Flood D, Rawji M, Gobin G, Kasupski G, Chan CK; International Conference on AIDS.
Int Conf AIDS. 1991 Jun 16-21; 7: 240 (abstract no. W.B.2232).
The Wellesly Hospital, Toronto, Canada
OBJECTIVE: To evaluate the usefulness of a new diagnostic technique, direct fluorescent antibody (DFA) in the detection of Pneumocystis carinii (PC) in bronchoalveolar lavage (BAL) of HIV-infected patients. METHODS: In a tertiary HIV-referral hospital, between 11/89 and 11/90, 91 consecutive HIV-infected patients were evaluated for possible PC pneumonia. All patients underwent BAL as part of the diagnostic workup. Eighty-four BAL specimens were divided into 2 aliquots and processed independently in a blinded fashion in 2 separate laboratories. One aliquot was cytospun and DFA stain was used, whereas the other was cytospun and processed using the conventional GMS stain. Both were then examined independently for the presence of PC. RESULTS: 40/84 (48%) were positive for PC using DFA, whereas 33/84 (39%) were positive using the GMS stain. Using the conventional GMS stain as the laboratory gold standard for the detection of PC, DFA stain has a sensitivity of 97%, specificity of 84%, positive predictive value of 80% and negative predictive value of 98%. The clinical and radiologic features of the 8 patients who were positive on DFA but negative on GMS ("False Positives") were compatible with PC pneumonia. They were treated in the conventional fashion with complete recovery in all but 1 where death occurred. We therefore concluded that PC was missed by the GMS stain in those 8 patients. CONCLUSION: DFA is an excellent diagnostic test and our data would suggest that it is more sensitive than the conventional GMS stain in the detection of PC. A cost comparison indicates that DFA stain is less time consuming, but the cost of DFA is more than the GMS stain.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Fluorescent Antibody Technique
- HIV Infections
- HIV Seropositivity
- Humans
- Pneumonia
- Pneumonia, Pneumocystis
- Sensitivity and Specificity
- Staining and Labeling
- parasitology
Other ID:
UI: 102192836
From Meeting Abstracts