title: Clinical significance of positivePneumocystis jiroveciipolymerase chain reaction in non-human immunodeficiency virus immunocompromised patients in a real practice.
abstract: OBJECTIVE
  Pneumocystis jiroveciipolymerase chain reaction (PCR) can be helpful in diagnosingPneumocystispneumonia (PCP); however it has limitations. We evaluated the prevalence of positiveP. jiroveciiPCR from non-human immunodeficiency virus (HIV) immunocompromised patients and tried to determine the risk of PCP development.
  
  
  METHODS
  Between May 2009 and September 2012,P. jiroveciiPCR was performed in bronchoscopic specimens from 1,231 adult non-HIV immunocompromised patients suspected of respiratory infection. Only 169 patients (13.7%) who were tested positive forP. jiroveciiPCR were enrolled. Retrospective chart review was performed. PCP was defined in patients with positiveP. jiroveciiPCR who were treated for PCP based on the clinical decision.
  
  
  RESULTS
  From 169P. jiroveciiPCR-positive patients, 90 patients were in the PCP group (53.3%) and 79 patients were in the non-PCP group (46.7%). In the PCP group, 38% of patients expired or aggravated after therapy, whereas the majority of patients (84%) in the non-PCP group recovered without treatment for PCP. Independent risk factors for PCP by binary logistic regression analysis were underlying conditions- hematological malignancies, solid tumors or solid organ transplantation, dyspnea, age < 60 years, and albumin < 2.9 g/dL.
  
  
  CONCLUSIONS
  This study suggests that not allP. jiroveciiPCR-positive patients need to be treated for PCP. AmongP. jiroveciiPCR-positive patients, those who are less than 60 years old, with hematological malignancies, solid tumors or solid organ transplantation, low albumin, and with symptoms of dyspnea, the possibility of PCP might be higher. Treatment should also be selected to these patients.
authors.affiliation: Division of Pulmonary Medicine, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Hea Yon
authors.initials: HY
authors.lastname: Lee
authors.affiliation: Division of Pulmonary Medicine, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Hye Seon
authors.initials: HS
authors.lastname: Kang
authors.affiliation: Division of Pulmonary Medicine, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Hwa Young
authors.initials: HY
authors.lastname: Lee
authors.affiliation: Division of Pulmonary Medicine, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Chin Kook
authors.initials: CK
authors.lastname: Rhee
authors.affiliation: Division of Pulmonary Medicine, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Sook Young
authors.initials: SY
authors.lastname: Lee
authors.affiliation: Division of Pulmonary Medicine, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Seok Chan
authors.initials: SC
authors.lastname: Kim
authors.affiliation: Division of Pulmonary Medicine, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Seung Joon
authors.initials: SJ
authors.lastname: Kim
authors.affiliation: Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Yeon Joon
authors.initials: YJ
authors.lastname: Park
authors.affiliation: Division of Pulmonary Medicine, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Young Kyoon
authors.initials: YK
authors.lastname: Kim
authors.affiliation: Division of Pulmonary Medicine, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Ji Young
authors.initials: JY
authors.lastname: Kang
mesh_terms: D001992:Bronchoalveolar Lavage Fluid / Q000382:microbiology*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D008875:Middle Aged; D045363:Pneumocystis carinii / Q000302:isolation & purification*; D011020:Pneumonia, Pneumocystis / Q000382:microbiology / Q000401:mortality*; D016133:Polymerase Chain Reaction; D056910:Republic of Korea / Q000453:epidemiology
keywords: Immunocompromised; Pneumocystis; Pneumonia; Polymerase chain reaction