Sensitivity and specificity of nested and real-time PCR for the detection of Pneumocystis jiroveci in clinical specimens.


Journal Article

A polymerase chain reaction (PCR)-based test for Pneumocystis jiroveci (formerly Pneumocystis carinii f. sp. hominis) might be an alternative to histologic diagnoses of P. jiroveci pneumonia (PCP). However, previously developed nested PCR methods tend to have low specificities (high false-positive rates). In this study, nested and quantitative real-time PCR methods for the amplification of the P. jiroveci DHPS (dihydropteroate synthase) gene were evaluated in a variety of stored clinical samples from Spain, South Africa, and Brazil. The sensitivities of both assays were high, ranging from 62.5% to 100% depending on the type of specimen. In a subset of 71 microscopically confirmed PCP cases and 70 negative cases, the sensitivities and specificities were 94% and 81% for nested PCR and 94% and 96% for real-time PCR, respectively. Real-time PCR has a statistically significantly better specificity than nested PCR (P = .015) and is likely to generate fewer false positives.

Full Text

Cited Authors

  • Alvarez-Martínez, MJ; Miró, JM; Valls, ME; Moreno, A; Rivas, PV; Solé, M; Benito, N; Domingo, P; Muñoz, C; Rivera, E; Zar, HJ; Wissmann, G; Diehl, ARS; Prolla, JC; de Anta, MTJ; Gatell, JM; Wilson, PE; Meshnick, SR; Spanish PCP Working Group,

Published Date

  • October 2006

Published In

Volume / Issue

  • 56 / 2

Start / End Page

  • 153 - 160

PubMed ID

  • 16678378

Pubmed Central ID

  • 16678378

Electronic International Standard Serial Number (EISSN)

  • 1879-0070

International Standard Serial Number (ISSN)

  • 0732-8893

Digital Object Identifier (DOI)

  • 10.1016/j.diagmicrobio.2006.03.010


  • eng