Pneumocystis PCR: It Is Time to Make PCR the Test of Choice

Open Forum Infectious Diseases
Laura DoyleG W Procop

Abstract

The testing strategy for Pneumocystis at the Cleveland Clinic changed from toluidine blue staining to polymerase chain reaction (PCR). We studied the differences in positivity rates for these assays and compared each with the detection of Pneumocystis in companion specimens by cytology and surgical pathology. We reviewed the results of all Pneumocystis test orders 1 year before and 1 year after the implementation of a Pneumocystis-specific PCR. We also reviewed the corresponding cytology and surgical pathology results, if performed. Finally, we reviewed the medical records of patients with rare Pneumocystis detected by PCR in an effort to differentiate colonization vs true disease. Toluidine blue staining and surgical pathology had similar sensitivities and negative predictive values, both of which were superior to cytology. There was a >4-fold increase in the annual detection of Pneumocystis by PCR compared with toluidine blue staining (toluidine blue staining: 11/1583 [0.69%] vs PCR: 44/1457 [3.0%]; chi-square P < .001). PCR detected 1 more case than surgical pathology and was far more sensitive than cytology. Chart review demonstrated that the vast majority of patients with rare Pneumocystis detected were immunosuppressed, h...Continue Reading

References

May 1, 1979·AJR. American Journal of Roentgenology·P DeeK McKee
Oct 1, 1970·Archives of Disease in Childhood·A E Claireaux
Jul 10, 2004·Journal of Clinical Microbiology·G W ProcopM P Weinstein
Apr 13, 2007·Digestive Diseases and Sciences·Nirmal Kaur, Thomas C Mahl
Oct 16, 2010·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·A AlanioJ Menotti
May 11, 2012·Transplant Infectious Disease : an Official Journal of the Transplantation Society·E H Z WangE D Greanya
Oct 30, 2012·Methods in Molecular Biology·Judith Fillaux, Antoine Berry
Aug 31, 2013·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·M MailletP Pavese
Jul 11, 2014·Journal of Clinical Microbiology·Florence Robert-GangneuxJean-Pierre Gangneux
Oct 11, 2016·Canadian Respiratory Journal : Journal of the Canadian Thoracic Society·Maria L Calero-BernalEva M Carmona

Citations

May 16, 2019·Der Internist·F HitzenbichlerB Salzberger
Jan 1, 2018·Current Fungal Infection Reports·Spinello AntinoriCarlo Parravicini
Jan 9, 2021·BMC Infectious Diseases·Mohammad Y AlshahraniMohamed E Hamid

Related Concepts

Cytology
Surgical Pathology Specialty
Polymerase Chain Reaction
Tolonium chloride
Histiocytic Sarcoma
Diagnostic Procedure
Clinic
Staining Method
Pneumocystis Jiroveci Pneumonia

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Alzheimer's Disease: MS4A

Variants within the membrane-spanning 4-domains subfamily A (MS4A) gene cluster have recently been implicated in Alzheimer's disease in genome-wide association studies. Here is the latest research on Alzheimer's disease and MS4A.

Pediculosis pubis

Pediculosis pubis is a disease caused by a parasitic insect known as Pthirus pubis, which infests human pubic hair, as well as other areas with hair including eye lashes. Here is the latest research.

Rh Isoimmunization

Rh isoimmunization is a potentially preventable condition that occasionally is associated with significant perinatal morbidity or mortality. Discover the latest research on Rh Isoimmunization here.

Genetic Screens in iPSC-derived Brain Cells

Genetic screening is a critical tool that can be employed to define and understand gene function and interaction. This feed focuses on genetic screens conducted using induced pluripotent stem cell (iPSC)-derived brain cells. It also follows CRISPR-Cas9 approaches to generating genetic mutants as a means of understanding the effect of genetics on phenotype.

Enzyme Evolution

This feed focuses on molecular models of enzyme evolution and new approaches (such as adaptive laboratory evolution) to metabolic engineering of microorganisms. Here is the latest research.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Pharmacology of Proteinopathies

This feed focuses on the pharmacology of proteinopathies - diseases in which proteins abnormally aggregate (i.e. Alzheimer’s, Parkinson’s, etc.). Discover the latest research in this field with this feed.

Alignment-free Sequence Analysis Tools

Alignment-free sequence analyses have been applied to problems ranging from whole-genome phylogeny to the classification of protein families, identification of horizontally transferred genes, and detection of recombined sequences. Here is the latest research.