ArticleJournal of clinical microbiology2012
Clinical significance of quantifying Pneumocystis jirovecii DNA by using real-time PCR in bronchoalveolar lavage fluid from immunocompromised patients.
Article in Journal of clinical microbiology, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers.
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Who cites it
41 citing papers in PubMed, 102 citations in OpenAlex.
- Evaluation of the ELITe InGenius PCR assay compared with immunofluorescence for Pneumocystis jirovecii detection in respiratory samples.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026Article
- Significance of positive semi-quantitative PCR tests on bronchoalveolar lavage for Pneumocystis jirovecii pneumonia in HIV-negative immunocompromised ICU patients with acute respiratory failure.Annals of intensive care · 2025Article
- Diagnostic value of nanopore-based metagenomic third-generation sequencing in the diagnosis ofJournal of medical microbiology · 2025Observational
- Diagnostic tests for infections in critically ill immunocompromised patients.Intensive care medicine · 2024Article
- Quantitative real time PCR for distinction betweenFrontiers in cellular and infection microbiology · 2024Article
- The Use of Host Biomarkers for the Management of Invasive Fungal Disease.Journal of fungi (Basel, Switzerland) · 2022Review
- Clinical Utilization of DiaSorin Molecular Polymerase Chain Reaction inOpen forum infectious diseases · 2022Article
- Is It Possible to DifferentiateJournal of fungi (Basel, Switzerland) · 2021Article
- Detection of Pneumocystis jirovecii and Toxoplasma gondii in patients with lung infections by a duplex qPCR assay.PLoS neglected tropical diseases · 2021Article
- Semiquantitative Real-Time PCR to Distinguish Pneumocystis Pneumonia from Colonization in a Heterogeneous Population of HIV-Negative Immunocompromised Patients.Microbiology spectrum · 2021Article
- Quantitative PCR to Discriminate BetweenFrontiers in microbiology · 2021Article
- Outbreak-Causing Fungi: Pneumocystis jirovecii.Mycopathologia · 2020Review
- Diagnostic accuracy of (1→3)-β-D-glucan to predict Pneumocystis jirovecii pneumonia in non-HIV-infected patients.Radiology and oncology · 2020Article
- Ability of quantitative PCR to discriminateJournal of medical microbiology · 2020Article
- Clinical Performance of (1,3) Beta-D Glucan for the Diagnosis of Pneumocystis Pneumonia (PCP) in Cancer Patients Tested With PCP Polymerase Chain Reaction.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2019Article
- Pneumocystis jirovecii pneumonia prophylaxis in allogeneic hematopoietic cell transplant recipients: can we always follow the guidelines?Bone marrow transplantation · 2019Article
- Comparative Evaluation Between the RealStarAnnals of laboratory medicine · 2019Article
- Inter-Specimen Imbalance of Mitochondrial Gene Copy Numbers Predicts Clustering ofJournal of fungi (Basel, Switzerland) · 2018Article
- Molecular Demonstration of a Pneumocystis Outbreak in Stem Cell Transplant Patients: Evidence for Transmission in the Daycare Center.Frontiers in microbiology · 2017Article
- Detection of Pneumocystis jirovecii in oral wash from immunosuppressed patients as a diagnostic tool.PloS one · 2017Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Quantitative PCR (qPCR) is more sensitive than microscopy for detecting Pneumocystis jirovecii in bronchoalveolar lavage (BAL) fluid. We therefore developed a qPCR assay and compared the results with those of a routine immunofluorescence assay (IFA) and clinical data. The assay included automated DNA extraction, amplification of the mitochondrial large-subunit rRNA gene and an internal control, and quantification of copy numbers with the help of a plasmid clone. We studied 353 consecutive BAL fluids obtained for investigation of unexplained fever and/or pneumonia in 287 immunocompromised patients. No qPCR inhibition was observed. Seventeen (5%) samples were both IFA and qPCR positive, 63 (18%) were IFA negative and qPCR positive, and 273 (77%) were both IFA and qPCR negative. The copy number was significantly higher for IFA-positive/qPCR-positive samples than for IFA-negative/qPCR-positive samples (4.2 ± 1.2 versus 1.1 ± 1.1 log(10) copies/μl; P < 10(-4)). With IFA as the standard, the qPCR assay sensitivity was 100% for ≥2.6 log(10) copies/μl and the specificity was 100% for ≥4 log(10) copies/μl. Since qPCR results were not available at the time of decision-making, these findings did not trigger cotrimoxazole therapy. Patients with systemic inflammatory diseases and IFA-negative/qPCR-positive BAL fluid had a worse 1-year survival rate than those with IFA-negative/qPCR-negative results (P < 10(-3)), in contrast with solid-organ transplant recipients (P = 0.88) and patients with hematological malignancy (P = 0.26). Quantifying P. jirovecii DNA in BAL fluids independently of IFA positivity should be incorporated into the investigation of pneumonia in immunocompromised patients. The relevant threshold remains to be determined and may vary according to the underlying disease.
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