Significance of positive semi-quantitative PCR tests on bronchoalveolar lavage for Pneumocystis jirovecii pneumonia in HIV-negative immunocompromised intensive care unit (ICU) patients with acute respiratory failure
Authors' conclusion
Semi-quantitative PJ PCR was accurate in diagnosing PJP in non-HIV ICU patients with acute respiratory failure (ARF), and a Ct at low cycle values was more frequent in confirmed PJP than in colonization. The optimal Ct threshold was 30.
Study context
- Population
- Non-HIV immunocompromised ICU patients with acute respiratory failure (ARF) with at least one PJ Real-time PCR (rt-PCR) on broncho-alveolar lavage (BAL), 2013–202359 (12%) positive test
- Participants
- 481 participants
- Comparison
- PJ rt-PCR cycle threshold (Ct) value across confirmed, uncertain and ruled-out Pneumocystis jirovecii pneumonia (PJP)
- Outcome
- Ct threshold 30 (confirmed vs ruled-out)
Methodological detailsreviewers blinded to Ct values
- Reviewers blinded to Ct values
Performance
As reported in the abstract
AUC
0.931 (95% CI [0.850-1.0])
Sensitivity
86%
Specificity
89%
Further findings
Median Ct · differed significantly
Median serum BDG · differed significantly
rt-PCR overall accuracy
- Sensitivity
- 100% (95% CI = [85.7-100%])
- Specificity
- 94% (95% CI = [91.4-95.8%])
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Significance of positive semi-quantitative PCR tests on bronchoalveolar lavage for Pneumocystis jirovecii pneumonia in HIV-negative immunocompromised ICU patients with acute respiratory failure. Ann Intensive Care. Published 27 October 2025. doi:10.
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