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Test ID: PNRP Pneumocystis jiroveci, Molecular Detection, PCR, Varies

Reporting Name

Pneumocystis PCR

Useful For

Preferred test for detection of Pneumocystis

Clinical Information

Pneumocystis pneumonia is an important cause of opportunistic infection in patients who are immunocompromised, particularly those with HIV. The causative agent, Pneumocystis jiroveci, cannot be cultured in vitro, and, therefore, laboratory detection has historically relied upon microscopic identification directly from patient specimens using fluorescent stains or antibodies. Stains often lack sensitivity and require expertise on the part of the reader to differentiate Pneumocystis jiroveci from staining artifacts and other fungi. This real-time polymerase chain reaction assay provides a sensitive and specific detection of Pneumocystis from bronchoalveolar lavage fluid and other respiratory specimens.

Interpretation

A positive result indicates the presence of Pneumocystis DNA.

 

A negative result indicates the absence of detectable Pneumocystis DNA.

Report Available

1 to 3 days

Day(s) Performed

Monday through Sunday

Clinical Reference

1. Senecal J, Smyth E, Del Corpo O, et al: Non-invasive diagnosis of Pneumocystis jirovecii pneumonia: a systematic review and meta-analysis. Clin Microbiol Infect. 2022 Jan;28(1):23-30. doi: 10.1016/j.cmi.2021.08.017

2. Apostolopoulou A, Fishman JA: The pathogenesis and diagnosis of Pneumocystis jiroveci pneumonia. J Fungi (Basel). 2022 Nov 5;8(11):1167. doi: 10.3390/jof8111167

3. Fishman JA. Pneumocystis jiroveci. Semin Respir Crit Care Med. 2020 Feb;41(1):141-157. doi: 10.1055/s-0039-3399559

Method Name

Real-Time Polymerase Chain Reaction (PCR)

Specimen Type

Varies


Additional Testing Requirements


This test should always be performed in conjunction with fungal culture; order FGEN / Fungal Culture, Routine.



Shipping Instructions


Specimen must arrive within 7 days of collection; specimens older than 7 days will be rejected.



Necessary Information


Specimen source is required.



Specimen Required


The high sensitivity of amplification by polymerase chain reaction requires the specimen to be processed in an environment in which contamination of the specimen by Pneumocystis species DNA is unlikely.

 

Preferred Specimens: Pleural, respiratory (eg, bronchoalveolar lavage [BAL], bronchial washing, sputum), or fresh tissue

 

Acceptable Specimens: If no fresh specimen is available, digested respiratory specimens treated with N-acetyl-L-cysteine-sodium hydroxide (NALC/NaOH) are acceptable (eg, BAL, bronchial washing, respiratory fluid, sputum, or tracheal secretion)

 

Submit only 1 of the following specimens:

 

Preferred 

Specimen Type: Body fluid

Sources: Pleural

Container/Tube: Sterile container

Specimen Volume: 1 mL

Additional Information: Only fresh, non-NALC/NaOH-digested body fluid is acceptable.

 

Specimen Type: Respiratory

Sources: BAL, bronchial washing, tracheal secretions, or sputum

Container/Tube: Sterile container

Specimen Volume: 1 mL if only PCR ordered or 3 mL if PCR ordered with smear and culture

 

Specimen Type: Tissue

Sources: Respiratory

Container/Tube: Sterile container

Specimen Volume: 5-10 mm

Collection Instructions:

1. Submit fresh tissue.

2. Keep tissue moist with sterile water or sterile saline

 

Acceptable

Specimen Type: NALC/NaOH-digested respiratory specimens

Sources: BAL, bronchial washing, respiratory fluid, sputum, or tracheal secretion

Container/Tube: Sterile container

Specimen Volume: 2 mL

Collection Instructions:

1. Submit digested specimen treated with NALC/NaOH.

2. Clearly indicate on container and order form that specimen is a digested specimen.

 


Specimen Minimum Volume

Body fluid or nondigested respiratory specimen: 0.5 mL; Fresh tissue: 5 mm; NALC-NaOH-digested specimen: 1 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Varies Refrigerated (preferred) 7 days
  Frozen  7 days

Reference Values

Not applicable

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information

87798

LOINC Code Information

Test ID Test Order Name Order LOINC Value
PNRP Pneumocystis PCR 89996-3

 

Result ID Test Result Name Result LOINC Value
SRC63 Specimen Source 31208-2
81698 Pneumocystis PCR, Result 89996-3
24188 Special Information 48767-8
24189 Report Status No LOINC Needed

Forms

If not ordering electronically, complete, print, and send a Microbiology Test Request (T244) with the specimen.

Mayo Clinic Laboratories | Neurology Catalog Additional Information:

mml-Demyelinating-Diseases, mml-Neuroimmunology, mml-CNS-Infections, mml-Pediatric