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Evaluation of quantitative FTD-Pneumocystis jirovecii kit for Pneumocystis infection diagnosis
Gautier Hoarau1, Solène Le Gal2, Patricia Zunic3
1Department of Microbiology, CHU La Reunion, St Pierre, France; UMR PIMIT « processus infectieux en milieu insulaire tropical », Inserm 1187, CNRS 9192, IRD 249, université de La Réunion, CYROI, 97490 Sainte-Clotilde, Reunion.
Abstract:
We evaluated the Fast track Diagnostics (FTD) Pneumocystis PCR kit, targeting the mitochondrial large subunit ribosomal RNA gene (mtLSU rRNA) of Pneumocystis jirovecii (P. jirovecii). A hundred and thirty-three patients were prospectively enrolled. Respiratory specimens were examined using both microscopy and the PCR assay. Twenty-six patients led to P. jirovecii detection. Fourteen patients presented with Pneumocystis pneumonia (PCP) whereas 12 patients were considered to be colonized. The median copy numbers in bronchoalveolar lavage fluid were significantly different in the PCP and colonization groups (1.35×108/ml vs. 1.45×105/ml, P < 0.0001). Lower and upper cut-off values of 3.9×105 copies/ml and 3.2×106 copies/ml allowed differentiating PCP and colonization. The FTD P. jirovecii assay was secondarily compared to an in-house reference PCR assay targeting the mtLSUrRNA gene. A concordance rate of 97.5% was observed (Cohen's kappa coefficient κ=0.935). The FTD Pneumocystis PCR kit showed good performance and represents an alternative method to diagnose P. jirovecii infections.
Insights
The Fast track Diagnostics (FTD) Pneumocystis PCR kit effectively detects Pneumocystis jirovecii (P. jirovecii) in respiratory samples. This assay shows high concordance with reference methods and can differentiate Pneumocystis pneumonia from colonization.
Area of Science:
- Medical diagnostics
- Molecular biology
- Infectious diseases
Background:
- Pneumocystis jirovecii (P. jirovecii) is an opportunistic pathogen causing Pneumocystis pneumonia (PCP).
- Accurate diagnosis of P. jirovecii infection is crucial for timely treatment.
Purpose of the Study:
- To evaluate the performance of the Fast track Diagnostics (FTD) Pneumocystis PCR kit for P. jirovecii detection.
- To compare the FTD assay with microscopy and an in-house PCR reference method.
Main Methods:
- Prospective enrollment of 133 patients with respiratory specimens.
- Analysis using microscopy and the FTD Pneumocystis PCR assay targeting the mitochondrial large subunit ribosomal RNA gene (mtLSU rRNA).
- Comparison of FTD assay results with an in-house PCR reference assay.
Main Results:
- P. jirovecii was detected in 26 patients; 14 had PCP and 12 were colonized.
- Significantly different median P. jirovecii copy numbers were observed between PCP and colonization groups.
- The FTD assay demonstrated a 97.5% concordance rate (κ=0.935) with the in-house PCR assay.
Conclusions:
- The FTD Pneumocystis PCR kit is a reliable and accurate diagnostic tool for P. jirovecii.
- The assay effectively differentiates between P. jirovecii pneumonia and colonization based on fungal load.
- FTD Pneumocystis PCR kit offers a valuable alternative for diagnosing P. jirovecii infections.
