Pneumocystosis and quantitative PCR

Issa, N.; Gabriel, Frédéric; Baulier, G.; Mourissoux, G.; Accoceberry, Isabelle; Guisset, Olivier; Camou, Fabrice

doi:10.1016/j.medmal.2018.04.396

Cited by 8 publications

(4 citation statements)

References 27 publications

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“…To facilitate the interpretation of PCR results, cut-off values of P jirovecii DNA copy number or Ct values have been suggested by several authors. 15,18,19,21,[26][27][28][29][30][31] As observed in our and other studies, the fungal burden is different in samples from patients belonging to different PCP categories and is lower in colonised patients than in patients with possible PCP and with proven infection. [17][18][19][20]26,31,32 However, an overlap of the fungal load was observed between the different categories.…”

Section: Research and Treatment Of Cancer And The Mycoses Study Groupsupporting

confidence: 85%

Performance of the RealStar^®Pneumocystis jirovecii PCR kit for the diagnosis of Pneumocystis pneumonia

Salsé

Mercier

Carles

et al. 2021

Mycoses

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Background Pneumonia due to Pneumocystis jirovecii (PCP) is a frequent infection in HIV‐positive and also in immunocompromised HIV‐negative patients. PCR analysis of pulmonary samples has become an essential element in PCP laboratory diagnosis. Currently, many commercially PCR‐based tests are available for P jirovecii detection and need to be evaluated. Objectives We evaluated the performance of the RealStar® P jirovecii PCR kit for PCP diagnosis. Methods We performed the RealStar® P jirovecii PCR and an in‐house PCR in 219 pulmonary samples. We then assessed the performance of the RealStar® P jirovecii PCR kit by classifying patients in proven, probable, possible PCP or no final diagnosis, on the basis of the clinical and radiological signs and direct examination of bronchoalveolar lavage samples. Results The results showed excellent concordance (96.8%) with another in‐house PCR, previously used in the laboratory. The available clinical data allowed classifying 219 patients as having proven PCP (n = 6), probable PCP (n = 27), possible PCP (n = 29) and no final diagnosis of PCP (n = 157). The RealStar® P jirovecii PCR kit performed well with samples from patients with proven and probable PCP, as indicated by the detection of P jirovecii DNA in all these samples. The percentage of positive samples in the possible PCP category was 75.9%. In patients with no final diagnosis of PCP, P jirovecii DNA was detected in 13.4% of samples, indicating colonisation by this pathogen. Conclusions The RealStar® P jirovecii PCR kit shows excellent performance for PCP diagnosis.

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Section: Research and Treatment Of Cancer And The Mycoses Study Groupsupporting

confidence: 85%

Performance of the RealStar^®Pneumocystis jirovecii PCR kit for the diagnosis of Pneumocystis pneumonia

Salsé

Mercier

Carles

et al. 2021

Mycoses

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“…To date, we found 31 articles in PubMed that established a cut-off for molecular diagnosis of Pj using qPCR. Among them, 19 were retrospective [4,14,16,19,20,22,23,26,[42][43][44][45][46][47][48][49][50][51], 9 were prospective [13,15,18,21,[23][24][25]52,53], and 3 were mixed [12,54,55]. In 26 of them, authors accepted the diagnosis of PjP when one or more of the following criteria were present: clinical presentation suggestive of PjP, adequate response to PjP treatment, lung images suggestive of pneumonia caused by Pj, and/or a microscopy-positive Pj sample.…”

Section: Discussionmentioning

confidence: 99%

Is It Possible to Differentiate Pneumocystis jirovecii Pneumonia and Colonization in the Immunocompromised Patients with Pneumonia?

Aguilar

Rueda

Maya

et al. 2021

JoF

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Respiratory sample staining is a standard tool used to diagnose Pneumocystis jirovecii pneumonia (PjP). Although molecular tests are more sensitive, their interpretation can be difficult due to the potential of colonization. We aimed to validate a Pneumocystis jirovecii (Pj) real-time PCR (qPCR) assay in bronchoscopic bronchoalveolar lavage (BAL) and oropharyngeal washes (OW). We included 158 immunosuppressed patients with pneumonia, 35 lung cancer patients who underwent BAL, and 20 healthy individuals. We used a SYBR green qPCR assay to look for a 103 bp fragment of the Pj mtLSU rRNA gene in BAL and OW. We calculated the qPCR cut-off as well as the analytical and diagnostic characteristics. The qPCR was positive in 67.8% of BAL samples from the immunocompromised patients. The established cut-off for discriminating between disease and colonization was Ct 24.53 for BAL samples. In the immunosuppressed group, qPCR detected all 25 microscopy-positive PjP cases, plus three additional cases. Pj colonization in the immunocompromised group was 66.2%, while in the cancer group, colonization rates were 48%. qPCR was ineffective at diagnosing PjP in the OW samples. This new qPCR allowed for reliable diagnosis of PjP, and differentiation between PjP disease and colonization in BAL of immunocompromised patients with pneumonia.

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“…Studies assessing a clearly defined population of HIV/AIDS and PCP in any clinical setting were included if they had specific diagnostic criteria for PCP. These were predefined using clinical case definitions [27] or confirmation with laboratory testing using molecular assays, such as PCR, sequencing, and matrix-assisted laser desorption-ionization time of flight mass spectrometry (MALDI-TOF MS) [16][17][18]. Inclusion criteria were as follows; patients with HIV/AIDS and PCP, all types of studies encompassing data about patients with HIV/AIDS and PCP infected simultaneously, including clinical trials, retrospective, prospective, and cohort studies, gray literature including conference reports, etc.…”

Section: Selection Criteriamentioning

confidence: 99%

“…Recognition of at-risk patients is based on the severity of clinical symptoms(fever, cough, difficulty breathing, chest pain, and tiredness) in high-risk populations [15]. However, radiological examination and specific polymerase chain reaction (PCR) assay in sputum, bronchoalveolar lavage (BAL), tissue biopsies, and serum β-D-glucan levels (a part of the cell wall of many different types of fungi)should support the diagnosis of PCP [16][17][18]. Liu et al [19] investigated the technical advantages of molecular methods, especially PCR-based methods, for the detection of P. jirovecii among BAL fluid specimens.…”

Section: Introductionmentioning

confidence: 99%

Global prevalence, mortality, and main characteristics of HIV-associated pneumocystosis: A systematic review and meta-analysis

Ahmadpour,

Valilou,

Ghanizadegan

et al. 2024

PLoS ONE

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The epidemiology of Human Immunodeficiency Virus (HIV)-associated pneumocystosis (HAP) is poorly described on a worldwide scale. We searched related databases between January 2000 and December 2022 for studies reporting HAP. Meta-analysis was performed using StatsDirect (version 2.7.9) and STATA (version 17) according to the random-effects model for DerSimonian and Laird method and metan and metaprop commands, respectively. Twenty-nine studies with 38554 HIV-positive, 79893 HIV-negative, and 4044 HAP populations were included. The pooled prevalence of HAP was 35.4% (95% CI 23.8 to 47.9). In contrast, the pooled prevalence of PCP among HIV-negative patients was 10.16% (95% CI 2 to 25.3). HIV-positive patients are almost 12 times more susceptible to PCP than the HIV-negative population (OR: 11.710; 95% CI: 5.420 to 25.297). The mortality among HAP patients was 52% higher than non-PCP patients (OR 1.522; 95% CI 0.959 to 2.416). HIV-positive men had a 7% higher chance rate for PCP than women (OR 1.073; 95% CI 0.674 to 1.706). Prophylactic (OR: 6.191; 95% CI: 0.945 to 40.545) and antiretroviral therapy (OR 3.356; 95% CI 0.785 to 14.349) were used in HAP patients six and three times more than HIV-positive PCP-negatives, respectively. The control and management strategies should revise and updated by health policy-makers on a worldwide scale. Finally, for better management and understanding of the epidemiology and characteristics of this coinfection, designing further studies is recommended.

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Pneumocystosis and quantitative PCR

Cited by 8 publications

References 27 publications

Performance of the RealStar^®Pneumocystis jirovecii PCR kit for the diagnosis of Pneumocystis pneumonia

Performance of the RealStar^®Pneumocystis jirovecii PCR kit for the diagnosis of Pneumocystis pneumonia

Is It Possible to Differentiate Pneumocystis jirovecii Pneumonia and Colonization in the Immunocompromised Patients with Pneumonia?

Global prevalence, mortality, and main characteristics of HIV-associated pneumocystosis: A systematic review and meta-analysis

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Pneumocystosis and quantitative PCR

Cited by 8 publications

References 27 publications

Performance of the RealStar®Pneumocystis jirovecii PCR kit for the diagnosis of Pneumocystis pneumonia

Performance of the RealStar®Pneumocystis jirovecii PCR kit for the diagnosis of Pneumocystis pneumonia

Is It Possible to Differentiate Pneumocystis jirovecii Pneumonia and Colonization in the Immunocompromised Patients with Pneumonia?

Global prevalence, mortality, and main characteristics of HIV-associated pneumocystosis: A systematic review and meta-analysis

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Performance of the RealStar^®Pneumocystis jirovecii PCR kit for the diagnosis of Pneumocystis pneumonia

Performance of the RealStar^®Pneumocystis jirovecii PCR kit for the diagnosis of Pneumocystis pneumonia