Open AccessDetection of Pneumocystis jirovecii and Toxoplasma gondii in patients with lung infections by a duplex qPCR assay
Author(s) -
Yun Wu,
Fei Wang,
Chaoyue Wang,
Xinming Tang,
Xianyong Liu,
Shaogang Li,
Nicholas R. Waterfield,
Wei Wang,
Xun Suo,
Guowei Yang
Publication year - 2021
Publication title -
plos neglected tropical diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.99
H-Index - 135
eISSN - 1935-2735
pISSN - 1935-2727
DOI - 10.1371/journal.pntd.0010025
Subject(s) - pneumocystis jirovecii , toxoplasma gondii , toxoplasmosis , virology , pneumonia , immunology , biology , population , medicine , microbiology and biotechnology , human immunodeficiency virus (hiv) , antibody , environmental health
Pneumocystis pneumonia (PCP) and pulmonary toxoplasmosis (PT) are caused by Pneumocystis jirovecii and Toxoplasma gondii . The clinical symptoms and imaging of PCP and PT are indistinguishable. A duplex qPCR was developed to differentiate between these two pathogens. In testing 92 clinical samples to validate the performance of this method for P . jirovecii detection, it identified 31 positive samples for P . jirovecii infection, consistent with clinical diagnosis. Among the remainder of the 61 clinical samples with suspected PCP, yet showing as negative by the conventional PCR diagnosis approach, 6 of them proved positive using our new assay. Our new approach also produced similar results in identification of T . gondii infections, giving a result of 2 positive and 20 negative in clinical samples. An investigation was undertaken on the prevalence of P . jirovecii and T . gondii infections using 113 samples from lung infection patients. 9% (10/113) were shown to be positive with infections of P . jirovecii , 2% with T . gondii (2/113) and 5% (6/113) were co-infected with both pathogens. Although this duplex qPCR can detect individual P . jirovecii and T . gondii infection, and co-infection of both pathogens, further large-scale investigations are needed to validate its performance, especially in T . gondii detection. Our assay provides a rapid and accurate tool for PCP and PT diagnosis in immunocompromised population and clinical surveillance of these infections in patients with no immune defects.