(1-3)-Beta-D-glucan in association with lactate dehydrogenase as biomarkers of Pneumocystis pneumonia (PcP) in HIV-infected patients

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Abstract

Pneumocystis pneumonia (PcP) is a major HIV-related illness caused by Pneumocystis jirovecii. Definitive diagnosis of PcP requires microscopic detection of P. jirovecii in pulmonary specimens. The objective of this study was to evaluate the usefulness of two serum markers in the diagnosis of PcP. Serum levels of (1-3)-beta-d-glucan (BG) and lactate dehydrogenase (LDH) were investigated in 100 HIV-positive adult patients and 50 healthy blood donors. PcP cases were confirmed using indirect immunofluorescence with monoclonal anti-Pneumocystis antibodies and nested-PCR to amplify the large subunit mitochondrial rRNA gene of P. jirovecii in pulmonary specimens. BG and LDH levels in serum were measured using quantitative microplate-based assays. BG and LDH positive sera were statistically associated with PcP cases (P a parts per thousand currency signaEuro parts per thousand 0.001). Sensitivity, specificity, positive/negative predictive values (PPV/NPV), and positive/negative likelihood ratios (PLR/NLR) were 91.3 \%, 61.3 \%, 85.1 \%, 79.2 \%, 2.359, and 0.142, respectively, for the BG kit assay, and 91.3 \%, 35.5 \%, 75.9 \%, 64.7 \%, 1.415 and 0.245, respectively, for the LDH test. Serologic markers levels combined with the clinical diagnostic criteria for PcP were evaluated for their usefulness in diagnosis of PcP. The most promising cutoff levels for diagnosis of PcP were determined to be 400 pg/ml of BG and 350 U/l of LDH, which combined with clinical data presented 92.8 \% sensitivity, 83.9 \% specificity, 92.8 \% PPV, 83.9 \% NPV, 5.764 PLR and 0.086 NLR (P < 0.001). This study confirmed that BG is a reliable indicator for detecting P. jirovecii infection. The combination between BG/LDH levels and clinical data is a promising alternative approach for PcP diagnosis.
Original languageUnknown
Pages (from-to)1173-1180
JournalEuropean Journal of Clinical Microbiology and Infectious Diseases
Volume33
Issue number7
DOIs
Publication statusPublished - 1 Jan 2014

Keywords

    Cite this

    @article{83d2016445224a50bfd10aac49daea7e,
    title = "(1-3)-Beta-D-glucan in association with lactate dehydrogenase as biomarkers of Pneumocystis pneumonia (PcP) in HIV-infected patients",
    abstract = "Pneumocystis pneumonia (PcP) is a major HIV-related illness caused by Pneumocystis jirovecii. Definitive diagnosis of PcP requires microscopic detection of P. jirovecii in pulmonary specimens. The objective of this study was to evaluate the usefulness of two serum markers in the diagnosis of PcP. Serum levels of (1-3)-beta-d-glucan (BG) and lactate dehydrogenase (LDH) were investigated in 100 HIV-positive adult patients and 50 healthy blood donors. PcP cases were confirmed using indirect immunofluorescence with monoclonal anti-Pneumocystis antibodies and nested-PCR to amplify the large subunit mitochondrial rRNA gene of P. jirovecii in pulmonary specimens. BG and LDH levels in serum were measured using quantitative microplate-based assays. BG and LDH positive sera were statistically associated with PcP cases (P a parts per thousand currency signaEuro parts per thousand 0.001). Sensitivity, specificity, positive/negative predictive values (PPV/NPV), and positive/negative likelihood ratios (PLR/NLR) were 91.3 \{\%}, 61.3 \{\%}, 85.1 \{\%}, 79.2 \{\%}, 2.359, and 0.142, respectively, for the BG kit assay, and 91.3 \{\%}, 35.5 \{\%}, 75.9 \{\%}, 64.7 \{\%}, 1.415 and 0.245, respectively, for the LDH test. Serologic markers levels combined with the clinical diagnostic criteria for PcP were evaluated for their usefulness in diagnosis of PcP. The most promising cutoff levels for diagnosis of PcP were determined to be 400 pg/ml of BG and 350 U/l of LDH, which combined with clinical data presented 92.8 \{\%} sensitivity, 83.9 \{\%} specificity, 92.8 \{\%} PPV, 83.9 \{\%} NPV, 5.764 PLR and 0.086 NLR (P < 0.001). This study confirmed that BG is a reliable indicator for detecting P. jirovecii infection. The combination between BG/LDH levels and clinical data is a promising alternative approach for PcP diagnosis.",
    keywords = "SERUM, COLONIZATION, IMMUNOCOMPROMISED PATIENTS, CLINICAL UTILITY, INVASIVE FUNGAL-INFECTIONS, BRONCHOALVEOLAR LAVAGE SPECIMENS, CARINII-PNEUMONIA, BETA-D-GLUCAN, JIROVECII PNEUMONIA, DIAGNOSIS",
    author = "J.F. Gaspar and O Matos",
    note = "PMID:24487911 WOS:000336986700015",
    year = "2014",
    month = "1",
    day = "1",
    doi = "10.1007/s10096-014-2054-6",
    language = "Unknown",
    volume = "33",
    pages = "1173--1180",
    journal = "European Journal of Clinical Microbiology and Infectious Diseases",
    issn = "0934-9723",
    publisher = "Springer Science Business Media",
    number = "7",

    }

    TY - JOUR

    T1 - (1-3)-Beta-D-glucan in association with lactate dehydrogenase as biomarkers of Pneumocystis pneumonia (PcP) in HIV-infected patients

    AU - Gaspar, J.F.

    AU - Matos, O

    N1 - PMID:24487911 WOS:000336986700015

    PY - 2014/1/1

    Y1 - 2014/1/1

    N2 - Pneumocystis pneumonia (PcP) is a major HIV-related illness caused by Pneumocystis jirovecii. Definitive diagnosis of PcP requires microscopic detection of P. jirovecii in pulmonary specimens. The objective of this study was to evaluate the usefulness of two serum markers in the diagnosis of PcP. Serum levels of (1-3)-beta-d-glucan (BG) and lactate dehydrogenase (LDH) were investigated in 100 HIV-positive adult patients and 50 healthy blood donors. PcP cases were confirmed using indirect immunofluorescence with monoclonal anti-Pneumocystis antibodies and nested-PCR to amplify the large subunit mitochondrial rRNA gene of P. jirovecii in pulmonary specimens. BG and LDH levels in serum were measured using quantitative microplate-based assays. BG and LDH positive sera were statistically associated with PcP cases (P a parts per thousand currency signaEuro parts per thousand 0.001). Sensitivity, specificity, positive/negative predictive values (PPV/NPV), and positive/negative likelihood ratios (PLR/NLR) were 91.3 \%, 61.3 \%, 85.1 \%, 79.2 \%, 2.359, and 0.142, respectively, for the BG kit assay, and 91.3 \%, 35.5 \%, 75.9 \%, 64.7 \%, 1.415 and 0.245, respectively, for the LDH test. Serologic markers levels combined with the clinical diagnostic criteria for PcP were evaluated for their usefulness in diagnosis of PcP. The most promising cutoff levels for diagnosis of PcP were determined to be 400 pg/ml of BG and 350 U/l of LDH, which combined with clinical data presented 92.8 \% sensitivity, 83.9 \% specificity, 92.8 \% PPV, 83.9 \% NPV, 5.764 PLR and 0.086 NLR (P < 0.001). This study confirmed that BG is a reliable indicator for detecting P. jirovecii infection. The combination between BG/LDH levels and clinical data is a promising alternative approach for PcP diagnosis.

    AB - Pneumocystis pneumonia (PcP) is a major HIV-related illness caused by Pneumocystis jirovecii. Definitive diagnosis of PcP requires microscopic detection of P. jirovecii in pulmonary specimens. The objective of this study was to evaluate the usefulness of two serum markers in the diagnosis of PcP. Serum levels of (1-3)-beta-d-glucan (BG) and lactate dehydrogenase (LDH) were investigated in 100 HIV-positive adult patients and 50 healthy blood donors. PcP cases were confirmed using indirect immunofluorescence with monoclonal anti-Pneumocystis antibodies and nested-PCR to amplify the large subunit mitochondrial rRNA gene of P. jirovecii in pulmonary specimens. BG and LDH levels in serum were measured using quantitative microplate-based assays. BG and LDH positive sera were statistically associated with PcP cases (P a parts per thousand currency signaEuro parts per thousand 0.001). Sensitivity, specificity, positive/negative predictive values (PPV/NPV), and positive/negative likelihood ratios (PLR/NLR) were 91.3 \%, 61.3 \%, 85.1 \%, 79.2 \%, 2.359, and 0.142, respectively, for the BG kit assay, and 91.3 \%, 35.5 \%, 75.9 \%, 64.7 \%, 1.415 and 0.245, respectively, for the LDH test. Serologic markers levels combined with the clinical diagnostic criteria for PcP were evaluated for their usefulness in diagnosis of PcP. The most promising cutoff levels for diagnosis of PcP were determined to be 400 pg/ml of BG and 350 U/l of LDH, which combined with clinical data presented 92.8 \% sensitivity, 83.9 \% specificity, 92.8 \% PPV, 83.9 \% NPV, 5.764 PLR and 0.086 NLR (P < 0.001). This study confirmed that BG is a reliable indicator for detecting P. jirovecii infection. The combination between BG/LDH levels and clinical data is a promising alternative approach for PcP diagnosis.

    KW - SERUM

    KW - COLONIZATION

    KW - IMMUNOCOMPROMISED PATIENTS

    KW - CLINICAL UTILITY

    KW - INVASIVE FUNGAL-INFECTIONS

    KW - BRONCHOALVEOLAR LAVAGE SPECIMENS

    KW - CARINII-PNEUMONIA

    KW - BETA-D-GLUCAN

    KW - JIROVECII PNEUMONIA

    KW - DIAGNOSIS

    U2 - 10.1007/s10096-014-2054-6

    DO - 10.1007/s10096-014-2054-6

    M3 - Article

    VL - 33

    SP - 1173

    EP - 1180

    JO - European Journal of Clinical Microbiology and Infectious Diseases

    JF - European Journal of Clinical Microbiology and Infectious Diseases

    SN - 0934-9723

    IS - 7

    ER -