Clinical use
This test is used in the diagnosis of respiratory infections caused by P jirovecii, particularly in immunocompromised and HIV positive patients. Induced sputum or BAL are the most appropriate samples for testing by molecular methods. The fungal biomarker beta 1-3, D-glucan (BDG) is normally also high in PCP.
Background
Pneumocystis jirovecii pneumonia (previously: Pneumocystis Carinii Pneumonia (PCP), is a fungal infection that most commonly affects the immunocompromised and, in some cases, can be severely life-threatening. Typically, patients at risk are those with any underlying disease states that alter host immunity such as those with HIV, cancer, transplant recipients, or those taking immunosuppressive therapies and medications. It presents sub-acutely with cough, fever, and hypoxia as the cardinal features, and is often subtle initially.
Specimen requirements
For molecular testing send samples in a sterile white top container:
- Sputum
- Bronchoalveolar lavage (BAL) – preferred
- Nasopharyngeal aspirate (NPA)
For BDG testing send blood in a serum separator tube, please note that the sample should be sent urgently to microbiology.
Minimum volume
- 5 ml for sputum, BAL, NPA
- 2 ml of serum
Turnaround time
24 hours from receipt at the referral laboratory.
Analysing laboratory
Molecular tests – Micropathology Ltd, Venture Centre, University of Warwick Science Park, Sir William Lyons Road, Coventry, CV4 7EZ
BDG testing – UKHSA Mycology Reference Laboratory, National Infection Services, UKHSA South West Laboratory, Science Quarter, Southmead Hospital, Bristol, BS10 5NB
Additional information
If delays in delivery to the laboratory are expected samples should be refrigerated at 2-8°C.