Document 0833
 DOCN  M9480833
 TI    Pneumocystis carinii pneumonia (PCP) diagnosis and follow-up by
       polymerase chain reaction (PCR) in bronchoalveolar lavage (BAL) of
       immunocompromised patients.
 DT    9410
 AU    Moonens F; Liesnard C; Van Vooren JP; Struelens M; Erasme Hospital,
       Universite libre de Bruxelles, Belgium.
 SO    Abstr Gen Meet Am Soc Microbiol. 1994;94:588 (abstract no. C-548).
       Unique Identifier : AIDSLINE ASM94/94313112
 AB    Several PCR protocols have been developed for the diagnosis of PCP. The
       aims of this study were to evaluate the sensitivity and specificity of
       simple and nested PCR compared with direct examination on cytospin
       slides after Giemsa and immunofluorescent staining, and to estimate the
       duration of post-PCP carriage by nested PCR of successive BAL of
       convalescent patients. Eighty nine BAL were carried out for diagnostic
       or graft follow-up purpose in 14 HIV and 29 organ transplant patients.
       Simple PCR (pAZ102-E and pAZ102-H primers) was performed on 13 BAL
       collected from 12 patients with clinical PCP, and 76 BAL from 40
       patients without current PCP. Nested PCR (internal primers chosen in the
       amplified sequence) was done on 41 BAL: 2 from patients with current
       PCP, 14 from patients who had had PCP within the 2 months, 6 from
       patients with long term PCP antecedents and 19 without PCP antecedents.
       Direct examination was positive in all cases of current PCP. Simple PCR
       was positive in all patients with current PCP as well as in one case of
       ancient PCP and in one case of cytomegalovirus pneumonia. Nested PCR was
       positive in the 2 cases of current PCP, in 5/14 BAL of patients with
       recent PCP, in 3 BAL of one patient with ancient PCP and current
       cytomegalovirus pneumonia, and in 3/19 BAL from patients without PCP
       antecedents. Nested PCR could not detect P. carinii longer than 5 weeks
       after initiation of treatment, except in one patient who was still
       symptomatic. Simple PCR was as sensitive as direct examination for the
       diagnosis of PCP. Nested PCR was less specific and should probably not
       be used as a diagnostic test. However, its high sensitivity could be
       useful in the follow-up of PCP patients, as there seemed to be no long
       term carriage in BAL detected by this method.
 DE    *Bronchoalveolar Lavage Fluid  Cytomegalovirus
       Infections/DIAGNOSIS/ETIOLOGY  Fluorescent Antibody Technique  Human
       HIV Infections/*COMPLICATIONS  Pneumonia, Pneumocystis
       carinii/*DIAGNOSIS/ETIOLOGY  Polymerase Chain Reaction/*METHODS
       Postoperative Complications/DIAGNOSIS  Transplantation  MEETING ABSTRACT

       SOURCE: National Library of Medicine.  NOTICE: This material may be
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