Diagnosis of Pneumonia: Specificity and Sensitivity of Polymerase Chain Reaction in Comparison with Immunofluorescence in Bronchoalveolar Lavage Specimens Free

Abstract

Summary

DNA amplification by the polymerase chain reaction (PCR) is a promising method for the detection of in immunosuppressed patients. The sensitivity and specificity of the PCR technique has been assessed in comparison with the immunofluoresence method (IF) on bronchoalveolar lavage fluid (BALF). Results correlated in 43 (78·8%) of 52 cases studied. PCR gave positive results with BALF from all 32 patients found to have pneumonia (PCP); IF gave positive results with 26 of them. PCR was more sensitive and as specific as IF. However, at the present time, we do not believe that it is clinically useful for detection of in BALF samples. DNA amplification by PCR should be reserved for testing IF-negative BALF samples from patients judged clinically to have PCP.

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1993-06-01
2024-03-29
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References

  1. Peters BS, Beck EJ, Coleman DG et al. Changing disease patterns in patients with AIDS in a referral centre in the United Kingdom: the changing face of AIDS. BMJ 1991; 302:203–207
    [Google Scholar]
  2. Jules-Elysee KM, Stover DE, Zaman MB, Bernard EM, White DA. Aerosolized pentamidine: effect on diagnosis and presentation of Pneumocystis carinii pneumonia. Ann Intern Med 1990; 112:750–757
    [Google Scholar]
  3. Montgomery AB. Pneumocystis carinii pneumonia prophylaxis: past, present and future. AIDS 1992; 6:227–228
    [Google Scholar]
  4. Raviglione MC. Extrapulmonary pneumocystosis: the first 50 cases. Rev Infect Dis 1990; 12:1127–1138
    [Google Scholar]
  5. Sparling TG, Dong SR, Hegedus C, Burdge DR. Aerosolized pentamidine and disseminated infection with Pneumocystis carinii . Ann Intern Med 1989; 111:442
    [Google Scholar]
  6. Levine SJ, Masur H, Gill VJ et al. The effects of aerosolized pentamidine prophylaxis on the diagnosis of Pneumocystis carinii pneumonia by induced sputum examination in patients infected with the human immunodeficiency virus. Am Rev Resp Dis 1991; 144:760–764
    [Google Scholar]
  7. Wakefield AE, Pixley FJ, Banerji S et al. Detection of Pneumocystis carinii with DNA amplification. Lancet 1990; 336:451–453
    [Google Scholar]
  8. Wakefield AE, Guiver L, Miller RF, Hopkin JM. DNA amplification on induced sputum samples for diagnosis of Pneumocystis carinii pneumonia. Lancet 1991; 337:1378–1379
    [Google Scholar]
  9. Peters SE, Wakefield AE, Banerji S, Hopkin J. Quantification of the detection of Pneumocystis carinii by DNA amplification. Mol Cell Probes 1992; 6:115–117
    [Google Scholar]
  10. Klech H, Pohl W. eds Technical recommendations and guide lines for bronchoalveolar lavage (BAL): report of the European Society of Pneumology task group on BAL. Eur RespirJ 1989; 2:561–585
    [Google Scholar]
  11. Sambrook J, Fritsch EF, Maniatis T. Molecular cloning: a laboratory manual. C old Spring Harbor, NY: Cold Spring Harbor Laboratory Press; 1989
    [Google Scholar]
  12. Wakefield AE, Hopkin JM, Burns J, Hipkiss JB, Stewart TJ, Moxon ER. Cloning of DNA from Pneumocystis carinii . J Infect Dis 1988; 158:859–862
    [Google Scholar]
  13. Sinclair K, Wakefield AE, Banerji S, Hopkin J. Pneumocystis carinii organisms derived from rat and human hosts are genetically distinct. Mol Biochem Parasitol 1991; 45:183–184
    [Google Scholar]
  14. Sackett DL, Haynes RB, Guyatt GH, Tugwell P. The in terpretation of diagnostic data. In Sackett DL, Haynes RB, Guyatt GH, Tugwell P. eds Clinical epidemiology: a basic science for clinical medicine. Boston/Toronto/ London: Little, Brown and Company; 199169–152
    [Google Scholar]
  15. Daly LE, Bourke GJ, McGilvray J. Confidence intervals and hypothesis tests: two-group comparisons. In Daly LE, Bourke GJ, McGilvray J. eds Interpretation and uses of medical statistics, 4th edn. Oxford: Blackwell Scientific Publications; 1991102–138
    [Google Scholar]
  16. Antinori A, Murri R, Tamburrini E, De Luca A, Ortona L. Failure of low-dose dapsone-pyrimethamine in primary prophylaxis of Pneumocystis carinii pneumonia. Lancet 1992; 340:788
    [Google Scholar]
  17. Hopewell PC. Pneumocystis carinii pneumonia. Current con cepts. In Sande MA, Volberding PA. eds The medical management of AIDS Philadelphia, WB: Saunders Company; 1992261–283
    [Google Scholar]
  18. Lipschik GY, Gill VJ, Lundgren JD et al. Improved diagnosis of Pneumocystis carinii infection by polymerase chain reaction on induced sputum or blood. Lancet 1992; 340:203–206
    [Google Scholar]
  19. Blumenfeld W, McCook O, Holodniy M, Katzenstein DA. Correlation of morphologic diagnosis of Pneumocystis carinii with the presence of pneumocystis DNA amplified by the polymerase chain reaction. Mod Pathol 1992; 5:103–106
    [Google Scholar]
  20. Peters SE, Wakefield AE, Sinclair K, Millard PR, Hopkin J. A search for Pneumocystis carinii in post-mortem lungs by DNA amplification. J Pathol 1992; 166:195–198
    [Google Scholar]
  21. Goesch TR, Gotz G, Stellbrinck KH, Albrecht H, Weh HJ, Hossfeld DK. Possible transfer of Pneumocystis carinii between immunodeficient patients. Lancet 1990; 336:627
    [Google Scholar]
  22. Chave J-P, David S, Wauters J-P, Van Melle G, Francioli P. Transmission of Pneumocystis carinii from AIDS patients to other immunosuppressed patients: a cluster of Pneumocystis carinii pneumonia in renal transplant recipients. AIDS 1991; 5:927–932
    [Google Scholar]
  23. Jacobs JL, Libby DM, Winters RA et al. A cluster of Pneumocystis carinii pneumonia in adults without predisposing illnesses. N Engl J Med 1991; 324:246–250
    [Google Scholar]
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