ArticleMycoses2025
Performance of Quantitative PCR to Distinguish Pneumocystis jirovecii Pneumonia From Colonisation in Immunocompromised Patients.
Article in Mycoses, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Quantitative real-time PCR in the diagnosis of opportunistic infections in immunocompromised patients: Diagnostic performance, clinical utility, and future directions.Infectious diseases & immunity · 2026Review
- Past Achievements, Present Gaps, and Future Priorities in Pneumocystis jirovecii Research: A Global Bibliometric Analysis.Pathogens (Basel, Switzerland) · 2026Review
- Biomarkers in Invasive Pulmonary Fungal Infections: Where Do We Stand?Journal of fungi (Basel, Switzerland) · 2026Review
- Article
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5 authors.
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Abstract
backgroundPneumocystis jirovecii pneumonia (PCP) is a severe opportunistic infection affecting immunocompromised patients. Quantitative polymerase chain reaction (qPCR) is widely used for the detection of P. jirovecii in respiratory samples. However, the diagnosis of PCP remains challenging and the high prevalence of P. jirovecii airway colonisation complicates the interpretation of positive results. The aim of this study was to assess the utility of P. jirovecii PCR Quantification Cycle (Cq) values in differentiating between PCP and colonisation in PCR-positive respiratory samples from immunocompromised patients.
methodsAdult patients with P. jirovecii detected by qPCR in respiratory samples (bronchoalveolar lavage (BAL), sputum and oral wash) collected between 2017 and 2023 were retrospectively enrolled in the study. Patients were classified as having PCP or P. jirovecii colonisation and Cq values were compared between the groups. Receiver-operating characteristics (ROC) curve analyses were used to assess the performance of Cq values to distinguish between PCP and colonisation, and to establish Cq cut-off values for the different sample types.
resultOf 520 included participants, 247 patients (47.5%) were classified as PCP and 273 (52.5%) as colonised. The median Cq value was significantly lower in the PCP group compared to colonised patients in BAL (33.0 vs. 36.6, p < 0.001) and sputum (33.4 vs. 36.0, p < 0.0001), yielding a ROC area under the curve of 0.75 and 0.73, respectively. Cq levels for oral wash did not differ between PCP and colonisation and lacked discriminatory power with a ROC AUC of 0.45. A Cq cut-off level at 31 for BAL and sputum could predict PCP with a positive predictive value of > 85% while Cq < 38 provided a negative predictive value of 89% for BAL and 73% for sputum.
conclusionDifferent Cq cut-off values in BAL and sputum may support discrimination between PCP and colonisation and assist physicians in their clinical management of PCP.
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