Diagnosis of Pneumocystis jirovecii Pneumonia: Role of β-D-Glucan Detection and PCR

被引：3
作者：
Alanio A. [1 ,2 ,3 ]
Bretagne S. [1 ,2 ,3 ]
机构：
[1] Laboratoire de Parasitologie-Mycologie, Hôpital Saint-Louis, Groupe Hospitalier Lariboisière Saint Louis Fernand Widal, Paris
[2] Université Paris Diderot, Sorbonne Paris Cité, Paris
[3] CNRS URA3012, Unité de Mycologie Moléculaire, Centre National de Référence Mycoses Invasives, Institut Pasteur, 25 rue du Dr Roux, Paris Cedex 15
来源：
Current Fungal Infection Reports | 2014年 / 8卷 / 4期
关键词：
Beta-D-glucan; Bronchoalveolar lavage; Carriage; Induced sputum; PCR; Pneumocystis jirovecii; Pneumocystis pneumonia; Pneumocystosis; Quantitative PCR; Real-time PCR; Serum; Threshold;
D O I：
10.1007/s12281-014-0198-6
中图分类号：
学科分类号：
摘要：
Pneumocystis jirovecii pneumonia (PCP) is a life-threatening fungal infection in HIV-infected and non-HIV immunocompromised patients. Diagnosis usually relies on the observation of the fungal forms (acsi or trophic) in lower respiratory specimens (bronchoalveolar lavage or induced sputum). Fungal load is lower in non-HIV immunocompromised patients, making microscopical diagnosis strenuous. Biomarkers such as P. jirovecii DNA detection by PCR and β-D-glucan (BDG) detection were developed in the 1990s to circumvent microscopic examination lacking sensitivity when fungal load is low. These biomarkers have high negative predictive value, resulting in exclusion of PCP when negative. Positive BDG results would urge for the detection of other fungal infection, especially in non-HIV immunocompromised patients. For diagnostic use, quantitative PCR (qPCR) is the gold standard, and positive PCR results must be interpreted quantitatively. No consensus has been reached on defined thresholds. Combined strategies using qPCR in respiratory samples and BDG detection or qPCR in serum appear promising. © 2014, Springer Science+Business Media New York.
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页码：322 / 330
页数：8
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