Adachi N
First Department of Internal Medicine, Osaka City University Medical School, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1994 May;32(5):433-40.
We evaluated the utility of the polymerase chain reaction (PCR) method in detecting Pneumocystis carinii (PC) and cytomegalovirus (CMV) in bronchoalveolar lavage (BAL) specimens from patients suspected of having opportunistic infection of the lung. We evaluated BAL samples obtained from 41 immunosuppressed patients who had signs and symptoms of acute lower respiratory tract infection. In addition, we studied 16 immunocompetent patients. PC-DNA was detected in 19 cases and CMV-DNA was detected in three cases, in the immunosuppressed group. The diagnosis could not be established by conventional techniques in nine of these positive cases. PC-DNA was detected in all cases in which PC organisms had been demonstrated by silver or Giemsa staining. Neither PC nor CMV-DNA was detected in immunocompetent patients. We conclude that the PCR assay has greater sensitivity for the detection of PC and CMV-DNA in BAL specimens than conventional approaches and therefore enhances our diagnostic capability for PC and CMV pneumonia.
我们评估了聚合酶链反应(PCR)方法在检测疑似肺部机会性感染患者支气管肺泡灌洗(BAL)标本中卡氏肺孢子虫(PC)和巨细胞病毒(CMV)的效用。我们评估了41例有急性下呼吸道感染体征和症状的免疫抑制患者的BAL样本。此外,我们研究了16例免疫功能正常的患者。在免疫抑制组中,19例检测到PC-DNA,3例检测到CMV-DNA。在这些阳性病例中有9例无法通过传统技术确诊。在所有经银染或吉姆萨染色证实有PC病原体的病例中均检测到PC-DNA。免疫功能正常的患者中未检测到PC和CMV-DNA。我们得出结论,PCR检测法在检测BAL标本中的PC和CMV-DNA方面比传统方法具有更高的灵敏度,因此提高了我们对PC和CMV肺炎的诊断能力。