Format

Send to

Choose Destination
J Mycol Med. 2019 Jun;29(2):107-111. doi: 10.1016/j.mycmed.2019.04.001. Epub 2019 Apr 30.

Detection of Pneumocystis jirovecii by quantitative real-time PCR in oral rinses from Pneumocystis pneumonia asymptomatic human immunodeficiency virus patients.

Author information

1
The University of Manchester, Faculty of Biology, Medicine and Health, M1 7DN, Manchester, United Kingdom. Electronic address: marcin.fraczek@manchester.ac.uk.
2
Department of Sexual Medicine and HIV, Manchester University NHS Foundation Trust, Manchester, United Kingdom.
3
The University of Manchester, Faculty of Biology, Medicine and Health, M1 7DN, Manchester, United Kingdom; Mycology Reference Centre Manchester, Manchester University NHS Foundation Trust, M23 9LT, United Kingdom.
4
Department of Infectious Diseases and the National Aspergillosis Centre, Manchester University NHS Foundation Trust, Manchester, M23 9LT, United Kingdom.
5
The University of Manchester, Faculty of Biology, Medicine and Health, M1 7DN, Manchester, United Kingdom.
6
The University of Manchester, Faculty of Biology, Medicine and Health, M1 7DN, Manchester, United Kingdom; Department of Infectious Diseases and the National Aspergillosis Centre, Manchester University NHS Foundation Trust, Manchester, M23 9LT, United Kingdom.
7
The University of Manchester, Faculty of Biology, Medicine and Health, M1 7DN, Manchester, United Kingdom; Department of Infectious Diseases and the National Aspergillosis Centre, Manchester University NHS Foundation Trust, Manchester, M23 9LT, United Kingdom; Mycology Reference Centre Manchester, Manchester University NHS Foundation Trust, M23 9LT, United Kingdom.

Abstract

Pneumocystis pneumonia (PCP) is a potentially life-threatening fungal infection usually seen in immunocompromised patients. Pneumocystis jirovecii can be easily detected from oral rinse samples in HIV patients with suspected PCP. In this study, a quantitative real-time PCR assay was used to establish the frequency of detection of P. jirovecii in oral rinses from HIV patients without respiratory symptoms or suspicion of PCP. Two saline oral rinses were collected from 100 ambulant HIV patients and from 60 COPD patients (comparator group). Four HIV patients were positive for P. jirovecii. In three patients, the first sample was positive and in one the second one was positive. One of these patients was on PCP prophylaxis and had a CD4+ count of 76 cells/mm3. The mean CD4+ count for all patients was 527 cells/mm3. All qRT-PCR test results for the COPD patients were negative. No patient developed PCP at six months follow-up. The qRT-PCR assay can be used to detect P. jirovecii DNA in oral rinse samples from HIV patients without evident clinical symptoms, however the oral carriage of this fungus was rare in our cohort of patients. In conclusion, although rare, a positive oral rinse P. jirovecii result may reflect colonisation, in particular in patients with HIV. This needs to be kept in mind when using oral rinses and qRT-PCR in the diagnosis of P. jirovecii infection.

KEYWORDS:

HIV; Oral rinse; PCP; Pneumocystis jirovecii; qRT-PCR

PMID:
31047784
DOI:
10.1016/j.mycmed.2019.04.001
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center