Diagnostic accuracy of the 1,3-beta-d-glucan test and lactate dehydrogenase for pneumocystis pneumonia in non-HIV patients

Abstract We evaluated the serum levels of (1–3)-beta-d-glucan (BG) and lactate dehydrogenase (LDH) as a tool to support pneumocystis pneumonia (PCP) diagnostic procedures in non-HIV patients. We retrospectively collected non-HIV (human immunodeficiency virus) patients presenting clinical features of...

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Autores principales: Ruixue Sun, Dan Lv, Meng Xiao, Li Zhang, Jun Xu, Xuezhong Yu, Huadong Zhu, Jing Yang
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Publicado: Nature Portfolio 2021
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spelling oai:doaj.org-article:777b17ba158c44d5bc6489da78d8c9442021-12-02T13:41:34ZDiagnostic accuracy of the 1,3-beta-d-glucan test and lactate dehydrogenase for pneumocystis pneumonia in non-HIV patients10.1038/s41598-021-88729-z2045-2322https://doaj.org/article/777b17ba158c44d5bc6489da78d8c9442021-04-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-88729-zhttps://doaj.org/toc/2045-2322Abstract We evaluated the serum levels of (1–3)-beta-d-glucan (BG) and lactate dehydrogenase (LDH) as a tool to support pneumocystis pneumonia (PCP) diagnostic procedures in non-HIV patients. We retrospectively collected non-HIV (human immunodeficiency virus) patients presenting clinical features of PCP between April 1st, 2013, and December 31st, 2018. A total of 225 included patients were tested for Pneumocystis jirovecii by polymerase chain reaction (PCR) and methenamine silver staining. Based on different exclusion criteria, 179 cases were included in the BG group, and 196 cases were included in the LDH group. In each group, cases with positive immunofluorescence (IF) microscopy and PCR were considered proven PCP, while cases with only positive PCR were considered probable PCP. Fifty patients with negative IF and PCR results and proven to be non-PCP infection were chosen randomly as the control group. The cut-off levels of BG and LDH to distinguish non-PCP from probable PCP were 110 pg/mL and 296 U/L with 88% sensitivity and 86% specificity, and 66% sensitivity and 88% specificity, respectively. The cut-off levels of BG and LDH to distinguish non-PCP from proven PCP were 285.8 pg/mL and 379 U/L with 92% sensitivity and 96% specificity, and 85% sensitivity and 77% specificity, respectively. The cut-off levels of BG and LDH to distinguish non-PCP from proven/probable PCP were 144.1 pg/mL and 363 U/L with 90% sensitivity, 86% specificity and 80% sensitivity, 76% specificity respectively. BG and LDH are reliable indicators for detecting P. jirovecii infection in HIV-uninfected immunocompromised patients.Ruixue SunDan LvMeng XiaoLi ZhangJun XuXuezhong YuHuadong ZhuJing YangNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-10 (2021)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Ruixue Sun
Dan Lv
Meng Xiao
Li Zhang
Jun Xu
Xuezhong Yu
Huadong Zhu
Jing Yang
Diagnostic accuracy of the 1,3-beta-d-glucan test and lactate dehydrogenase for pneumocystis pneumonia in non-HIV patients
description Abstract We evaluated the serum levels of (1–3)-beta-d-glucan (BG) and lactate dehydrogenase (LDH) as a tool to support pneumocystis pneumonia (PCP) diagnostic procedures in non-HIV patients. We retrospectively collected non-HIV (human immunodeficiency virus) patients presenting clinical features of PCP between April 1st, 2013, and December 31st, 2018. A total of 225 included patients were tested for Pneumocystis jirovecii by polymerase chain reaction (PCR) and methenamine silver staining. Based on different exclusion criteria, 179 cases were included in the BG group, and 196 cases were included in the LDH group. In each group, cases with positive immunofluorescence (IF) microscopy and PCR were considered proven PCP, while cases with only positive PCR were considered probable PCP. Fifty patients with negative IF and PCR results and proven to be non-PCP infection were chosen randomly as the control group. The cut-off levels of BG and LDH to distinguish non-PCP from probable PCP were 110 pg/mL and 296 U/L with 88% sensitivity and 86% specificity, and 66% sensitivity and 88% specificity, respectively. The cut-off levels of BG and LDH to distinguish non-PCP from proven PCP were 285.8 pg/mL and 379 U/L with 92% sensitivity and 96% specificity, and 85% sensitivity and 77% specificity, respectively. The cut-off levels of BG and LDH to distinguish non-PCP from proven/probable PCP were 144.1 pg/mL and 363 U/L with 90% sensitivity, 86% specificity and 80% sensitivity, 76% specificity respectively. BG and LDH are reliable indicators for detecting P. jirovecii infection in HIV-uninfected immunocompromised patients.
format article
author Ruixue Sun
Dan Lv
Meng Xiao
Li Zhang
Jun Xu
Xuezhong Yu
Huadong Zhu
Jing Yang
author_facet Ruixue Sun
Dan Lv
Meng Xiao
Li Zhang
Jun Xu
Xuezhong Yu
Huadong Zhu
Jing Yang
author_sort Ruixue Sun
title Diagnostic accuracy of the 1,3-beta-d-glucan test and lactate dehydrogenase for pneumocystis pneumonia in non-HIV patients
title_short Diagnostic accuracy of the 1,3-beta-d-glucan test and lactate dehydrogenase for pneumocystis pneumonia in non-HIV patients
title_full Diagnostic accuracy of the 1,3-beta-d-glucan test and lactate dehydrogenase for pneumocystis pneumonia in non-HIV patients
title_fullStr Diagnostic accuracy of the 1,3-beta-d-glucan test and lactate dehydrogenase for pneumocystis pneumonia in non-HIV patients
title_full_unstemmed Diagnostic accuracy of the 1,3-beta-d-glucan test and lactate dehydrogenase for pneumocystis pneumonia in non-HIV patients
title_sort diagnostic accuracy of the 1,3-beta-d-glucan test and lactate dehydrogenase for pneumocystis pneumonia in non-hiv patients
publisher Nature Portfolio
publishDate 2021
url https://doaj.org/article/777b17ba158c44d5bc6489da78d8c944
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