Journal Article

Molecular diagnosis of Pneumocystis pneumonia

Isabelle Durand-Joly, Magali Chabé, Fabienne Soula, Laurence Delhaes, Daniel Camus and Eduardo Dei-Cas

in FEMS Immunology & Medical Microbiology

Volume 45, issue 3, pages 405-410
Published in print September 2005 | ISSN: 0928-8244
Published online January 2006 | e-ISSN: 1574-695X | DOI: https://dx.doi.org/10.1016/j.femsim.2005.06.006
Molecular diagnosis of Pneumocystis pneumonia

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Abstract

The detection of Pneumocystis DNA in clinical specimens by using PCR assays is leading to important advances in Pneumocystis pneumonia (PcP) clinical diagnosis, therapy and epidemiology. Highly sensitive and specific PCR tools improved the clinical diagnosis of PcP allowing an accurate, early diagnosis of Pneumocystis infection, which should lead to a decreased duration from onset of symptoms to treatment, a period with recognized impact on prognosis. This aspect has marked importance in HIV-negative immunocompromised patients, who develop often PcP with lower parasite rates than AIDS patients. The specific amplification of selected polymorphous sequences of Pneumocystis jirovecii genome, especially of internal transcribed spacer regions of the nuclear rRNA operon, has led to the identification of specific parasite genotypes which might be associated with PcP severity. Moreover, multi-locus genotyping revealed to be a useful tool to explore person-to-person transmission. Furthermore, PCR was recently used for detecting P. jirovecii dihydropteroate synthase gene mutations, which are apparently associated with sulfa drug resistance. PCR assays detected Pneumocystis-DNA in bronchoalveolar lavage fluid or biopsy specimens, but also in oropharyngeal washings obtained by rinsing of the mouth. This non-invasive procedure may reach 90%-sensitivity and has been used for monitoring the response to treatment in AIDS patients and for typing Pneumocystis isolates.

Keywords: Pneumocystosis diagnosis; Pneumocystis pneumonia; Pneumocystis jirovecii; PCR; mtLSUrRNA; ITS; DHPS; SSCP; PcP epidemiology

Journal Article.  3750 words. 

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