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Dichtl, K; Seybold, U; Wagener, J.
Evaluation of a Turbidimetric β-d-Glucan Test for Detection of Pneumocystis jirovecii Pneumonia.
J Clin Microbiol. 2018; 56(7): Doi: 10.1128/JCM.00286-18 [OPEN ACCESS]
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Dichtl Karl

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Currently, diagnosis of Pneumocystis jirovecii pneumonia (PJP) relies on analysis of lower respiratory specimens, either by microscopy or quantitative real-time PCR (qPCR). Thus, bronchoscopy is required, which is associated with increased risk of respiratory failure. We assessed the value of noninvasive serologic β-d-glucan (BDG) testing for laboratory diagnosis of PJP using a newly available turbidimetric assay. We identified 73 cases of PJP with positive qPCR results from lower respiratory specimens for Pneumocystis and serology samples dating from 1 week before to 4 weeks after qPCR. In addition, 25 sera from controls with suspected PJP but specimens negative for Pneumocystis by qPCR were identified. Sera were tested with a turbidimetric BDG assay (Fujifilm Wako Chemicals Europe GmbH, Neuss, Germany), using an 11-pg/ml cutoff. Sensitivity and specificity were calculated based on qPCR test results as a reference. The turbidimetric BDG assay identified 63/73 patients with positive or slightly positive qPCR tests for an overall sensitivity of 86%; after exclusion of cases with only slightly positive qPCR results, sensitivity was 91%. No correlation between serum BDG levels and respiratory specimen DNA levels was found. Serologic BDG testing was negative in 25/25 controls with negative qPCR for a specificity of 100% using the predefined cutoff. In 22/25 samples (88%), no BDG was detected. Serologic BDG testing using the turbidimetric assay showed high sensitivity and specificity compared to qPCR of lower respiratory specimens for the diagnosis of PJP. Both turnover time and test performance will allow clinicians to delay or in some cases forego bronchoscopy.
Find related publications in this database (using NLM MeSH Indexing)
Diagnostic Tests, Routine - administration & dosage
Female - administration & dosage
Fungal Polysaccharides - blood
Germany - administration & dosage
Humans - administration & dosage
Immunocompromised Host - administration & dosage
Immunoturbidimetry - standards
Male - administration & dosage
Middle Aged - administration & dosage
Pneumocystis - administration & dosage
Pneumonia, Pneumocystis - blood, diagnosis
Real-Time Polymerase Chain Reaction - administration & dosage
Retrospective Studies - administration & dosage
Sensitivity and Specificity - administration & dosage
beta-Glucans - blood

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