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A prospective, blinded study of quantitative touch-down polymerase chain reaction using oral-wash samples for diagnosis of Pneumocystis pneumonia in HIV-infected patients.

The Journal of Infectious Diseases

AIDS-Related Opportunistic Infections, diagnosis, microbiology, DNA, Fungal, analysis, HIV Infections, complications, Humans, Mouth, Pneumocystis, genetics, isolation & purification, Pneumonia, Pneumocystis, Polymerase Chain Reaction, methods, Prospective Studies, Reproducibility of Results, Sensitivity and Specificity, Single-Blind Method, Therapeutic Irrigation

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      Abstract

      Oral-wash samples obtained during 113 episodes of suspected Pneumocystis pneumonia (PCP) in human immunodeficiency virus-infected patients were tested by use of a quantitative touch-down PCR (QTD PCR) assay. QTD PCR had a sensitivity of 88% and a specificity of 85%. Treatment for PCP prior to oral wash collection had an impact on the sensitivity, and PCR-positive oral-wash samples obtained within < or =1 day of treatment from patients without PCP had significantly fewer copies per tube than did those from patients with PCP; thus, application of a post hoc cut-off value of 50 copies/tube increased the specificity to 100%. QTD PCR of oral-wash samples can be an accurate and noninvasive method for diagnosis of PCP.

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      Journal
      15116305
      10.1086/383322

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