Detection of Pneumocystis carinii and characterization of mutations associated with sulfa resistance in bronchoalveolar lavage samples from human immunodeficiency virus-infected subjects

Anna Zingale, Paola Carrera, Adriano Lazzarin, Paolo Scarpellini

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Abstract

One hundred ninety-four bronchoalveolar specimens were evaluated by microscopic examination and by amplification of a sequence of a Pneumocystis carinii dihidropteroate synthase gene for identification of mutations linked to sulfa resistance. PCR sensitivity and specificity were 100 and 86.7%, respectively, compared to results of microscopic examination. However, 7 out of 19 microscopy-negative, PCR-positive samples were collected from subjects with a clinically high probability of P. carinii pneumonia, suggesting that PCR may be more sensitive than microscopic examination, although the absolute performance of PCR cannot be determined. Mutations were identified in 28 out of 70 (40%) PCR-positive specimens and were significantly more common in patients exposed to sulfa drugs (21 out of 29 [72.4%]) than in those not exposed to sulfa drugs (4 out of 35 [11.4%]).

Original languageEnglish
Pages (from-to)2709-2712
Number of pages4
JournalJournal of Clinical Microbiology
Volume41
Issue number6
Publication statusPublished - Jun 1 2003

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Pneumocystis carinii
Bronchoalveolar Lavage
HIV
Polymerase Chain Reaction
Mutation
Pneumocystis Pneumonia
Pharmaceutical Preparations
Microscopy
Sensitivity and Specificity
Genes

ASJC Scopus subject areas

  • Microbiology
  • Microbiology (medical)

Cite this

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abstract = "One hundred ninety-four bronchoalveolar specimens were evaluated by microscopic examination and by amplification of a sequence of a Pneumocystis carinii dihidropteroate synthase gene for identification of mutations linked to sulfa resistance. PCR sensitivity and specificity were 100 and 86.7{\%}, respectively, compared to results of microscopic examination. However, 7 out of 19 microscopy-negative, PCR-positive samples were collected from subjects with a clinically high probability of P. carinii pneumonia, suggesting that PCR may be more sensitive than microscopic examination, although the absolute performance of PCR cannot be determined. Mutations were identified in 28 out of 70 (40{\%}) PCR-positive specimens and were significantly more common in patients exposed to sulfa drugs (21 out of 29 [72.4{\%}]) than in those not exposed to sulfa drugs (4 out of 35 [11.4{\%}]).",
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