Hoarau Gautier, Le Gal Solène, Zunic Patricia, Poubeau Patrice, Antok Emmanuel, Jaubert Julien, Nevez Gilles, Picot Sandrine
Department of Microbiology, CHU La Reunion, St Pierre, France; UMR PIMIT « processus infectieux en milieu insulaire tropical », Inserm 1187, CNRS 9192, IRD 249, université de La Réunion, CYROI, 97490 Sainte-Clotilde, Reunion.
University of Brest, GEIHP EA, 3142, Brest, France.
Diagn Microbiol Infect Dis. 2017 Nov;89(3):212-217. doi: 10.1016/j.diagmicrobio.2017.08.001. Epub 2017 Aug 9.
We evaluated the Fast track Diagnostics (FTD) Pneumocystis PCR kit, targeting the mitochondrial large subunit ribosomal RNA gene (mtLSU rRNA) of Pneumocystis jirovecii (P. jirovecii). A hundred and thirty-three patients were prospectively enrolled. Respiratory specimens were examined using both microscopy and the PCR assay. Twenty-six patients led to P. jirovecii detection. Fourteen patients presented with Pneumocystis pneumonia (PCP) whereas 12 patients were considered to be colonized. The median copy numbers in bronchoalveolar lavage fluid were significantly different in the PCP and colonization groups (1.35×10/ml vs. 1.45×10/ml, P < 0.0001). Lower and upper cut-off values of 3.9×10 copies/ml and 3.2×10 copies/ml allowed differentiating PCP and colonization. The FTD P. jirovecii assay was secondarily compared to an in-house reference PCR assay targeting the mtLSUrRNA gene. A concordance rate of 97.5% was observed (Cohen's kappa coefficient κ=0.935). The FTD Pneumocystis PCR kit showed good performance and represents an alternative method to diagnose P. jirovecii infections.
我们评估了Fast track Diagnostics(FTD)肺孢子菌PCR试剂盒,该试剂盒针对耶氏肺孢子菌(P. jirovecii)的线粒体大核糖体RNA基因(mtLSU rRNA)。前瞻性纳入了133例患者。使用显微镜检查和PCR检测对呼吸道标本进行检测。26例患者检测出耶氏肺孢子菌。14例患者患有肺孢子菌肺炎(PCP),而12例患者被认为是定植。支气管肺泡灌洗液中的中位拷贝数在PCP组和定植组中有显著差异(1.35×10/ml对1.45×10/ml,P < 0.0001)。3.9×10拷贝/ml和3.2×10拷贝/ml的下限和上限临界值可区分PCP和定植。其次,将FTD耶氏肺孢子菌检测与针对mtLSUrRNA基因的内部参考PCR检测进行比较。观察到一致性率为97.5%(Cohen卡方系数κ = 0.935)。FTD肺孢子菌PCR试剂盒表现出良好的性能,是诊断耶氏肺孢子菌感染的一种替代方法。