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首页> 外文期刊>The American Journal of the Medical Sciences >Polymerase chain reaction-based detection of Pneumocystis jirovecii in bronchoalveolar lavage fluid for the diagnosis of pneumocystis pneumonia.
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Polymerase chain reaction-based detection of Pneumocystis jirovecii in bronchoalveolar lavage fluid for the diagnosis of pneumocystis pneumonia.

机译：基于聚合酶链反应的支气管肺泡灌洗液中的纳氏肺孢子虫检测可用于诊断肺囊虫性肺炎。

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INTRODUCTION: The diagnosis of pneumocystis pneumonia (PCP) in non-human immunodeficiency virus (HIV)-infected immunocompromised patients is notoriously difficult. The recent advent of polymerase chain reaction (PCR)-based detection systems, based on the identification of single fungal genes, has markedly improved diagnostic accuracy in this ominous disease. In an attempt to further improve diagnostic yield, the authors used a PCR-based detection system for Pneumocystis jirovecii, based on targeting 3 distinct genes. METHODS: During the 4-year period (January 2005 to January 2009), all consecutive immunocompromised patients suspected of having PCP in the differential diagnosis underwent bronchoscopy with bronchoalveolar lavage sampling for the evaluation of the etiology of pulmonary infiltrates. Bronchoalveolar fluid was tested for the presence of a wide variety of possible etiological microorganisms. RESULTS: In a cohort of 214 immunocompromised patients (of which 198 were non-HIV immunocompromised patients) who underwent bronchoscopy with bronchoalveolar lavage for evaluation of pulmonary infiltrates, PCR correctly diagnosed PCP in 75% (42/56) compared with 14% (8/56) diagnosed by traditional stains, and increased diagnostic yield 5.4-fold. CONCLUSIONS: Given the absence of a sensitive gold standard, this study demonstrates the usefulness of a multigene PCR-based detection of Pneumocystis jirovecii DNA for supporting the clinical diagnosis of PCP, with high sensitivity and negative predictive value rates compared with direct stains, especially in non-HIV immunocompromised patients.
机译：简介：众所周知，非人免疫缺陷病毒（HIV）感染的免疫功能低下患者的肺囊虫性肺炎（PCP）诊断非常困难。基于单一真菌基因的鉴定，基于聚合酶链反应（PCR）的检测系统的最新出现显着提高了这种不祥疾病的诊断准确性。为了进一步提高诊断率，作者针对靶向3个不同的基因使用了基于PCR的肺炎双胞菌检测系统。方法：在4年期间（2005年1月至2009年1月），所有在鉴别诊断中怀疑患有PCP的连续免疫受损患者均接受了支气管镜和支气管肺泡灌洗，以评估肺部浸润的病因。测试了支气管肺泡液中各种可能的病原微生物的存在。结果：在214例免疫功能低下患者（其中198例非HIV免疫低下患者）接受支气管镜和支气管肺泡灌洗以评估肺部浸润的研究中，PCR正确诊断PCP的比例为75％（42/56），而14％（8） / 56）通过传统污渍进行诊断，并且诊断产率提高了5.4倍。结论：由于缺乏灵敏的金标准，这项研究证明了基于多基因PCR的猪肺炎双孢杆菌DNA检测对支持PCP的临床诊断的实用性，与直接染色相比具有较高的灵敏度和阴性预测价值率，特别是在非HIV免疫力低下的患者。

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