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Performance of a Real Time PCR for Pneumocystis jirovecii Identification in Induced Sputum of AIDS Patients: Differentiation between Pneumonia and Colonization

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Autor(es):
Chagas, Oscar Jose ; Nagatomo, Priscila Paiva ; Pereira-Chioccola, Vera Lucia ; Gava, Ricardo ; Buccheri, Renata ; Barbaro Del Negro, Gilda Maria ; Benard, Gil
Número total de Autores: 7
Tipo de documento: Artigo Científico
Fonte: JOURNAL OF FUNGI; v. 8, n. 3, p. 14-pg., 2022-03-01.
Resumo

Pneumocystis jirovecii pneumonia (PcP) remains an important cause of morbimortality worldwide and a diagnostic challenge. Conventional methods have low accuracy, hardly discriminating colonization from infection, while some new high-cost or broncho-alveolar lavage-based methods have limited usefulness in developing countries. Quantitative PCR (qPCR) tests may overcome these limitations due to their high accuracy, possibility of automation, and decreasing cost. We evaluated an in-house qPCR targeting the fungus mtSSU gene using induced sputum. Sensitivity of the assay (ten target gene copies/assay) was determined using recombinant plasmids. We prospectively studied 86 AIDS patients with subacute respiratory symptoms in whom PcP was suspected. qPCR results were determined as quantification cycles (Cq) and compared with a qualitative PCR performed in the same IS, serum 1,3-beta-D-Glucan assay, and a clinical/laboratory/radiology index for PcP. The qPCR clustered the patients in three groups: 32 with Cq <= 31 (qPCR+), 45 with Cq >= 33 (qPCR-), and nine with Cq between 31-33 (intermediary), which, combined with the other three analyses, enabled us to classify the groups as having PcP, not P. jirovecii-infected, and P. jirovecii-colonized, respectively. This molecular assay may contribute to improve PcP management, avoiding unnecessary treatments, and our knowledge of the natural history of this infection. (AU)

Processo FAPESP: 17/00231-3 - Diagnóstico precoce de candidemia em pacientes críticos: análise comparativa entre os métodos de PCR em tempo real, MALDI-TOF e detecção de 1,3-beta-D-glucana
Beneficiário:Gilda Maria Barbaro Del Negro
Modalidade de apoio: Auxílio à Pesquisa - Regular