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Monoclonal antibody to Pneumocystis carinii. Comparison with silver stain in bronchial lavage specimens
K S Homer1, E L Wiley, A L Smith
1Department of Pathology, Parkland Memorial Hospital, University of Texas Southwestern Medical Center, Dallas 75235-9072.
Abstract:
Monoclonal 3F6 anti-Pneumocystis carinii antibody (MAB-3F6) was used to stain cell blocks from 164 bronchial lavage specimens from patients with the acquired immune deficiency syndrome (AIDS) and AIDS-related complex and compared with slides stained with Grocott's modification of the Gomori methenamine silver stain. Pneumocystis organisms were present in 83 of 164 cases using MAB-3F6 stain, whereas Grocott's modified silver stain demonstrated Pneumocystis organisms in 48. MAB-3F6 demonstrated Pneumocystis organisms in 38 cases with negative silver stains, whereas silver stain identified Pneumocystis organisms in only three MAB-3F6-negative cases. Of 70 patients with clinical Pneumocystis pneumonia at the time of the specimen was obtained, 59 had MAB-3F6-positive specimens, whereas 39 had organisms detected using Grocott's modified silver stain. Of 37 patients without clinically apparent Pneumocystis pneumonia any time in their course, 4 had abundant organisms and 33 had negative stains with MAB-3F6. MAB-3F6 detected Pneumocystis organisms in 22 of 31 cases of Pneumocystis pneumonia that had no organisms identified using Grocott's silver stain (X2 = 5.76, P = 0.016). MAB-3F6 immunochemical staining is a more sensitive method than Grocott's modified silver stain to detect Pneumocystis organisms.
Insights
Monoclonal 3F6 anti-Pneumocystis carinii antibody (MAB-3F6) staining is more sensitive for detecting Pneumocystis organisms in AIDS patients than traditional silver stains. This immunochemical method offers improved diagnostic accuracy for Pneumocystis pneumonia.
Area of Science:
- Medical Microbiology
- Immunology
- Infectious Diseases
Background:
- Pneumocystis pneumonia (PCP) is a significant opportunistic infection in individuals with Acquired Immune Deficiency Syndrome (AIDS).
- Accurate and sensitive diagnostic methods are crucial for timely treatment of PCP.
- Grocott's modified silver stain is a conventional method for detecting Pneumocystis organisms, but its sensitivity can be limited.
Purpose of the Study:
- To evaluate the diagnostic sensitivity of a monoclonal antibody stain (MAB-3F6) compared to Grocott's modified silver stain for detecting Pneumocystis carinii in bronchial lavage specimens.
- To assess the utility of MAB-3F6 in diagnosing Pneumocystis pneumonia in an immunocompromised patient population.
Main Methods:
- A retrospective study involving 164 bronchial lavage specimens from patients with AIDS or AIDS-related complex.
- Specimens were stained using both MAB-3F6 and Grocott's modified silver stain.
- Comparison of organism detection rates between the two staining methods.
Main Results:
- MAB-3F6 detected Pneumocystis organisms in 83 of 164 cases, significantly more than the 48 cases identified by silver stain.
- MAB-3F6 identified organisms in 38 cases where silver stain was negative, while silver stain found organisms in only three MAB-3F6-negative cases.
- In patients with clinical Pneumocystis pneumonia, MAB-3F6 had a higher detection rate (59/70) compared to silver stain (39/70).
- MAB-3F6 detected Pneumocystis in 22 of 31 cases that were negative by silver stain (P = 0.016).
Conclusions:
- Monoclonal 3F6 anti-Pneumocystis carinii antibody (MAB-3F6) staining is a more sensitive diagnostic method for detecting Pneumocystis organisms than Grocott's modified silver stain.
- MAB-3F6 offers improved sensitivity for diagnosing Pneumocystis pneumonia, particularly in immunocompromised patients.
- This immunochemical staining technique enhances the detection of Pneumocystis in clinical specimens.