Pneumocystis Jirovecii detection and comparison of multiple diagnostic methods with quantitative real-time PCR in patients with respiratory symptoms
| Autor: | Osama M Alshehri, Mohammed Alfaifi, Irfan Ahmad, Ali G. Alkhathami, Megh Singh Dhakad, Abdulrahim R. Hakami, Mohammad Y. Alshahrani, Hafiz Imtiaz Ahmad |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
0106 biological sciences
0301 basic medicine medicine.medical_specialty Diagnostic methods Respiratory tract infection Pneumocystis Jirovecii 01 natural sciences Gastroenterology Article Giemsa stain 03 medical and health sciences Internal medicine parasitic diseases medicine Pneumocystis jirovecii In patient Respiratory system lcsh:QH301-705.5 biology medicine.diagnostic_test business.industry Incidence (epidemiology) GMSS staining biology.organism_classification respiratory tract diseases Staining PCR 030104 developmental biology Bronchoalveolar lavage lcsh:Biology (General) General Agricultural and Biological Sciences business 010606 plant biology & botany |
| Zdroj: | Saudi Journal of Biological Sciences, Vol 27, Iss 6, Pp 1423-1427 (2020) Saudi Journal of Biological Sciences |
| ISSN: | 1319-562X |
| Popis: | Pneumocystis jirovecii (PCP) remains a significant cause of mortality and morbidity in patients with respiratory infections. Accurate diagnosis of PCP is still a diagnostic challenge. Hence, the main objectives were to study the incidence of Pneumocystis Jirovecii pneumonia infection among respiratory problems patients and to compare the real-time quantitative PCR technique with various diagnostic methodologies. Patients who have respiratory symptoms of PCP like breathlessness, cough, and fever were enrolled. Bronchoalveolar lavage (BAL) samples were collected and homogenized, and then smears were prepared for examination by Gomorimethanamine silver staining (GMSS), Immunofluorescent staining (IFAT), Toludine blue O (TBO), and Giemsa staining. Further, RT-PCR was also performed for the detection of PCP. The mean patients’ age was 52 (SD ±16) years. 41% were female, and 59% of the patients were male. Weight loss (80%), fever (92%), cough (100%), and dyspnea (76%) were the most common complaints. Twenty-eight patients have been diagnosed with pulmonary infiltrates using chest X-ray. Out of 100 patients, 35% were positive for PCP. The organism was detected using IFAT in all the 35 specimens, 15 of 35 (42.86%) by GMSS, 8 of 35 (17.6%) by Giemsa stain, and 1 of 35 (2.8%) was detected by TBO stains. RT-PCR showed that 39 patients was found to be positive for PCP. Thirty-five of these 39 patients had a positive IFAT (89.74%); the IFAT was negative or undefined in 4 samples. All 39 patients (100%) had signs and symptoms for PCP. Our results suggest that RT-PCR is still the most highly sensitive method for Pneumocystis Jirovecii detection. In poor resource settings where RT-PCR and IFAT is not available, diagnosis of Pneumocystis jirovecii pneumonia remains a complicated issue. In settings where RT-PCR & IFAT are not available, GMSS staining may be the next best choice to detect PCP. |
| Databáze: | OpenAIRE |
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