biostudies-literatureUnknown9(1)Damhorst GL<h4>Background</h4><i>Pneumocystis jirovecii</i> polymerase chain reaction (PCR) testing is a sensitive diagnostic tool but does not distinguish infection from colonization. Cycle threshold (C_T) may correlate with fungal burden and could be considered in clinical decision making. Clinical use of PCR and significance of C_T values have not previously been examined with the DiaSorin Molecular platform.<h4>Methods</h4>Retrospective review of <i>P jirovecii</i> PCR, C_T values and clinical data from 18 months in a multihospital academic health system. The diagnostic performance of PCR with respect to pathology and correlation of C_T with severity were examined.<h4>Results</h4>Ninety-nine of 1006 (9.8%) assays from 786 patients in 919 encounters were positive. Among 91 (9.9%) encounters in which <i>P jirovecii</i> pneumonia (PJP) was treated, 41 (45%) were influenced by positive PCR. Negative PCR influenced discontinuation of therapy in 35 cases. Sensitivity and specificity of PCR were 93% (95% CI, 68%-100%) and 94% (95% CI, 91%-96%) with respect to pathology. C_T values from deep respiratory specimens were significantly different among treated patients (<i>P</i> = .04) and those with positive pathology results (<i>P</i> < .0001) compared to patients not treated and those with negative pathology, respectively, and was highly predictive of positive pathology results (area under the curve = 0.92). No significant difference was observed in comparisons based on indicators of disease severity.<h4>Conclusions</h4><i>Pneumocystis jirovecii</i> PCR was a highly impactful tool in the diagnosis and management of PJP, and use of C_T values may have value in the treatment decision process in select cases. Further investigation in a prospective manner is needed.Open forum infectious diseasesofab634https://www.ebi.ac.uk/biostudies/studies/S-EPMC8754379biostudies-literatureClinical Utilization of DiaSorin Molecular Polymerase Chain Reaction in <i>Pneumocystis</i> Pneumonia.PMC8754379Burd EMRara RBusch LMWebster ASBabiker ABroder KJOverton ECDamhorst GLKraft CSfalseClinical Utilization of DiaSorin Molecular Polymerase Chain Reaction in <i>Pneumocystis</i> Pneumonia.<h4>Background</h4><i>Pneumocystis jirovecii</i> polymerase chain reaction (PCR) testing is a sensitive diagnostic tool but does not distinguish infection from colonization. Cycle threshold (C_T) may correlate with fungal burden and could be considered in clinical decision making. Clinical use of PCR and significance of C_T values have not previously been examined with the DiaSorin Molecular platform.<h4>Methods</h4>Retrospective review of <i>P jirovecii</i> PCR, C_T values and clinical data from 18 months in a multihospital academic health system. The diagnostic performance of PCR with respect to pathology and correlation of C_T with severity were examined.<h4>Results</h4>Ninety-nine of 1006 (9.8%) assays from 786 patients in 919 encounters were positive. Among 91 (9.9%) encounters in which <i>P jirovecii</i> pneumonia (PJP) was treated, 41 (45%) were influenced by positive PCR. Negative PCR influenced discontinuation of therapy in 35 cases. Sensitivity and specificity of PCR were 93% (95% CI, 68%-100%) and 94% (95% CI, 91%-96%) with respect to pathology. C_T values from deep respiratory specimens were significantly different among treated patients (<i>P</i> = .04) and those with positive pathology results (<i>P</i> < .0001) compared to patients not treated and those with negative pathology, respectively, and was highly predictive of positive pathology results (area under the curve = 0.92). No significant difference was observed in comparisons based on indicators of disease severity.<h4>Conclusions</h4><i>Pneumocystis jirovecii</i> PCR was a highly impactful tool in the diagnosis and management of PJP, and use of C_T values may have value in the treatment decision process in select cases. Further investigation in a prospective manner is needed.2022-01-01T00:00:00Z2022 Jan2024-02-15T15:04:23.441Z2022-02-11T15:23:13.106ZS-EPMC87543793503646710.1093/ofid/ofab634