Title: ECIL guidelines for the diagnosis of Pneumocystis jirovecii pneumonia in patients with haematological malignancies and stem cell transplant recipients
Authors: Alanio, Alexandre ×
Hauser, Philippe M
Lagrou, Katrien
Melchers, Willem J G
Helweg-Larsen, Jannik
Matos, Olga
Cesaro, Simone
Maschmeyer, Georg
Einsele, Hermann
Donnelly, J Peter
Cordonnier, Catherine
Maertens, Johan
Bretagne, Stéphane #
Issue Date: Sep-2016
Publisher: Oxford University Press
Series Title: The Journal of Antimicrobial Chemotherapy vol:71 issue:9 pages:2386-2396
Article number: 10.1093/jac/dkw156
Abstract: The Fifth European Conference on Infections in Leukaemia (ECIL-5) convened a meeting to establish evidence-based recommendations for using tests to diagnose Pneumocystis jirovecii pneumonia (PCP) in adult patients with haematological malignancies. Immunofluorescence assays are recommended as the most sensitive microscopic method (recommendation A-II: ). Real-time PCR is recommended for the routine diagnosis of PCP ( A-II: ). Bronchoalveolar lavage (BAL) fluid is recommended as the best specimen as it yields good negative predictive value ( A-II: ). Non-invasive specimens can be suitable alternatives ( B-II: ), acknowledging that PCP cannot be ruled out in case of a negative PCR result ( A-II: ). Detecting β-d-glucan in serum can contribute to the diagnosis but not the follow-up of PCP ( A-II: ). A negative serum β-d-glucan result can exclude PCP in a patient at risk ( A-II: ), whereas a positive test result may indicate other fungal infections. Genotyping using multilocus sequence markers can be used to investigate suspected outbreaks ( A-II: ). The routine detection of dihydropteroate synthase mutations in cases of treatment failure is not recommended ( B-II: ) since these mutations do not affect response to high-dose co-trimoxazole. The clinical utility of these diagnostic tests for the early management of PCP should be further assessed in prospective, randomized interventional studies.
ISSN: 0305-7453
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Faculty of health and social work - UC Leuven
Laboratory of Clinical Bacteriology and Mycology
× corresponding author
# (joint) last author

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