Chest
Original ResearchRespiratory InfectionPolymerase Chain Reaction for Diagnosing Pneumocystis Pneumonia in Non-HIV Immunocompromised Patients With Pulmonary Infiltrates
Section snippets
Materials and Methods
This study was approved by the ethics committee of the Pitié-Salpêtrière Teaching Hospital in Paris, France. All consecutive HIV-uninfected immunocompromised patients admitted between January 2002 and October 2005 to the ICU or pulmonology department with pulmonary infiltrates and respiratory failure were included prospectively. All patients had undergone HIV testing that was negative. Patients were admitted to the ICU if their Pao2 on room air was < 60 mm Hg or they required invasive or
Results
From January 2002 to October 2005, 448 immunocompromised patients without AIDS underwent respiratory specimen collection to evaluate pulmonary infiltrates. BAL fluid was obtained in 351 patients and IS in 97 patients (Fig 1). As shown in Table 1, at the time the pulmonary infiltrates developed, 296 (66%) patients were receiving treatment for hematologic malignancies, 72 (16.1%) were bone marrow or stem cell transplant recipients (47 autologous and 25 allogeneic), 44 (9.8%) were receiving
Discussion
Although efforts to understand the life cycle of P jiroveci have been stymied by the lack of culture methods, important insights into the biology of the organism have been obtained, and knowledge of its genomic organization has improved.1, 16 These advances allowed the development of a PCR assay for P jiroveci DNA. In this study, we evaluated the effectiveness of the PCR assay for diagnosing PCP in a large cohort of HIV-uninfected patients with pulmonary infiltrates. Compared to IFA,
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Sources of support: This study was supported by a grant from the Assistance-Publique Hôpitaux de Paris (AOM 04139), a nonprofit institution.
The authors declare no conflict of interest.
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).