Comparison of DNA amplification and immunofluorescence for detecting Pneumocystis carinii in patients receiving immunosuppressive therapy

Transplantation. 1992 Sep;54(3):468-70. doi: 10.1097/00007890-199209000-00016.

Abstract

Two studies were performed to compare the sensitivity of DNA amplification with immunofluorescence for the detection of Pneumocystis carinii in asymptomatic normal and immunosuppressed subjects receiving no anti-Pneumocystis chemoprophylaxis. In the first study, immunofluorescence and silver stains were used to examine 12 induced sputa and 12 bronchoalveolar lavage specimens from 24 normal control subjects; induced sputa from 20 renal transplant recipients; and induced sputa from 11 patients with fibrosing alveolitis. All specimens were negative for P carinii using both stains, apart from one renal patient in whom 2 P carinii cysts were seen by immunofluorescence alone. In the second study, DNA amplification and immunofluorescence were used to examine induced sputa from 3 groups of 10 control, renal, and heart/lung transplant recipients. All 30 specimens were negative for P carinii by immunofluorescence. However, 3 renal and 2 heart/lung patients were positive for P carinii by DNA amplification alone. One of these patients developed P carinii pneumonia 6 weeks after sputum induction. DNA amplification is a more sensitive technique than immunofluorescence for detecting P carinii. P carinii colonization occurs in asymptomatic organ transplant recipients, but not in normal individuals.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Azathioprine / therapeutic use
  • Cyclosporine / therapeutic use
  • Female
  • Fluorescent Antibody Technique*
  • Gene Amplification*
  • Heart-Lung Transplantation / immunology
  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Kidney Transplantation / immunology
  • Male
  • Middle Aged
  • Pneumonia, Pneumocystis / diagnosis
  • Pneumonia, Pneumocystis / drug therapy
  • Pneumonia, Pneumocystis / genetics*
  • Prednisolone / therapeutic use
  • Radiography, Thoracic
  • Respiratory Function Tests
  • Staining and Labeling

Substances

  • Immunosuppressive Agents
  • Cyclosporine
  • Prednisolone
  • Azathioprine