Journal of Fungi (Dec 2020)

Variable Correlation between Bronchoalveolar Lavage Fluid Fungal Load and Serum-(1,3)-β-<span style="font-variant: small-caps">d</span>-Glucan in Patients with Pneumocystosis—A Multicenter ECMM Excellence Center Study

  • Toine Mercier,
  • Nesrine Aissaoui,
  • Maud Gits-Muselli,
  • Samia Hamane,
  • Juergen Prattes,
  • Harald H. Kessler,
  • Ivana Mareković,
  • Sanja Pleško,
  • Jörg Steinmann,
  • Ulrike Scharmann,
  • Johan Maertens,
  • Katrien Lagrou,
  • Blandine Denis,
  • Stéphane Bretagne,
  • Alexandre Alanio

DOI
https://doi.org/10.3390/jof6040327
Journal volume & issue
Vol. 6, no. 4
p. 327

Abstract

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Pneumocystis jirovecii pneumonia is a difficult invasive infection to diagnose. Apart from microscopy of respiratory specimens, two diagnostic tests are increasingly used including real-time quantitative PCR (qPCR) of respiratory specimens, mainly in bronchoalveolar lavage fluids (BAL), and serum β-1,3-d-glucan (BDG). It is still unclear how these two biomarkers can be used and interpreted in various patient populations. Here we analyzed retrospectively and multicentrically the correlation between BAL qPCR and serum BDG in various patient population, including mainly non-HIV patients. It appeared that a good correlation can be obtained in HIV patients and solid organ transplant recipients but no correlation can be observed in patients with hematologic malignancies, solid cancer, and systemic diseases. This observation reinforces recent data suggesting that BDG is not the best marker of PCP in non-HIV patients, with potential false positives due to other IFI or bacterial infections and false-negatives due to low fungal load and low BDG release.

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