SynthesisClinical infectious diseases : an official publication of the Infectious Diseases Society of America2024
Polymerase Chain Reaction on Respiratory Tract Specimens of Immunocompromised Patients to Diagnose Pneumocystis Pneumonia: A Systematic Review and Meta-analysis.
Synthesis in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Diagnostic tests performance in detecting Pneumocystis jirovecii: A systematic review and meta-analysis.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2025Pooled it
- 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
- Predictors and mortality in PCR-positive pneumocystis pneumonia among non-HIV patients.BMC infectious diseases · 2026Article
- Global perspective on gaps in fungal diagnostics in low-resource settings: WHO landscape analysis and research priorities for invasive fungal diseases.The Lancet. Microbe · 2026Review
- Combined Serum (1,3)-β-D-Glucan and Oral Wash PCR as a Noninvasive Diagnostic Strategy for Early Detection ofOpen forum infectious diseases · 2026Article
- Biomarkers in Invasive Pulmonary Fungal Infections: Where Do We Stand?Journal of fungi (Basel, Switzerland) · 2026Review
- Research progress on the current status of respiratory pathogen infections and their detection methods.Frontiers in microbiology · 2026Review
- Blood mNGS-Detected Epstein-Barr Virus in ICU Patients with Pneumonia: Associations with Disease Severity Markers and Inflammatory Burden.Infection and drug resistance · 2026Article
- Multi-site screening forFrontiers in cellular and infection microbiology · 2026Article
- Standardization and Clinical Evaluation of a Real-Time PCR Assay for the Diagnosis of Pneumocystis jirovecii Pneumonia.Mycopathologia · 2025Article
- Article
- The 2025 EQUALJAC-antimicrobial resistance · 2025Article
- CRISPR-driven diagnostics: Molecular mechanisms, clinical efficacy and translational challenges.Clinical and translational medicine · 2025Review
- Article
- Review
- The Molecular Diagnosis of Invasive Fungal Diseases with a Focus on PCR.Diagnostics (Basel, Switzerland) · 2025Review
- The Role of Polymerase Chain Reaction (PCR) and Quantification Cycle Values in the Diagnosis ofJournal of fungi (Basel, Switzerland) · 2025Article
- Post-COVID-19 severeThe Journal of international medical research · 2025Review
- Bone Marrow Infection byInfectious disease reports · 2025Article
- A Laboratory-Developed Assay for the Simultaneous Detection ofJournal of fungi (Basel, Switzerland) · 2025Article
Corrections and comments
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Authors and funding
17 authors.
Funding
Abstract
backgroundThis meta-analysis examines the comparative diagnostic performance of polymerase chain reaction (PCR) for the diagnosis of Pneumocystis pneumonia (PCP) on different respiratory tract samples, in both human immunodeficiency virus (HIV) and non-HIV populations.
methodsA total of 55 articles met inclusion criteria, including 11 434 PCR assays on respiratory specimens from 7835 patients at risk of PCP. QUADAS-2 tool indicated low risk of bias across all studies. Using a bivariate and random-effects meta-regression analysis, the diagnostic performance of PCR against the European Organisation for Research and Treatment of Cancer-Mycoses Study Group definition of proven PCP was examined.
resultsQuantitative PCR (qPCR) on bronchoalveolar lavage fluid provided the highest pooled sensitivity of 98.7% (95% confidence interval [CI], 96.8%-99.5%), adequate specificity of 89.3% (95% CI, 84.4%-92.7%), negative likelihood ratio (LR-) of 0.014, and positive likelihood ratio (LR+) of 9.19. qPCR on induced sputum provided similarly high sensitivity of 99.0% (95% CI, 94.4%-99.3%) but a reduced specificity of 81.5% (95% CI, 72.1%-88.3%), LR- of 0.024, and LR+ of 5.30. qPCR on upper respiratory tract samples provided lower sensitivity of 89.2% (95% CI, 71.0%-96.5%), high specificity of 90.5% (95% CI, 80.9%-95.5%), LR- of 0.120, and LR+ of 9.34. There was no significant difference in sensitivity and specificity of PCR according to HIV status of patients.
conclusionsOn deeper respiratory tract specimens, PCR negativity can be used to confidently exclude PCP, but PCR positivity will likely require clinical interpretation to distinguish between colonization and active infection, partially dependent on the strength of the PCR signal (indicative of fungal burden), the specimen type, and patient population tested.
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