Summary
Direct fluorescence monoclonal antibody stain (DFA) was compared prospectively, with calcofluor white (CFW) stain for the diagnosis ofPneumocystis carinii in 163 respiratory specimens from 97 patients. The patient population included persons with HIV infection (58%), bone marrow transplant recipients (10%), immunosuppressed patients owing to chemotherapy (21%) and others (11%). Nineteen specimens including 12 sputa, six bronchoalveolar lavage fluids (BALs) and one induced sputum were positive by DFA. In contrast, only six sputa, and five BALs were positive by CFW. All specimens positive by CFW were also positive by DFA. Of 86 sputa that were negative by either method 29 were followed by more invasive sample collections. Three specimens were followed by induced sputum collection, 18 by BAL, six by lung biopsy, and two by pleural fluid aspiration. All the subsequent induced sputa, pleural fluids, and lung biopsies were negative by both methods. However, four of 18 subsequent BALs (22%) were positive by both methods, provided at least two CFW stained slides were examined per specimen. Except for expectorated sputum, it is concluded that CFW is a rapid and inexpensive test to detectP. carinii in most respiratory specimens.
Zusammenfassung
Im prospektiven Vergleich wurde die diagnostische Aussagekraft der direkten Antikörper-Fluoreszenz-Technik und der Calcofluor-Weiß (CFW)-Färbung zum Nachweis vonPneumocystis carinii in 163 Proben aus dem unteren Respirationstrakt von 97 Patienten geprüft. Die Gruppe setzte sich aus Patienten mit HIV-Infektion (58%), Knochenmarktransplantations-Empfängern (10%), nach Chemotherapie immunsupprimierten Patienten (21%) und anderen (11%) zusammen. Mit DFA-Technik waren 19 Proben positiv; darunter waren 12 Sputumproben, sechs bronchoalveoläre Lavage (BAL)-Flüssigkeiten und ein induziertes Sputum. Mit CFW-Färbung waren sechs Sputumproben und fünf BAL-Proben positiv. Alle mit CFW positiven Proben waren auch mit DFA positiv. Eine erneute Probenahme mit invasiveren Methoden erfolgte in 29 von 86 mit beiden Nachweis-Verfahren negativen Fällen. In drei Fällen wurde induziertes Sputum gewonnen, in 18 Fällen eine BAL, in sechs Fällen eine Lungenbiopsie und in zwei Fällen eine Pleurapunktion durchgeführt. Alle in der Folge gewonnenen induzierten Sputa, Pleuraflüssigkeiten und Lungenbiopsien waren mit beiden Methoden negativ. Doch in vier der 18 BAL-Flüssigkeiten (22%) wurdeP. carinii nachgewiesen, dabei waren mindestens zwei mit CFW gefärbte Ausstriche pro Probe untersucht worden. Mit Ausnahme von Spontansputum eignet sich die CFW-Färbung als einfaches und billiges Verfahren bei den meisten Proben aus den tiefen Atemwegen zum Nachweis vonP. carinii.
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Aslanzadeh, J., Stelmach, P.S. Detection ofPneumocystis carinii with direct fluorescence antibody and calcofluor white stain. Infection 24, 248–250 (1996). https://doi.org/10.1007/BF01781104
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DOI: https://doi.org/10.1007/BF01781104