Pnemocystis jiroveci pneumonia: Comparison between conventional PCR and staining techniques

• Published in: Pathologie biologie (Paris) Vol. 57; no. 5; pp. 373 - 377
• Main Authors: Kaouech, E, Kallel, K, Anane, S, Belhadj, S, Abdellatif, S, Mnif, K, Ben Othmane, T, Ben Lakhal, S, Kilani, B, Ben Châabane, T, Chaker, E
• Format: Journal Article
• Language: French
• Published: France 01.07.2009
• Subjects: Adolescent; Adult; AIDS-Related Opportunistic Infections - diagnosis; AIDS-Related Opportunistic Infections - diagnostic imaging; AIDS-Related Opportunistic Infections - microbiology; Bronchoalveolar Lavage Fluid - microbiology; Coloring Agents; DNA, Fungal - analysis; Eosine Yellowish-(YS); False Positive Reactions; Female; Hematologic Neoplasms - complications; Humans; Immunocompromised Host; Immunologic Deficiency Syndromes - complications; Infant; Male; Methenamine; Methylene Blue; Middle Aged; Pneumocystis carinii - isolation & purification; Pneumonia, Pneumocystis - diagnosis; Pneumonia, Pneumocystis - diagnostic imaging; Pneumonia, Pneumocystis - microbiology; Polymerase Chain Reaction; Radiography; Staining and Labeling - methods; Tolonium Chloride; Young Adult
• ISSN: 1768-3114
• DOI: 10.1016/j.patbio.2008.09.013

Diagnosis of pneumocystis pneumonia is usually based on clinical features and X-rays photography and confirmed in the laboratory by visualisation of Pneumocystis organisms in stained preparations of respiratory specimens using several techniques (Gomori-Grocott, May-Grünwald Giemsa, bleu de toluidine O). Actually, PCR has considerably increased sensitivity of detection of Pneumocystis. The aim of this study is to compare conventional PCR results to those of staining techniques (Gomori-Grocott, May-Grünwald Giemsa) in addition to the X-ray and clinical findings in order to evaluate the contribution of each method. Sixty-four respiratory specimens were collected from 54 immuno-compromised patients with clinical symptoms of pulmonary infection. We diagnosed pneumocystis pneumonia in 16 patients according to staining techniques and/or typical clinical and radiological findings and/or response to treatment. Of the 15 patients, 14 were positive by PCR and only five were positive by direct examination, yielding a sensitivity and specificity of 93.3 and 87.1% for PCR and 33.3 and 100% for staining techniques. Conventional PCR provides a sensitive and objective method for the detection Pneumocystis jiroveci from less invasive sample.