Is real time PCR preferable to the direct immunofluorescence in the diagnosis of Pneumocystis jirovecii pneumonia in HIV-infected patients?

Bossart, Simon; Mühlethaler, Konrad; Garzoni, Christian; Furrer, Hansjakob (2020). Is real time PCR preferable to the direct immunofluorescence in the diagnosis of Pneumocystis jirovecii pneumonia in HIV-infected patients? BMC research notes, 13(1) Biomed Central 10.1186/s13104-020-05075-5

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OBJECTIVES In this study, we compared IFA and real-time PCR in bronchoalveolar lavage specimens of HIV infected patients. A total of 66 BALs from 62 HIV patients were included in the study. 30 IFA positive and 36 IFA negative specimens were tested with real-time PCR, targeting the major surface glycoprotein. We performed a retrospective analysis of the patient's medical records, compared the results of the IFA and PCR tests and analyzed costs, expenditure of time and personal expenses. RESULTS All of the 30 IFA positive samples were PCR positive. 35 of 36 IFA negative probes were also negative in the PCR assay. Considering the PCR results as a binary outcome (positive/negative) sensitivity was 100%, specificity 97.2%. The patient with negative IFA and positive PCR had a clear clinical picture of PCP and responded to PCP treatment. PCR was more than twice as expensive and time-consuming as IFA. Diagnostic accuracy for PCP of PCR and IFA was comparable in HIV-infected patients, but IFA was significantly less expensive and less time-consuming. Therefore, IFA testing can continue to be used as gold standard in the diagnosis of PCP in HIV patients. However, in special cases, IFA may lack sensitivity and PCR should be added to the diagnostic armamentarium.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Dermatology
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Infectiology
04 Faculty of Medicine > Service Sector > Institute for Infectious Diseases
04 Faculty of Medicine > Service Sector > Institute for Infectious Diseases > Clinical Microbiology

UniBE Contributor:

Bossart, Simon; Mühlethaler, Konrad and Furrer, Hansjakob

Subjects:

500 Science > 570 Life sciences; biology
600 Technology > 610 Medicine & health

ISSN:

1756-0500

Publisher:

Biomed Central

Language:

English

Submitter:

Annelies Luginbühl

Date Deposited:

12 May 2020 16:02

Last Modified:

17 May 2020 02:47

Publisher DOI:

10.1186/s13104-020-05075-5

PubMed ID:

PMC7195742

Uncontrolled Keywords:

HIV Immunofluorescence assay Pneumocystis jirovecii Pneumocystis pneumonia Real-time PCR

BORIS DOI:

10.7892/boris.143969

URI:

https://boris.unibe.ch/id/eprint/143969

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