Year: 2015
Type: article
Study design: Observational Study
Abstract: Pneumocystis jirovecii is a symbiotic respiratory fungus that presents in 2 clinical forms: pneumonia in immunocompromised patients or colonization, defined by the presence of the organism without associated clinical symptoms. Currently, diagnosis requires invasive bronchoscopy, which may not be available in some settings and is inappropriate for detecting colonization in healthy individuals. Noninvasive diagnostic techniques and molecular strain typing tools that can be used on these samples are critical for conducting studies to better understand transmission. We evaluated 2 real-time polymerase chain reaction (PCR) assays targeting dihydropteroate synthase and the major surface glycoprotein for detection in 77 oropharyngeal washes (OPWs) from 43 symptomatic human immunodeficiency virus-infected patients who underwent bronchoscopy. We also evaluated the ability of a new microsatellite (MS) genotyping panel to strain type infections from these samples. Each PCR used individually provided a high sensitivity (>80%) for detection of pneumonia but a modest specificity (<70%). When used in combination, specificity was increased to 100% with a drop in sensitivity (74%). Concentration of organisms by PCR in the OPW tended to be lower in colonized individuals compared with those with pneumonia, but differences in concentration could not clearly define colonization in symptomatic individuals. Oropharyngeal wash samples were genotyped using 6 MSs with ≥4 alleles successfully genotyped in the majority of colonized patients and ≥5 alleles in patients with pneumonia. The MS profile was consistent over time within patients with serial OPWs analyzed. Microsatellite genotyping on noninvasive samples may aid in studying the molecular epidemiology of this pathogen without requiring invasive diagnostic techniques.
Source: Open Forum Infectious Diseases
DOI: 10.1093/ofid/ofv080
Authors: Jonathan J. Juliano, Eric Barnett, Christian M. Parobek, Steve M. Taylor, Steven R. Meshnick, Stephen Stone, Emily Chang, Serena Fong, Laurence Huang
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $4,053
Funders: Infectious Diseases Society of America, Georgia Clinical and Translational Science Alliance, National Institutes of Health, Center for AIDS Research, University of Washington, University of North Carolina at Chapel Hill, National Heart, Lung, and Blood Institute, National Institute of General Medical Sciences, National Institute of Allergy and Infectious Diseases, National Center for Advancing Translational Sciences
Awards: G1241812954, Patient-Oriented Research and Mentoring in HIV-associated Pulmonary Diseases, G1429886331, G1468449596, G1939027404, G1951574862, G2029515989, G2127051194, G2230551448, G312351181, G366390703, NRSA in Genetics, G4914173380, G6103388094, G6163189475, G6401929829, G654751394, G7224923192, G8541996175, G9000020834, G9000022244, G9000033749, G9000036922, G9000075494, G9000264444, G9000337013
OpenAlex ID: W1850807102