Evaluation of the performance of DiaSorin molecular Pneumocystis jirovecii-CMV multiplex real-time PCR assay from bronchoalveolar lavage samples

• Published in: Journal de mycologie médicale Vol. 30; no. 2; p. 100936
• Main Authors: Kilic, A., Elliott, S., Hester, L., Palavecino, E.
• Format: Journal Article
• Language: English
• Published: France Elsevier Masson SAS 01.06.2020
• Subjects: Bronchoalveolar Lavage; Bronchoalveolar Lavage Fluid - chemistry; Bronchoalveolar Lavage Fluid - microbiology; Bronchoalveolar Lavage Fluid - virology; Case-Control Studies; CMV; Cytomegalovirus - genetics; Cytomegalovirus Infections - diagnosis; Cytomegalovirus Infections - virology; Diagnosis, Differential; DiaSorin Molecular PJ-CMV assay; Humans; Immunocompromised Host; Molecular Diagnostic Techniques - methods; Multiplex Polymerase Chain Reaction - methods; Mycological Typing Techniques - methods; Pneumocystis carinii - genetics; Pneumocystis jirovecii; pneumonia; Pneumonia - diagnosis; Pneumonia - microbiology; Pneumonia - pathology; Pneumonia - virology; Pneumonia, Pneumocystis - diagnosis; Pneumonia, Pneumocystis - microbiology; real-time PCR; Real-Time Polymerase Chain Reaction - methods; Sensitivity and Specificity; Virology - methods; DiaSorin Molecular PJ-CMV assay; real-time PCR; pneumonia; CMV; Pneumocystis jirovecii
• ISSN: 1156-5233; 1773-0449
• DOI: 10.1016/j.mycmed.2020.100936

The aim of this study was to evaluate the performance of the DiaSorin Molecular PJ-CMV multiplex real-time PCR (PJ-CMV PCR) assay (DiaSorin Molecular LLC, USA) in bronchoalveolar lavage (BAL) samples compared to direct immunofluorescence assay (IFA) for the detection of Pneumocystis jirovecii and assess CMV and P. jirovecii co-infection rate in immunosuppressed patients with suspected pneumonia. A total of 125 BAL samples from immunosuppressed patients submitted for PJP-IFA were tested. Surplus samples were saved and further tested by using the PJ-CMV PCR assay. Among the 125 samples, P. jirovecii was detected in 31.2% (39/125) and in 40% (50/125) of the specimens using IFA and PJ-CMV PCR respectively. Eleven of the PJ-CMV PCR positive samples were negative by direct IFA for P. jirovecii. All samples positive by direct IFA were also positive by PJ-CMV PCR. Using the direct IFA as a gold standard, the PJ-CMV PCR sensitivity, specificity, positive predictive value and negative predictive value for detection of P. jirovecii were 100%, 87.2%, 78% and 100%, respectively. However, after reviewing the clinical diagnosis, the specificity and PPV increased to 100%. Of the 50 P. jirovecii samples positive by PJ-CMV PCR, 18 (36%) were also positive for CMV by the PJ-CMV PCR. The co-infection rate was found to be 37.5% (6/16) and 35.2% (12/34) in HIV infected and non-HIV infected patients. This study indicated that the DiaSorin Molecular PJ-CMV multiplex real-time PCR assay has higher sensitivity than direct IFA for detection of P. jirovecii and provides rapid detection of PJ and CMV infection in BAL samples.