Abstract
A collaborative study was undertaken at two institutions to assess the performance of a direct fluorescent-antibody stain for the detection of Pneumocystis carinii in respiratory specimens from patients with known or suspected human immunodeficiency virus type 1 infections. A total of 163 specimens (125 induced sputa, 37 bronchoalveolar lavage fluids, and 1 tracheal aspirate) from 124 patients were examined by using modified Giemsa (Diff-Quik; Baxter American Scientific Products, Chicago, Ill.) and direct fluorescent-antibody stains. A total of 73 specimens contained P. carinii, which was detected in 66 (92%) of the specimens by using the modified Giemsa and in 71 (97%) of the specimens by using the fluorescent-antibody stain. One bronchoalveolar lavage fluid specimen in which P. carinii was detected only with the fluorescent-antibody stain was determined to be a false-positive based on subsequent clinical evaluation of the patient. Although the overall time for processing and examining specimens stained with either stain was not significantly different for those specimens containing P. carinii, considerably less time was required for microscopic examination of those fluorescent-antibody-stained specimens lacking P. carinii.
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- 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]
- Blumenfeld W., Kovacs J. A. Use of a monoclonal antibody to detect Pneumocystis carinii in induced sputum and bronchoalveolar lavage fluid by immunoperoxidase staining. Arch Pathol Lab Med. 1988 Dec;112(12):1233–1236. [PubMed] [Google Scholar]
- 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]
- 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]
- 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]
- Elvin K. M., Björkman A., Linder E., Heurlin N., Hjerpe A. Pneumocystis carinii pneumonia: detection of parasites in sputum and bronchoalveolar lavage fluid by monoclonal antibodies. BMJ. 1988 Aug 6;297(6645):381–384. doi: 10.1136/bmj.297.6645.381. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 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]
- 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]
- Golden J. A., Hollander H., Stulbarg M. S., Gamsu G. Bronchoalveolar lavage as the exclusive diagnostic modality for Pneumocystis carinii pneumonia. A prospective study among patients with acquired immunodeficiency syndrome. Chest. 1986 Jul;90(1):18–22. doi: 10.1378/chest.90.1.18. [DOI] [PubMed] [Google Scholar]
- 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]
- 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]
- 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]
- 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]
- 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]
- Ng V. L., Yajko D. M., McPhaul L. W., Gartner I., Byford B., Goodman C. D., Nassos P. S., Sanders C. A., Howes E. L., Leoung G. Evaluation of an indirect fluorescent-antibody stain for detection of Pneumocystis carinii in respiratory specimens. J Clin Microbiol. 1990 May;28(5):975–979. doi: 10.1128/jcm.28.5.975-979.1990. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 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]
- 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]
- Stover D. E., White D. A., Romano P. A., Gellene R. A. Diagnosis of pulmonary disease in acquired immune deficiency syndrome (AIDS). Role of bronchoscopy and bronchoalveolar lavage. Am Rev Respir Dis. 1984 Oct;130(4):659–662. doi: 10.1164/arrd.1984.130.4.659. [DOI] [PubMed] [Google Scholar]