Clinical Performance of BAL Metagenomic Next-Generation Sequence and Serum (1,3)-β-D-Glucan for Differential Diagnosis of Pneumocystis jirovecii Pneumonia and Pneumocystis jirovecii Colonisation

Liu, Li; Yuan, Mingjuan; Shi, Yi; Su, Xin

doi:10.3389/fcimb.2021.784236

Cited by 27 publications

(36 citation statements)

References 32 publications

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“…Liu et al. ( Liu et al., 2021 ) evaluated the performance of BALF-mNGS in differentiating colonization and infection with Pneumocystis jirovecii and suggested that the fungal load differed significantly between the two groups ( P. jirovecii pneumonia and P. jirovecii colonization). However, there is still a scarcity of clinical experience in the diagnosis of fungal infections, particularly aspergillosis.…”

Section: Introductionmentioning

confidence: 99%

“…Yang et al (Yang et al, 2021) observed that mNGS (lung biopsy, bronchoalveolar lavage fluid [BALF]) had a significantly higher sensitivity than conventional tests for diagnosing pulmonary fungal infections. Liu et al (Liu et al, 2021) evaluated the performance of BALF-mNGS in differentiating colonization and infection with Pneumocystis jirovecii and suggested that the fungal load differed significantly between the two groups (P. jirovecii pneumonia and P. jirovecii colonization). However, there is still a scarcity of clinical experience in the diagnosis of fungal infections, particularly aspergillosis.…”

Section: Introductionmentioning

confidence: 99%

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Metagenomic next-generation sequencing for the diagnosis of pulmonary aspergillosis in non-neutropenic patients: a retrospective study

Bao¹,

Song²,

Chen³

et al. 2022

Front. Cell. Infect. Microbiol.

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This study aimed to obtain further in-depth information on the value of metagenomic next-generation sequencing (mNGS) for diagnosing pulmonary aspergillosis in non-neutropenic patients. We did a retrospective study, in which 33 non-neutropenic patients were included, of which 12 were patients with pulmonary aspergillosis and 21 were diagnosed with non-pulmonary aspergillosis. Fungi and all other co-pathogens in bronchoalveolar lavage fluid (BALF) (27 cases), blood (6 cases), and/or pleural fluid (1 case) samples were analyzed using mNGS. One of the patients submitted both BALF and blood samples. We analyzed the clinical characteristics, laboratory tests, and radiologic features of pulmonary aspergillosis patients and compared the diagnostic accuracy, including sensitivity, specificity, positive predictive value, and negative predictive value of mNGS with conventional etiological methods and serum (1,3)-β-D-glucan. We also explored the efficacy of mNGS in detecting mixed infections and co-pathogens. We further reviewed modifications of antimicrobial therapy for patients with pulmonary aspergillosis according to the mNGS results. Finally, we compared the detection of Aspergillus in BALF and blood samples from three patients using mNGS. In non-neutropenic patients, immunocompromised conditions of non-pulmonary aspergillosis were far less prevalent than in patients with pulmonary aspergillosis. More patients with pulmonary aspergillosis received long-term systemic corticosteroids (50% vs. 14.3%, p < 0.05). Additionally, mNGS managed to reach a sensitivity of 91.7% for diagnosing pulmonary aspergillosis, which was significantly higher than that of conventional etiological methods (33.3%) and serum (1,3)-β-D-glucan (33.3%). In addition, mNGS showed superior performance in discovering co-pathogens (84.6%) of pulmonary aspergillosis; bacteria, bacteria-fungi, and bacteria-PJP-virus were most commonly observed in non-neutropenic patients. Moreover, mNGS results can help guide effective treatments. According to the mNGS results, antimicrobial therapy was altered in 91.7% of patients with pulmonary aspergillosis. The diagnosis of Aspergillus detected in blood samples, which can be used as a supplement to BALF samples, seemed to show a higher specificity than that in BALF samples. mNGS is a useful and effective method for the diagnosis of pulmonary aspergillosis in non-neutropenic patients, detection of co-pathogens, and adjustment of antimicrobial treatment.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Metagenomic next-generation sequencing for the diagnosis of pulmonary aspergillosis in non-neutropenic patients: a retrospective study

Bao¹,

Song²,

Chen³

et al. 2022

Front. Cell. Infect. Microbiol.

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“…In a recent study, Liu et al found that BDG assays correctly classified 25 patients out of 27 patients with low Pj fungal burden as either Pj colonized or PjP. In their study, quantification of Pj fungal burden relied on the quantification of Pj reads obtained thanks to a metagenomics approach applied to BAL [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

Usefulness of ß-d-Glucan Assay for the First-Line Diagnosis of Pneumocystis Pneumonia and for Discriminating between Pneumocystis Colonization and Pneumocystis Pneumonia

Bigot

Vellaissamy

Senghor

et al. 2022

JoF

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According to the immunodepression status, the diagnosis of Pneumocystis jirovecii pneumonia (PjP) may be difficult. Molecular methods appear very sensitive, but they lack specificity because Pj DNA can be detected in Pneumocystis-colonized patients. The aim of this study was to evaluate the value of a serum ß-d-Glucan (BDG) assay for the diagnosis of PjP in a large cohort of HIV-negative and HIV-positive patients, either as a first-line diagnostic test for PjP or as a tool to distinguish between colonization and PjP in cases of low fungal load. Data of Pj qPCR performed on bronchopulmonary specimens over a 3-year period were retrieved retrospectively. For each result, we searched for a BDG serum assay performed within +/−5 days. Among the 69 episodes that occurred in HIV-positive patients and the 609 episodes that occurred in immunocompromised HIV-negative patients, we find an equivalent sensitivity of BDG assays compared with molecular methods to diagnose probable/proven PjP, in a first-line strategy. Furthermore, BDG assay can be used confidently to distinguish between infected and colonized patients using a 80 pg/mL cut-off. Finally, it is necessary to search for causes of false positivity to increase BDG assay performance. BDG assay represents a valuable adjunctive tool to distinguish between colonization and infection.

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“…Pediatric pneumonia is a lung inflammation caused by a variety of pathogens [11]. It is a common respiratory disease in children, and the main symptoms include fever, cough, shortness of breath, dyspnea [12]. Pneumonia is one of the most common illnesses in infants and children.…”

Section: Discussionmentioning

confidence: 99%

Chrysoeriol alleviated inflammation in infantile pneumonia by inhibiting PI3K/AKT/mTOR signaling pathway

Wang¹,

Hong²

2022

Trop. J. Pharm Res

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Purpose: To assess the therapeutic effects of chrysoeriol (CHE) on pediatric pneumonia and determine the mechanism of action. Methods: The role of chrysoeriol was investigated in a human lung fibroblasts (HFL1) cell model of pneumonia. The effects of lipopolysaccharide (LPS) and CHE on cell viability and apoptosis were determined by CCK-8 kit and flow cytometry, respectively, while oxidative stress was determined by evaluating the levels of superoxide dismutase (SOD), glutathione, r-glutamyl cysteine +glycine (GSH)- px, myeloperoxidase (MPO) and malondialdehyde (MDA). Inflammatory response was assessed by determining IL-1β, TNF-α, IL-18 and IL-10 levels using enzyme-linked immunosorbent assay (ELISA). The mechanisms of action of CHE were evaluated by immunoblot assays. Results: Chrysoeriol increased the viability of LPS-induced pneumonia cells (p < 0.001) but decreased cell apoptosis (p < 0.001). Furthermore, chrysoeriol reduced oxidative stress and inflammation in LPSinduced pneumonia cells, and suppressed the activation of PI3K/AKT/mTOR pathway. Conclusion: Chrysoeriol alleviates inflammation of infantile pneumonia by inhibiting PI3K/ AKT /mTOR signaling pathway. Thus, CHE is a potential drug for the management of pneumonia. Keywords: Chrysoeriol; Pneumonia; Cell viability; Oxidative stress; PI3K/AKT/mTOR pathway

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Clinical Performance of BAL Metagenomic Next-Generation Sequence and Serum (1,3)-β-D-Glucan for Differential Diagnosis of Pneumocystis jirovecii Pneumonia and Pneumocystis jirovecii Colonisation

Cited by 27 publications

References 32 publications

Metagenomic next-generation sequencing for the diagnosis of pulmonary aspergillosis in non-neutropenic patients: a retrospective study

Metagenomic next-generation sequencing for the diagnosis of pulmonary aspergillosis in non-neutropenic patients: a retrospective study

Usefulness of ß-d-Glucan Assay for the First-Line Diagnosis of Pneumocystis Pneumonia and for Discriminating between Pneumocystis Colonization and Pneumocystis Pneumonia

Chrysoeriol alleviated inflammation in infantile pneumonia by inhibiting PI3K/AKT/mTOR signaling pathway

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