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ß-D-glucan and S-adenosylmethionine serum levels for the diagnosis of Pneumocystis pneumonia in HIV-negative patients: a prospective study.
de Boer, Mark G J; Gelinck, Luc B S; van Zelst, Bertrand D; van de Sande, Wendy W J; Willems, Luuk N A; van Dissel, Jaap T; de Jonge, Robert; Kroon, Frank P.
Afiliação
  • de Boer MG; Department of Infectious Diseases (C5P), Leiden University Medical Center, Leiden, The Netherlands. M.G.J.de_Boer@lumc.nl
J Infect ; 62(1): 93-100, 2011 Jan.
Article em En | MEDLINE | ID: mdl-20970450
OBJECTIVE: To prospectively assess the diagnostic utility of S-adenosylmethionine (AdoMet) and (1→3)-ß-D-glucan (ß-D-glucan) serum markers for Pneumocystis pneumonia (PCP) in HIV-negative patients. METHODS: HIV-negative, immunocompromised patients suspected of PCP based on clinical presentation and chest imaging were included. PCP was confirmed or rejected by results of direct microscopy and/or real-time PCR on broncho-alveolar lavage (BAL) fluid. Measurement of serum ß-D-glucan and AdoMet was performed on serum samples collected at enrollment and during follow-up. Both serum ß-D-glucan and AdoMet were assessed for diagnostic accuracy and correlation with clinical and laboratory parameters. RESULTS: In 31 patients enrolled (21 PCP-positive, 10 PCP-negative), AdoMet levels did not discriminate between patients with and without PCP. Elevated serum ß-D-glucan was a reliable indicator for PCP with a sensitivity of 0.90 and specificity of 0.89 at the 60 pg/ml cut-off. In PCP-positive patients ß-D-glucan serum levels decreased during treatment and inversely correlated with Pneumocystis PCR cycle threshold values in BAL fluid. CONCLUSIONS: The level of ß-D-glucan--but not AdoMet--was diagnostic for PCP within the clinical context and may serve as marker for pulmonary fungal load and treatment monitoring.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Pneumonia por Pneumocystis / S-Adenosilmetionina / Beta-Glucanas Tipo de estudo: Diagnostic_studies / Observational_studies Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Infect Ano de publicação: 2011 Tipo de documento: Article País de afiliação: Holanda

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Pneumonia por Pneumocystis / S-Adenosilmetionina / Beta-Glucanas Tipo de estudo: Diagnostic_studies / Observational_studies Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Infect Ano de publicação: 2011 Tipo de documento: Article País de afiliação: Holanda