Comparison of smear examination, serological methods, and genetic tests in patients with <i>Pneumocystis</i> pneumonia (PCP)

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  • ニューモシスチス肺炎（<i>Pneumocystis</i> pneumonia; PCP）の診断における遺伝子検査，塗抹検査，血清学的検査の比較検討

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<p>Because to date, a method to culture Pneumocystis jirovecii, the causative agent of Pneumocystis pneumonia (PCP), has not yet been developed, PCP has been conventionally diagnosed on the basis of finding of nonculture methods such as smear examination, serological methods, and genetic tests. In this study, we compared with laboratory test results obtained by the loop-mediated isothermal amplification (LAMP) assay, Diff-Quik staining, and β-D glucan examination for PCP diagnosis. In the comparison of results, concordance rates were 94.6% sensitivity and 94.7% specificity for LAMP assay, 67.6% sensitivity and 96.5% specificity for Diff-Quik staining, and 89.1% sensitivity and 86.0% specificity for β-D glucan examination. When the results of these 3 laboratory tests were combined and compared for PCP diagnosis, all patients who showed positive results in 2 or more of the tests were diagnosed as having PCP. Patients diagnosed as having PCP showed positive results in at least one of these tests. Although the LAMP assay showed the highest sensitivity, it was considered inappropriate to apply this test alone for PCP diagnosis because the possibility of colonization by P. jirovecii could not be denied. By combining these tests, we hope that the PCP diagnostic accuracy will be improved, and early diagnosis and therapy of the disease will be achieved.</p>

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