Diagnosis of Pneumocystis pneumonia by real-time PCR in patients with various underlying diseases
Background: Pneumocystis pneumonia (PCP) is a disease caused by the opportunistic infection of the fungus Pneumocystis jirovecii. Several PCR methods have been developed to aid in the diagnosis of PCP. In this study, we evaluated the performance of a real-time PCR in the diagnosis of PCP, in patient...
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| Format: | Article |
| Language: | English |
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Elsevier
2020-10-01
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| Series: | Journal of Microbiology, Immunology and Infection |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1684118219301471 |
| _version_ | 1818291440651862016 |
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| author | Shu-Li Yang Ying-Hao Wen Yu-Shan Wu Mei-Chia Wang Pi-Yueh Chang Shuan Yang Jang-Jih Lu |
| author_facet | Shu-Li Yang Ying-Hao Wen Yu-Shan Wu Mei-Chia Wang Pi-Yueh Chang Shuan Yang Jang-Jih Lu |
| author_sort | Shu-Li Yang |
| collection | DOAJ |
| description | Background: Pneumocystis pneumonia (PCP) is a disease caused by the opportunistic infection of the fungus Pneumocystis jirovecii. Several PCR methods have been developed to aid in the diagnosis of PCP. In this study, we evaluated the performance of a real-time PCR in the diagnosis of PCP, in patients with various underlying diseases. Methods: Ninety-seven BAL samples and 94 sputum samples from 191 patients were used in the study. Patients were classified as PCP (121 patients) or non-PCP (70 patients) based on their clinical and radiological presentations. Results: Real time PCR amplified the P. jirovecii mitochondrial large-subunit rRNA gene with a detection limit of 68 copies of DNA per reaction. Non-PCP pathogens including 32 different fungi and bacteria were also evaluated. Overall, 71.9% of the samples from PCP patients and 14.5% of those from non-PCP patients were positive for the PCR test with a CT value of the real-time PCR below 45. The main underlying diseases of the patients were hematological or solid malignancies (47.1%) and HIV infection (8.9%). The CT values of the test were significantly lower in BAL samples from PCP patients than those from non-PCP patients (p = 0.024). No non-PCP patient had a CT value below 30, whereas samples from 24.8% of PCP patients with underlying diseases had a CT value below 30. Conclusion: Since false positive PCR results were obtained, perhaps due to colonization, we suggest that the diagnosis of PCP should be based on a combination of clinical symptoms, underlying diseases, and PCR results. |
| first_indexed | 2024-12-13T02:44:06Z |
| format | Article |
| id | doaj.art-46bd264c92b648cfb5f62480eececc43 |
| institution | Directory Open Access Journal |
| issn | 1684-1182 |
| language | English |
| last_indexed | 2024-12-13T02:44:06Z |
| publishDate | 2020-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Microbiology, Immunology and Infection |
| spelling | doaj.art-46bd264c92b648cfb5f62480eececc432022-12-22T00:02:14ZengElsevierJournal of Microbiology, Immunology and Infection1684-11822020-10-01535785790Diagnosis of Pneumocystis pneumonia by real-time PCR in patients with various underlying diseasesShu-Li Yang0Ying-Hao Wen1Yu-Shan Wu2Mei-Chia Wang3Pi-Yueh Chang4Shuan Yang5Jang-Jih Lu6Department of Laboratory Medicine, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; Department of Medical Biotechnology and Laboratory Science, Chang Gung University, Taoyuan, TaiwanDepartment of Laboratory Medicine, Chang Gung Memorial Hospital, Linkou, Taoyuan, TaiwanDepartment of Laboratory Medicine, Chang Gung Memorial Hospital, Linkou, Taoyuan, TaiwanDepartment of Laboratory Medicine, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; Department of Medical Biotechnology and Laboratory Science, Chang Gung University, Taoyuan, TaiwanDepartment of Laboratory Medicine, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; Department of Medical Biotechnology and Laboratory Science, Chang Gung University, Taoyuan, Taiwan; Graduate Institute of Biomedical Sciences, Chang Gung University, Taoyuan, TaiwanDepartment of Laboratory Medicine, Chang Gung Memorial Hospital, Linkou, Taoyuan, TaiwanDepartment of Laboratory Medicine, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; Department of Medical Biotechnology and Laboratory Science, Chang Gung University, Taoyuan, Taiwan; Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Corresponding author. Department of Laboratory Medicine, Chang Gung Memorial Hospital, No. 5, Fu-Shin Street, Kweishan 333, Taoyuan, Taiwan. Fax: +886 3 3971827.Background: Pneumocystis pneumonia (PCP) is a disease caused by the opportunistic infection of the fungus Pneumocystis jirovecii. Several PCR methods have been developed to aid in the diagnosis of PCP. In this study, we evaluated the performance of a real-time PCR in the diagnosis of PCP, in patients with various underlying diseases. Methods: Ninety-seven BAL samples and 94 sputum samples from 191 patients were used in the study. Patients were classified as PCP (121 patients) or non-PCP (70 patients) based on their clinical and radiological presentations. Results: Real time PCR amplified the P. jirovecii mitochondrial large-subunit rRNA gene with a detection limit of 68 copies of DNA per reaction. Non-PCP pathogens including 32 different fungi and bacteria were also evaluated. Overall, 71.9% of the samples from PCP patients and 14.5% of those from non-PCP patients were positive for the PCR test with a CT value of the real-time PCR below 45. The main underlying diseases of the patients were hematological or solid malignancies (47.1%) and HIV infection (8.9%). The CT values of the test were significantly lower in BAL samples from PCP patients than those from non-PCP patients (p = 0.024). No non-PCP patient had a CT value below 30, whereas samples from 24.8% of PCP patients with underlying diseases had a CT value below 30. Conclusion: Since false positive PCR results were obtained, perhaps due to colonization, we suggest that the diagnosis of PCP should be based on a combination of clinical symptoms, underlying diseases, and PCR results.http://www.sciencedirect.com/science/article/pii/S1684118219301471Pneumocystis pneumoniaUnderlying diseases |
| spellingShingle | Shu-Li Yang Ying-Hao Wen Yu-Shan Wu Mei-Chia Wang Pi-Yueh Chang Shuan Yang Jang-Jih Lu Diagnosis of Pneumocystis pneumonia by real-time PCR in patients with various underlying diseases Journal of Microbiology, Immunology and Infection Pneumocystis pneumonia Underlying diseases |
| title | Diagnosis of Pneumocystis pneumonia by real-time PCR in patients with various underlying diseases |
| title_full | Diagnosis of Pneumocystis pneumonia by real-time PCR in patients with various underlying diseases |
| title_fullStr | Diagnosis of Pneumocystis pneumonia by real-time PCR in patients with various underlying diseases |
| title_full_unstemmed | Diagnosis of Pneumocystis pneumonia by real-time PCR in patients with various underlying diseases |
| title_short | Diagnosis of Pneumocystis pneumonia by real-time PCR in patients with various underlying diseases |
| title_sort | diagnosis of pneumocystis pneumonia by real time pcr in patients with various underlying diseases |
| topic | Pneumocystis pneumonia Underlying diseases |
| url | http://www.sciencedirect.com/science/article/pii/S1684118219301471 |
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