate PCP and colonization diagnoses.
</jats:p>