Ng V L, Yajko D M, McPhaul L W, Gartner I, Byford B, Goodman C D, Nassos P S, Sanders C A, Howes E L, Leoung G
Department of Laboratory Medicine, University of California, San Francisco 94143.
J Clin Microbiol. 1990 May;28(5):975-9. doi: 10.1128/jcm.28.5.975-979.1990.
Two prospective studies were undertaken to evaluate a commercial indirect fluorescent-antibody (IFA) stain for the detection of Pneumocystis carinii in respiratory specimens from individuals at risk for or with the acquired immunodeficiency syndrome. The first study compared IFA with Diff-Quik (DQ; a rapid Giemsa-like stain) for detecting P. carinii in 95 induced sputa obtained from 77 asymptomatic patients who had survived one previous episode of P. carinii pneumonia and who were being treated prophylactically with aerosolized pentamidine. Only one induced sputum specimen was found to contain P. carinii; organisms were detected by both stains. The second study compared the performance of the IFA stain versus DQ, modified toluidine blue O, and Gomori methenamine silver stains for detecting P. carinii in symptomatic individuals at risk for or with acquired immunodeficiency syndrome. Of 182 specimens examined, P. carinii was detected in 105 by one or more stains; the DQ stain detected 73 (70%), the modified toluidine blue O stain detected 75 (71%), the Gomori methenamine silver stain detected 76 (72%), and the IFA stain detected 95 (90%). The IFA stain was more sensitive (P less than 0.01) than the other traditional stains for detecting P. carinii; however, a subsequent clinical evaluation revealed that a subset of IFA-positive-only specimens were from patients whose clinical symptoms resolved without specific anti-P. carinii therapy.
开展了两项前瞻性研究，以评估一种用于检测卡氏肺孢子虫的商用间接荧光抗体（IFA）染色法，该染色法用于检测来自有获得性免疫缺陷综合征风险或患有该综合征的个体的呼吸道标本中的卡氏肺孢子虫。第一项研究将IFA与Diff-Quik（DQ；一种类似吉姆萨的快速染色法）进行比较，以检测从77名无症状患者获得的95份诱导痰标本中的卡氏肺孢子虫，这些患者曾有过一次卡氏肺孢子虫肺炎发作且存活下来，正在接受雾化戊烷脒预防性治疗。仅发现一份诱导痰标本含有卡氏肺孢子虫；两种染色法均检测到了病原体。第二项研究比较了IFA染色法与DQ、改良甲苯胺蓝O和Gomori六胺银染色法在有获得性免疫缺陷综合征风险或患有该综合征的有症状个体中检测卡氏肺孢子虫的性能。在检查的182份标本中，通过一种或多种染色法在105份标本中检测到卡氏肺孢子虫；DQ染色法检测到73份（70%），改良甲苯胺蓝O染色法检测到75份（71%），Gomori六胺银染色法检测到76份（72%），IFA染色法检测到95份（90%）。IFA染色法在检测卡氏肺孢子虫方面比其他传统染色法更敏感（P小于0.01）；然而，随后的临床评估显示，仅IFA阳性的标本中有一部分来自临床症状自行缓解且未接受特异性抗卡氏肺孢子虫治疗的患者。
