Jiancheng Wang, Minjun Huang, Yi-jun An, Lan Sun, Zengzhu Guo, Jianrong Su, Xixiong Kang
Beijing Tropical Medicine Research Institute, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
Diagn Microbiol Infect Dis. 2009 Aug;64(4):396-401. doi: 10.1016/j.diagmicrobio.2009.04.009.
We evaluated the clinical value of polymerase chain reaction (PCR) for screening Pneumocystis carinii pneumonia (PCP) in non-HIV-infected immunocompromised patients. We retrospectively analyzed PCR and Grocott's methenamine silver (GMS) staining on 1044 clinical specimens obtained from 756 patients. Positive rates of PCR and GMS staining in sputum specimens were 21.1% and 9.5%, respectively (P < 0.01), and in bronchoalveolar lavage (BAL), specimens were 31.9% and 25.5%, respectively. Among 5 patient groups, the highest GMS staining and PCR positive rates were observed in immunosuppressed patients. In 28 GMS staining-positive patients, positive rates of PCR and GMS staining after a short anti-PCP treatment were 39.3% and 17.9%, respectively. In 5 patients with positive PCR but negative GMS staining results in initial sputum examination, GMS staining result turned positive in subsequent BAL specimens. In conclusion, PCR is sensitive for detection of Pneumocystis in sputum specimens and is useful for screening PCP in non-HIV-infected high-risk patients.
我们评估了聚合酶链反应（PCR）在筛查非HIV感染的免疫功能低下患者卡氏肺孢子虫肺炎（PCP）中的临床价值。我们回顾性分析了从756例患者获取的1044份临床标本的PCR及格罗科特六胺银（GMS）染色结果。痰标本中PCR和GMS染色的阳性率分别为21.1%和9.5%（P<0.01），支气管肺泡灌洗（BAL）标本中分别为31.9%和25.5%。在5个患者组中，免疫抑制患者的GMS染色和PCR阳性率最高。在28例GMS染色阳性患者中，短程抗PCP治疗后PCR和GMS染色的阳性率分别为39.3%和17.9%。在5例初始痰检PCR阳性但GMS染色阴性的患者中，后续BAL标本的GMS染色结果转为阳性。总之，PCR对痰标本中肺孢子虫的检测敏感，有助于筛查非HIV感染的高危患者中的PCP。
