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M9480833.TXT
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1994-09-05
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Document 0833
DOCN M9480833
TI Pneumocystis carinii pneumonia (PCP) diagnosis and follow-up by
polymerase chain reaction (PCR) in bronchoalveolar lavage (BAL) of
immunocompromised patients.
DT 9410
AU Moonens F; Liesnard C; Van Vooren JP; Struelens M; Erasme Hospital,
Universite libre de Bruxelles, Belgium.
SO Abstr Gen Meet Am Soc Microbiol. 1994;94:588 (abstract no. C-548).
Unique Identifier : AIDSLINE ASM94/94313112
AB 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.
DE *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 MEETING ABSTRACT
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).