<i>Pneumocystis jirovecii</i> Pneumonia Diagnostic Approach: Real-Life Experience in a Tertiary Centre
<i>Pneumocystis jirovecii</i> pneumonia (PJP) in immunocompromised patients entails high mortality and requires adequate laboratory diagnosis. We compared the performance of a real time-PCR assay against the immunofluorescence assay (IFA) in the routine of a large microbiology laboratory...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-03-01
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| Series: | Journal of Fungi |
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| Online Access: | https://www.mdpi.com/2309-608X/9/4/414 |
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| author | Cristina Veintimilla Ana Álvarez-Uría Pablo Martín-Rabadán Maricela Valerio Marina Machado Belén Padilla Roberto Alonso Cristina Diez Patricia Muñoz Mercedes Marín |
| author_facet | Cristina Veintimilla Ana Álvarez-Uría Pablo Martín-Rabadán Maricela Valerio Marina Machado Belén Padilla Roberto Alonso Cristina Diez Patricia Muñoz Mercedes Marín |
| author_sort | Cristina Veintimilla |
| collection | DOAJ |
| description | <i>Pneumocystis jirovecii</i> pneumonia (PJP) in immunocompromised patients entails high mortality and requires adequate laboratory diagnosis. We compared the performance of a real time-PCR assay against the immunofluorescence assay (IFA) in the routine of a large microbiology laboratory. Different respiratory samples from HIV and non-HIV-infected patients were included. The retrospective analysis used data from September 2015 to April 2018, which included all samples for which a <i>P. jirovecii</i> test was requested. A total of 299 respiratory samples were tested (bronchoalveolar lavage fluid (<i>n</i> = 181), tracheal aspirate (<i>n</i> = 53) and sputum (<i>n</i> = 65)). Forty-eight (16.1%) patients fulfilled the criteria for PJP. Five positive samples (10%) had only colonization. The PCR test was found to have a sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 96%, 98%, 90% and 99%, compared to 27%, 100%, 100% and 87%, for the IFA, respectively. PJ-PCR sensitivity and specificity were >80% and >90% for all tested respiratory samples. Median cycle threshold values in definite PJP cases were 30 versus 37 in colonized cases (<i>p</i> < 0.05). Thus, the PCR assay is a robust and reliable test for the diagnosis PJP in all respiratory sample types. Ct values of ≥36 could help to exclude PJP diagnosis. |
| first_indexed | 2024-03-11T04:51:55Z |
| format | Article |
| id | doaj.art-4c95503f80b04346aea579bf77457c94 |
| institution | Directory Open Access Journal |
| issn | 2309-608X |
| language | English |
| last_indexed | 2024-03-11T04:51:55Z |
| publishDate | 2023-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Fungi |
| spelling | doaj.art-4c95503f80b04346aea579bf77457c942023-11-17T19:57:49ZengMDPI AGJournal of Fungi2309-608X2023-03-019441410.3390/jof9040414<i>Pneumocystis jirovecii</i> Pneumonia Diagnostic Approach: Real-Life Experience in a Tertiary CentreCristina Veintimilla0Ana Álvarez-Uría1Pablo Martín-Rabadán2Maricela Valerio3Marina Machado4Belén Padilla5Roberto Alonso6Cristina Diez7Patricia Muñoz8Mercedes Marín9Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, 28007 Madrid, SpainDepartment of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, 28007 Madrid, SpainDepartment of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, 28007 Madrid, SpainDepartment of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, 28007 Madrid, SpainDepartment of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, 28007 Madrid, SpainDepartment of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, 28007 Madrid, SpainDepartment of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, 28007 Madrid, SpainDepartment of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, 28007 Madrid, SpainDepartment of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, 28007 Madrid, SpainDepartment of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain<i>Pneumocystis jirovecii</i> pneumonia (PJP) in immunocompromised patients entails high mortality and requires adequate laboratory diagnosis. We compared the performance of a real time-PCR assay against the immunofluorescence assay (IFA) in the routine of a large microbiology laboratory. Different respiratory samples from HIV and non-HIV-infected patients were included. The retrospective analysis used data from September 2015 to April 2018, which included all samples for which a <i>P. jirovecii</i> test was requested. A total of 299 respiratory samples were tested (bronchoalveolar lavage fluid (<i>n</i> = 181), tracheal aspirate (<i>n</i> = 53) and sputum (<i>n</i> = 65)). Forty-eight (16.1%) patients fulfilled the criteria for PJP. Five positive samples (10%) had only colonization. The PCR test was found to have a sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 96%, 98%, 90% and 99%, compared to 27%, 100%, 100% and 87%, for the IFA, respectively. PJ-PCR sensitivity and specificity were >80% and >90% for all tested respiratory samples. Median cycle threshold values in definite PJP cases were 30 versus 37 in colonized cases (<i>p</i> < 0.05). Thus, the PCR assay is a robust and reliable test for the diagnosis PJP in all respiratory sample types. Ct values of ≥36 could help to exclude PJP diagnosis.https://www.mdpi.com/2309-608X/9/4/414<i>Pneumocystis jirovecii</i> pneumoniaindirect immunofluorescencestainingpolymerase chain reaction (PCR)diagnostic accuracyimmunocompromised host |
| spellingShingle | Cristina Veintimilla Ana Álvarez-Uría Pablo Martín-Rabadán Maricela Valerio Marina Machado Belén Padilla Roberto Alonso Cristina Diez Patricia Muñoz Mercedes Marín <i>Pneumocystis jirovecii</i> Pneumonia Diagnostic Approach: Real-Life Experience in a Tertiary Centre Journal of Fungi <i>Pneumocystis jirovecii</i> pneumonia indirect immunofluorescence staining polymerase chain reaction (PCR) diagnostic accuracy immunocompromised host |
| title | <i>Pneumocystis jirovecii</i> Pneumonia Diagnostic Approach: Real-Life Experience in a Tertiary Centre |
| title_full | <i>Pneumocystis jirovecii</i> Pneumonia Diagnostic Approach: Real-Life Experience in a Tertiary Centre |
| title_fullStr | <i>Pneumocystis jirovecii</i> Pneumonia Diagnostic Approach: Real-Life Experience in a Tertiary Centre |
| title_full_unstemmed | <i>Pneumocystis jirovecii</i> Pneumonia Diagnostic Approach: Real-Life Experience in a Tertiary Centre |
| title_short | <i>Pneumocystis jirovecii</i> Pneumonia Diagnostic Approach: Real-Life Experience in a Tertiary Centre |
| title_sort | i pneumocystis jirovecii i pneumonia diagnostic approach real life experience in a tertiary centre |
| topic | <i>Pneumocystis jirovecii</i> pneumonia indirect immunofluorescence staining polymerase chain reaction (PCR) diagnostic accuracy immunocompromised host |
| url | https://www.mdpi.com/2309-608X/9/4/414 |
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