Etiological analysis of 1341 suspected cases without HIV positive of Pneumocystis pneumonia

LI Jing-jing; ZOU Yang; AN Yi-jun; QI Zhi-qun; LI Xiao-li; WANG Lei; HUANG Min-jun

doi:10.3969/j.issn.1007-8134.2016.05.004

Abstract：Objective To discuss the positive rate of Pneumocystis pneumonia (PCP) patients specimens detected by gomori’s methenamine silver (GMS) staining and polymerase chain reaction (PCR) used so as to provide more supportable laboratory basis for clinical practice. Methods A total of 1314 cases of suspected PCP patients with deep induced sputum or broncho-alveolar lavage fluid (BALF) specimens were collected. GMS staining microscopy and PCR method were combined to detect pneumocystis, it could be identified as PCP in the event of any method showing positive. Results A total of 285 patients were diagnosed as PCP, 114 of whom were GMS staining microscopic staining positive, 282 cases were PCR positive, 111 cases were double positive detected by 2 methods, 3 cases were GMS positive staining microscopic alone (all BALF after renal transplantation), and 171 cases of samples were PCR positive alone. In deep induced sputum specimens, GMS staining microscopy and PCR positive rates were 5.1% and 16.2% respectively (P<0.05 and BALF); And in BALF specimens, the positive rates were 23.3% and 42.2% respectively (P < 0.05). Patients with unknown cause fever complicated with pneumonia and organ transplant patients receiving immunosuppressive therapy had higher positive detection rate.Conclusions The positive rate of PCP detected by PCR method is higher than that by GMS staining microscopy, and the detection of PCP by the combination of PCR method and GMS staining microscopy has higher diagnostic value for clinical guidance.