Molecular diagnosis of Pneumocystis pneumonia in immunocompromised patients

Abstract : Purpose of review: Pneumocystis pneumonia (PCP) is a frequent opportunistic infection associated with a high mortality rate. PCP is of increasing importance in non-HIV immunocompromised patients, who present with severe respiratory distress with low fungal loads. Molecular detection of Pneumocystis in broncho-alveolar lavage (BAL) has become an important diagnostic tool, but quantitative PCR (qPCR) needs standardization. Recent findings: Despite a high negative predictive value, the positive predictive value of qPCR is moderate, as it also detects colonized patients. Attempts are made to set a cut-off value of qPCR to discriminate between PCP and colonization, or to use noninvasive samples or combined strategies to increase specificity. Summary: It is easy to set a qPCR cut-off for HIV-infected patients. In non-HIV IC patients, a gain in specificity could be obtained by combining strategies, that is, qPCR on BAL and a noninvasive sample, or qPCR and serum beta-1,3-D-glucan dosage.
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Submitted on : Thursday, September 12, 2019 - 3:50:01 PM
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Hélène Guegan, Florence Robert-Gangneux. Molecular diagnosis of Pneumocystis pneumonia in immunocompromised patients. Current Opinion in Infectious Diseases, Lippincott, Williams & Wilkins, 2019, 32 (4), pp.314-321. ⟨10.1097/QCO.0000000000000559⟩. ⟨hal-02153616⟩

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