The conventional diagnosis challenge : Real-time PCR and nested PCR correlation with the scoring system for individuals at high-risk of Pneumocystis jirovecii pneumonia

INTRODUCTION: Pneumocystis jirovecii is an opportunistic fungus that affects mainly people living with HIV (CD4 cell count lower than 200 cells/ml) and other immunosuppressed patients. Since P. jirovecii does not grow on routine mycological media, diagnosis of P. jirovecii pneumonia relies on indirect evidence of its presence in respiratory samples.

OBJECTIVES: To associate the results of direct immunofluorescence and two molecular methods with a score to predict P. jirovecii pneumonia in patients with AIDS.

MATERIALS AND METHODS: A prospective study was conducted with 40 patients. A respiratory sample collected before treatment was subjected to direct immunofluorescence using the Merifluor kit, to nested PCR targeting the mitochondrial large subunit ribosomal RNA, and to the VIASURE real-time PCR kit.

RESULTS: These three techniques revealed P. jirovecii in 6, 12, and 15 samples, respectively. All positive samples by direct immunofluorescence were positive by nested PCR, and all positive samples by nested PCR amplified by real-time PCR. There was a statistically significant association between the P. jirovecii pneumonia score and the molecular methods. Two patients were early diagnosed and responded well to treatment.

CONCLUSION: Molecular methods, especially real-time PCR, are recommended for early diagnosis of P. jirovecii pneumonia in AIDS patients.

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - volume:43

Enthalten in:

Biomedica : revista del Instituto Nacional de Salud - 43(2023), Sp. 1 vom: 31. Aug., Seite 255-266

Sprache:

Englisch

Weiterer Titel:

Desafío diagnóstico: PCR anidada y en tiempo real frente a un sistema de puntuación en individuos con gran riesgo de neumonía por Pneumocystis jirovecii

Beteiligte Personen:

Almeida-Siva, Fernando [VerfasserIn]
Almeida-Paes, Rodrigo [VerfasserIn]
Serra-Damasceno, Lisandra [VerfasserIn]
Motta-Santos, Edwiges [VerfasserIn]
Ferreira, Luiz Claudio [VerfasserIn]
Pereira-Quintella, Leonardo [VerfasserIn]
De Faria Ferreira, Marcela [VerfasserIn]
De Medeiros-Muniz, Mauro [VerfasserIn]
Zancopé-Oliveira, Rosely M [VerfasserIn]

Links:

Volltext

Themen:

Direct
Fluorescent antibody technique
Journal Article
Pneumocystis
Pneumonia
Real-time polymerase chain reaction

Anmerkungen:

Date Completed 20.09.2023

Date Revised 27.10.2023

published: Electronic

Citation Status MEDLINE

doi:

10.7705/biomedica.7020

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM36218738X