Evaluation of the Automated Becton Dickinson MAX Real-Time PCR Platform for Detection of
 Pneumocystis Jirovecii

Chien, Jung-Yien; Liu, Chia-Jung; Chuang, Pei-Chien; Lee, Tai-Fen; Huang, Yu-Tsung; Liao, Chun-Hsing; Hung, Chien‐Ching; Sheng, Wan-Huei; Yu, Chong‐Jen; Hsueh, Po-Ren

doi:10.2217/fmb-2016-0115

Cited by 13 publications

(6 citation statements)

References 27 publications

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“…To discriminate cases of PCP (PCP + ) from colonization (PCP − ), we applied retrospective case-criteria in line with the European Conference on Infections in Leukaemia (ECIL) guidelines [ 13 ] with the available data. According to previous studies, we considered that C T values above 35 corresponded to colonization and not overt PCP [ 12 , 14 ] regardless of the host’s HIV status. Thus, the criteria for PCP + among our PCR-positive cohort were i) positive DIF and/or ii) C T value below 36.…”

Section: Methodsmentioning

confidence: 99%

Epidemiological and clinical characteristics of immunocompromised patients infected with Pneumocystis jirovecii in a twelve-year retrospective study from Norway

Grønseth

Rogne²,

Hannula

et al. 2021

BMC Infect Dis

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Background Pneumocystis pneumonia (PCP) severely menaces modern chemotherapy and immunosuppression. Detailed description of the epidemiology of Pneumocystis jirovecii today is needed to identify candidates for PCP-prophylaxis. Methods We performed a 12-year retrospective study of patients with P. jirovecii detected by polymerase chain reaction in Central Norway. In total, 297 patients were included. Comprehensive biological, clinical and epidemiological data were abstracted from patients’ medical records. Regional incidence rates and testing trends were also assessed. Results From 2007 to 2017 we found a 3.3-fold increase in testing for P. jirovecii accompanied by a 1.8-fold increase in positive results. Simultaneously, regional incidence rates doubled from 5.0 cases per 100,000 person years to 10.8. A majority of the study population had predisposing conditions other than human immunodeficiency virus (HIV). Hematological (36.0%) and solid cancers (25.3%) dominated. Preceding corticosteroids were a common denominator for 72.1%. Most patients (74.4%) presented with at least two cardinal symptoms; cough, dyspnea or fever. Main clinical findings were hypoxia, cytopenias and radiological features consistent with PCP. A total of 88 (29.6%) patients required intensive care and 121 (40.7%) suffered at least one complication. In-hospital mortality was 21.5%. Three patients (1.0%) had received prophylaxis. Conclusions P. jirovecii is re-emerging; likely due to increasing immunosuppressants use. This opportunistic pathogen threatens the life of heterogenous non-HIV immunosuppressed populations currently at growth. Corticosteroids seem to be a major risk factor. A strategy to increase prophylaxis is called for.

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Section: Methodsmentioning

confidence: 99%

Epidemiological and clinical characteristics of immunocompromised patients infected with Pneumocystis jirovecii in a twelve-year retrospective study from Norway

Grønseth

Rogne²,

Hannula

et al. 2021

BMC Infect Dis

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“…Indeed, a few studies have observed higher fungal detection rates in BAL fluids than in URT samples [222324]. However, information regarding the yield obtained from different LRT sample types is limited, particularly in non-HIV immunocompromised patients [2526]. Alanio et al [26] reported that fungal burdens did not significantly differ between BAL fluids and induced sputum; however, we demonstrated low detection rates from sputum/ETA samples compared with BAL samples.…”

Section: Discussionmentioning

confidence: 52%

Comparative Evaluation Between the RealStarPneumocystis jiroveciiPCR Kit and the AmpliSensPneumocystis jirovecii(carinii)-FRT PCR Kit for DetectingP. jiroveciiin Non-HIV Immunocompromised Patients

Huh

Lim

et al. 2019

Ann Lab Med

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Background Real-time PCR is more sensitive than microscopic examination for detecting Pneumocystis jirovecii . We compared the performance of two assays for detecting P. jirovecii DNA: the RealStar Pneumocystis jirovecii PCR Kit 1.0 CE (Altona Diagnostics, Hamburg, Germany) and the AmpliSens Pneumocystis jirovecii ( carinii )-FRT PCR kit (InterLabService Ltd., Moscow, Russia). Methods We used 159 samples from the lower respiratory tract (112 bronchoalveolar lavage [BAL] fluid, 37 sputum, and 10 endotracheal aspirate [ETA] samples) of non-HIV immunocompromised patients. Nested PCR and sequencing were used to resolve discordant results. The performance of the two assays was evaluated according to clinical categories (clinical Pneumocystis pneumonia [PCP], possible PCP, or unlikely PCP) based on clinical and radiological observations. Results The positive and negative percent agreement values were 100% (95% confidence interval [CI], 85.4–100%) and 96.6% (95% CI, 90.9–98.9%), respectively, and kappa was 0.92 (95% CI, 0.84–0.99). P. jirovecii DNA load was significantly higher in the clinical PCP group than in the other groups ( P <0.05). When stratified by sample type, the positive rate for BAL fluids from the clinical PCP group was 100% using either assay, whereas the positive rate for sputum/ETA samples was only 20%. Conclusions The two assays showed similar diagnostic performance and detected low P. jirovecii burden in BAL fluids. Both assays may be useful as routine methods for detecting P. jirovecii DNA in a clinical laboratory setting, though their results should be interpreted considering sample type.

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“…Expectorated sputum or bronchoscopic samples (washing or bronchoalveolar lavage) were examined by qPCR in an automated Becton Dickinson MAX real-time PCR platform (Becton Dickinson, Diagnostic Systems, Sparks, MD, USA) 16. The primer sequences for the PJ target gene, major surface glycoprotein ( MSG ), were MSG-fw, 5ʹ-GAATGCAAATCCTTACAGACAG-3ʹ, and MSG-rv, 5ʹ-AAATCATGAACGAAATAACCATTGC-3ʹ.…”

Section: Methodsmentioning

confidence: 99%

“…A lower Ct value correlates with a higher PJ fungal burden. According to previous studies, a qPCR Ct value higher than 35, correlates with a clinically low PJ fungal burden and colonization 16,17. Thus, patients with a Ct value above 35 were excluded from this study.…”

Section: Methodsmentioning

confidence: 99%

“…Nevertheless, when using such techniques, the possibility of including patients with PJ colonization alone cannot be eliminated. According to recent studies, quantitative real-time PCR (qPCR) could semi-quantitate the PJ fungal burden, which could help differentiate colonization from infection 16,17. Therefore, in this study, we used qPCR for the diagnosis of PCP, and aimed to investigate the treatment outcomes and predictors of mortality among non-HIV-infected patients with PCP.…”

Section: Introductionmentioning

confidence: 99%

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Clinical characteristics, treatment outcomes, and prognostic factors of Pneumocystis pneumonia in non-HIV-infected patients

Liu¹,

Lee²,

Ruan³

et al. 2019

IDR

Self Cite

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Objectives: The incidence of Pneumocystis pneumonia (PCP) has been increasing among non-HIV-infected patients. Here, we investigated the clinical characteristics, treatment outcomes, and prognostic factors of PCP in non-HIV-infected patients. Patients and methods: Information on clinical characteristics, treatment outcomes, and prognostic factors of PCP patients who were treated at a medical center in northern Taiwan from October 2015 to October 2016 were retrieved from medical records and evaluated. Results: Among the patients with PCP included in the study, 84 were non-HIV-infected and 25 were HIV-infected. Non-HIV-infected patients with PCP had a longer duration between radiographic findings and treatment ( P <0.001), and a higher rate of hospital-associated PCP ( P <0.001), hypoxia ( P= 0.015), respiratory failure ( P <0.001), and mortality ( P= 0.006) than HIV-infected patients with PCP. Among non-HIV-infected patients, non-survivors had a higher fungal burden (46.2% vs 22.2%, P =0.039), higher requirement for adjunctive steroid treatment (94.9% vs 71.1%, P= 0.011), and higher rate of pneumothorax (17.9% vs 2.2%, P= 0.038) than survivors. Multiple logistic regression revealed that lymphopenia (odds ratio [OR] =3.24, 95% confidence interval [CI] =1.07–9.79; P= 0.037), adjunctive steroid use (OR =6.23, 95% CI =1.17–33.14; P= 0.032), and pneumothorax (OR =10.68, 95% CI =1.00–113.93; P= 0.050) were significantly associated with increased 60-day mortality among non-HIV-infected PCP patients. Conclusion: Lymphopenia, adjunctive steroid therapy, and pneumothorax were significantly associated with higher mortality in non-HIV-infected patients with PCP.

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Evaluation of the Automated Becton Dickinson MAX Real-Time PCR Platform for Detection of Pneumocystis Jirovecii

Abstract: The quantitative BD MAX real-time PCR is a rapid and highly sensitive modality for detecting P. jirovecii, especially in samples from bronchoalveolar lavage fluid/bronchial washing fluid.

Cited by 13 publications

References 27 publications

Epidemiological and clinical characteristics of immunocompromised patients infected with Pneumocystis jirovecii in a twelve-year retrospective study from Norway

Epidemiological and clinical characteristics of immunocompromised patients infected with Pneumocystis jirovecii in a twelve-year retrospective study from Norway

Comparative Evaluation Between the RealStarPneumocystis jiroveciiPCR Kit and the AmpliSensPneumocystis jirovecii(carinii)-FRT PCR Kit for DetectingP. jiroveciiin Non-HIV Immunocompromised Patients

<p>Clinical characteristics, treatment outcomes, and prognostic factors of <em>Pneumocystis</em> pneumonia in non-HIV-infected patients</p>

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