Important note: Information in this article was accurate in 1994. The state of the art may have changed since the publication date.
Pneumocystis carinii pneumonia (PCP) diagnosis and follow-up by polymerase chain reaction (PCR) in bronchoalveolar lavage (BAL) of immunocompromised patients.
Abstr Gen Meet Am Soc Microbiol. 1994;94:588 (abstract no. C-548). Unique Identifier : AIDSLINE ASM94/94313112 Moonens F; Liesnard C; Van Vooren JP; Struelens M; Erasme Hospital, Universite libre de Bruxelles, Belgium.
Abstract:
Several PCR protocols have been developed for the diagnosis of PCP. The aims of this study were to evaluate the sensitivity and specificity of simple and nested PCR compared with direct examination on cytospin slides after Giemsa and immunofluorescent staining, and to estimate the duration of post-PCP carriage by nested PCR of successive BAL of convalescent patients. Eighty nine BAL were carried out for diagnostic or graft follow-up purpose in 14 HIV and 29 organ transplant patients. Simple PCR (pAZ102-E and pAZ102-H primers) was performed on 13 BAL collected from 12 patients with clinical PCP, and 76 BAL from 40 patients without current PCP. Nested PCR (internal primers chosen in the amplified sequence) was done on 41 BAL: 2 from patients with current PCP, 14 from patients who had had PCP within the 2 months, 6 from patients with long term PCP antecedents and 19 without PCP antecedents. Direct examination was positive in all cases of current PCP. Simple PCR was positive in all patients with current PCP as well as in one case of ancient PCP and in one case of cytomegalovirus pneumonia. Nested PCR was positive in the 2 cases of current PCP, in 5/14 BAL of patients with recent PCP, in 3 BAL of one patient with ancient PCP and current cytomegalovirus pneumonia, and in 3/19 BAL from patients without PCP antecedents. Nested PCR could not detect P. carinii longer than 5 weeks after initiation of treatment, except in one patient who was still symptomatic. Simple PCR was as sensitive as direct examination for the diagnosis of PCP. Nested PCR was less specific and should probably not be used as a diagnostic test. However, its high sensitivity could be useful in the follow-up of PCP patients, as there seemed to be no long term carriage in BAL detected by this method.
Keywords: *Bronchoalveolar Lavage Fluid Cytomegalovirus Infections/DIAGNOSIS/ETIOLOGY Fluorescent Antibody Technique Human HIV Infections/*COMPLICATIONS Pneumonia, Pneumocystis carinii/*DIAGNOSIS/ETIOLOGY Polymerase Chain Reaction/*METHODS Postoperative Complications/DIAGNOSIS Transplantation ABSTRACT 941030
M94A0842
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Important note: Information in this article was accurate in 1994. The state of the art may have changed since the publication date.
