Skip to main content
NCBI home page
Journal of Clinical Microbiology logoLink to Journal of Clinical Microbiology
. 1990 May;28(5):975–979. doi: 10.1128/jcm.28.5.975-979.1990

Evaluation of an indirect fluorescent-antibody stain for detection of Pneumocystis carinii in respiratory specimens.

V L Ng 1, D M Yajko 1, L W McPhaul 1, I Gartner 1, B Byford 1, C D Goodman 1, P S Nassos 1, C A Sanders 1, E L Howes 1, G Leoung 1, et al.
PMCID: PMC267849  PMID: 1693631

Abstract

Two prospective studies were undertaken to evaluate a commercial indirect fluorescent-antibody (IFA) stain for the detection of Pneumocystis carinii in respiratory specimens from individuals at risk for or with the acquired immunodeficiency syndrome. The first study compared IFA with Diff-Quik (DQ; a rapid Giemsa-like stain) for detecting P. carinii in 95 induced sputa obtained from 77 asymptomatic patients who had survived one previous episode of P. carinii pneumonia and who were being treated prophylactically with aerosolized pentamidine. Only one induced sputum specimen was found to contain P. carinii; organisms were detected by both stains. The second study compared the performance of the IFA stain versus DQ, modified toluidine blue O, and Gomori methenamine silver stains for detecting P. carinii in symptomatic individuals at risk for or with acquired immunodeficiency syndrome. Of 182 specimens examined, P. carinii was detected in 105 by one or more stains; the DQ stain detected 73 (70%), the modified toluidine blue O stain detected 75 (71%), the Gomori methenamine silver stain detected 76 (72%), and the IFA stain detected 95 (90%). The IFA stain was more sensitive (P less than 0.01) than the other traditional stains for detecting P. carinii; however, a subsequent clinical evaluation revealed that a subset of IFA-positive-only specimens were from patients whose clinical symptoms resolved without specific anti-P. carinii therapy.

Full text

PDF
975

Images in this article

976Image
on p.976

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bigby T. D., Margolskee D., Curtis J. L., Michael P. F., Sheppard D., Hadley W. K., Hopewell P. C. The usefulness of induced sputum in the diagnosis of Pneumocystis carinii pneumonia in patients with the acquired immunodeficiency syndrome. Am Rev Respir Dis. 1986 Apr;133(4):515–518. doi: 10.1164/arrd.1986.133.4.515. [DOI] [PubMed] [Google Scholar]
  2. Blumenfeld W., Wagar E., Hadley W. K. Use of the transbronchial biopsy for diagnosis of opportunistic pulmonary infections in acquired immunodeficiency syndrome (AIDS). Am J Clin Pathol. 1984 Jan;81(1):1–5. doi: 10.1093/ajcp/81.1.1. [DOI] [PubMed] [Google Scholar]
  3. Broaddus C., Dake M. D., Stulbarg M. S., Blumenfeld W., Hadley W. K., Golden J. A., Hopewell P. C. Bronchoalveolar lavage and transbronchial biopsy for the diagnosis of pulmonary infections in the acquired immunodeficiency syndrome. Ann Intern Med. 1985 Jun;102(6):747–752. doi: 10.7326/0003-4819-102-6-747. [DOI] [PubMed] [Google Scholar]
  4. Coleman D. L., Dodek P. M., Luce J. M., Golden J. A., Gold W. M., Murray J. F. Diagnostic utility of fiberoptic bronchoscopy in patients with Pneumocystis carinii pneumonia and the acquired immune deficiency syndrome. Am Rev Respir Dis. 1983 Nov;128(5):795–799. doi: 10.1164/arrd.1983.128.5.795. [DOI] [PubMed] [Google Scholar]
  5. Esterly J. A. Pneumocystis carinii in lungs of adults at autopsy. Am Rev Respir Dis. 1968 May;97(5):935–937. doi: 10.1164/arrd.1968.97.5.935. [DOI] [PubMed] [Google Scholar]
  6. GROCOTT R. G. A stain for fungi in tissue sections and smears using Gomori's methenamine-silver nitrate technic. Am J Clin Pathol. 1955 Aug;25(8):975–979. doi: 10.1093/ajcp/25.8_ts.0975. [DOI] [PubMed] [Google Scholar]
  7. Gill V. J., Evans G., Stock F., Parrillo J. E., Masur H., Kovacs J. A. Detection of Pneumocystis carinii by fluorescent-antibody stain using a combination of three monoclonal antibodies. J Clin Microbiol. 1987 Oct;25(10):1837–1840. doi: 10.1128/jcm.25.10.1837-1840.1987. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Gosey L. L., Howard R. M., Witebsky F. G., Ognibene F. P., Wu T. C., Gill V. J., MacLowry J. D. Advantages of a modified toluidine blue O stain and bronchoalveolar lavage for the diagnosis of Pneumocystis carinii pneumonia. J Clin Microbiol. 1985 Nov;22(5):803–807. doi: 10.1128/jcm.22.5.803-807.1985. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Hartman B., Koss M., Hui A., Baumann W., Athos L., Boylen T. Pneumocystis carinii pneumonia in the acquired immunodeficiency syndrome (AIDS). Diagnosis with bronchial brushings, biopsy, and bronchoalveolar lavage. Chest. 1985 May;87(5):603–607. doi: 10.1378/chest.87.5.603. [DOI] [PubMed] [Google Scholar]
  10. Kovacs J. A., Gill V., Swan J. C., Ognibene F., Shelhamer J., Parrillo J. E., Masur H. Prospective evaluation of a monoclonal antibody in diagnosis of Pneumocystis carinii pneumonia. Lancet. 1986 Jul 5;2(8497):1–3. doi: 10.1016/s0140-6736(86)92555-9. [DOI] [PubMed] [Google Scholar]
  11. Kovacs J. A., Ng V. L., Masur H., Leoung G., Hadley W. K., Evans G., Lane H. C., Ognibene F. P., Shelhamer J., Parrillo J. E. Diagnosis of Pneumocystis carinii pneumonia: improved detection in sputum with use of monoclonal antibodies. N Engl J Med. 1988 Mar 10;318(10):589–593. doi: 10.1056/NEJM198803103181001. [DOI] [PubMed] [Google Scholar]
  12. Meuwissen J. H., Tauber I., Leeuwenberg A. D., Beckers P. J., Sieben M. Parasitologic and serologic observations of infection with Pneumocystis in humans. J Infect Dis. 1977 Jul;136(1):43–49. doi: 10.1093/infdis/136.1.43. [DOI] [PubMed] [Google Scholar]
  13. Michaelis L. L., Leight G. S., Pouell R. D., Jr, DeVita V. T. Pneumocystis pneumonia: the importance of early open lung biopsy. Ann Surg. 1976 Mar;183(3):301–306. doi: 10.1097/00000658-197603000-00016. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Moncada J. V., Schachter J., Wofsy C. Prevalence of Chlamydia trachomatis lung infection in patients with acquired immune deficiency syndrome. J Clin Microbiol. 1986 May;23(5):986–986. doi: 10.1128/jcm.23.5.986-.1986. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Murray J. F., Felton C. P., Garay S. M., Gottlieb M. S., Hopewell P. C., Stover D. E., Teirstein A. S. Pulmonary complications of the acquired immunodeficiency syndrome. Report of a National Heart, Lung, and Blood Institute workshop. N Engl J Med. 1984 Jun 21;310(25):1682–1688. doi: 10.1056/NEJM198406213102529. [DOI] [PubMed] [Google Scholar]
  16. Ng V. L., Gartner I., Weymouth L. A., Goodman C. D., Hopewell P. C., Hadley W. K. The use of mucolysed induced sputum for the identification of pulmonary pathogens associated with human immunodeficiency virus infection. Arch Pathol Lab Med. 1989 May;113(5):488–493. [PubMed] [Google Scholar]
  17. Ng V. L., York M., Hadley W. K. Unexpected isolation of Bordetella pertussis from patients with acquired immunodeficiency syndrome. J Clin Microbiol. 1989 Feb;27(2):337–338. doi: 10.1128/jcm.27.2.337-338.1989. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Ognibene F. P., Masur H., Rogers P., Travis W. D., Suffredini A. F., Feuerstein I., Gill V. J., Baird B. F., Carrasquillo J. A., Parrillo J. E. Nonspecific interstitial pneumonitis without evidence of Pneumocystis carinii in asymptomatic patients infected with human immunodeficiency virus (HIV). Ann Intern Med. 1988 Dec 1;109(11):874–879. doi: 10.7326/0003-4819-109-11-874. [DOI] [PubMed] [Google Scholar]
  19. Ognibene F. P., Shelhamer J., Gill V., Macher A. M., Loew D., Parker M. M., Gelmann E., Fauci A. S., Parrillo J. E., Masur H. The diagnosis of Pneumocystis carinii pneumonia in patients with the acquired immunodeficiency syndrome using subsegmental bronchoalveolar lavage. Am Rev Respir Dis. 1984 Jun;129(6):929–932. doi: 10.1164/arrd.1984.129.6.929. [DOI] [PubMed] [Google Scholar]
  20. Pifer L. L., Hughes W. T., Stagno S., Woods D. Pneumocystis carinii infection: evidence for high prevalence in normal and immunosuppressed children. Pediatrics. 1978 Jan;61(1):35–41. [PubMed] [Google Scholar]
  21. Pitchenik A. E., Ganjei P., Torres A., Evans D. A., Rubin E., Baier H. Sputum examination for the diagnosis of Pneumocystis carinii pneumonia in the acquired immunodeficiency syndrome. Am Rev Respir Dis. 1986 Feb;133(2):226–229. doi: 10.1164/arrd.1986.133.2.226. [DOI] [PubMed] [Google Scholar]
  22. Shelhamer J. H., Ognibene F. P., Macher A. M., Tuazon C., Steiss R., Longo D., Kovacs J. A., Parker M. M., Natanson C., Lane H. C. Persistence of Pneumocystis carinii in lung tissue of acquired immunodeficiency syndrome patients treated for pneumocystis pneumonia. Am Rev Respir Dis. 1984 Dec;130(6):1161–1165. doi: 10.1164/arrd.1984.130.6.1161. [DOI] [PubMed] [Google Scholar]
  23. WEISSE K., WEDLER E. Uber das Vorkommen der sogenannten Pneumocystis Carinii. Klin Wochenschr. 1954 Mar 15;32(11-12):270–271. doi: 10.1007/BF01466820. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Clinical Microbiology are provided here courtesy of American Society for Microbiology (ASM)

RESOURCES