Use of calcofluor-blue brightener for the diagnosis of Pneumocystis jirovecii pneumonia in bronchial-alveolar lavage fluids: A single-center prospective study.

Autor:	Desoubeaux G; CHU de Tours, Service de Parasitologie - Mycologie - Médecine tropicale, Tours - France.; Université François-Rabelais, CEPR - INSERM U1100 / Équipe 3, Faculté de Médecine, Tours - France., Franck-Martel C; CHU de Tours, Service de Parasitologie - Mycologie - Médecine tropicale, Tours - France., Caille A; CHU de Tours, CIC - INSERM 1415, Faculté de Médecine, Tours - France.; Université François-Rabelais, PRES Centre-Val de Loire, Tours - France., Drillaud N; CHU de Tours, Service de Parasitologie - Mycologie - Médecine tropicale, Tours - France., Lestrade Carluer de Kyvon MA; CHU de Tours, Service de Parasitologie - Mycologie - Médecine tropicale, Tours - France.; Université François-Rabelais, CEPR - INSERM U1100 / Équipe 3, Faculté de Médecine, Tours - France., Bailly É; CHU de Tours, Service de Parasitologie - Mycologie - Médecine tropicale, Tours - France., Chandenier J; CHU de Tours, Service de Parasitologie - Mycologie - Médecine tropicale, Tours - France.; Université François-Rabelais, CEPR - INSERM U1100 / Équipe 3, Faculté de Médecine, Tours - France.
Jazyk:	angličtina
Zdroj:	Medical mycology [Med Mycol] 2017 Apr 01; Vol. 55 (3), pp. 295-301.
DOI:	10.1093/mmy/myw068
Abstrakt:	The biological diagnosis of Pneumocystis jirovecii pneumonia (PjP) is based on the investigation of respiratory fluids by conventional staining methods and/or molecular biology. Diagnostic performance of an in-house technique based on calcofluor-blue brightener for the direct detection of P. jirovecii cysts was prospectively assessed in bronchial-alveolar lavage fluids (BALF) from patients with a suspected PjP infection over a three-year period in a single center: the diagnostic yield was compared to that of a commercial kit based on monoclonal immunofluorescence assay (IFA) on replicate smears. May-Grünwald Giemsa (MGG) staining and quantitative Polymerase Chain Reaction (qPCR) were also performed. The gold standard for each patient was the definitive diagnosis of PjP infection by an independent committee based on clinical, radiological, and biological data. Overall, 481 BALF were assessed: 42 were found to be positive for the detection of P. jirovecii by at least one laboratory technique, but only 35 were actually judged to be in agreement with the definitive diagnosis of PjP infection. The sensitivity of the calcofluor-blue brightener technique was 74.3% vs. 60.0%, 34.6%, and 82.9% for IFA, MGG, and qPCR, respectively; and its specificity was 99.6% vs. 99.3%, 100.0%, and 99.4% for IFA, MGG, and qPCR. No technique was shown to be statistically superior to calcofluor-blue brightener. Further validation of the test through multicenter studies is now required, but in light of its low cost and easy preparation, the use of calcofluor-blue brightener in BALF appears to be a valuable alternative method for the routine first-line diagnosis of PjP infection. (© The Author 2016. Published by Oxford University Press on behalf of The International Society for Human and Animal Mycology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
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