ECIL guidelines for the diagnosis of Pneumocystis jirovecii pneumonia in patients with haematological malignancies and stem cell transplant recipients

Alexandre Alanio, Philippe M. Hauser, Katrien Lagrou, Willem J.G. Melchers, Jannik Helweg-Larsen, Olga Matos, Simone Cesaro, Georg Maschmeyer, Hermann Einsele, J. Peter Donnelly, Catherine Cordonnier, Johan Maertens, Stéphane Bretagne, Samir Agrawal, Christopher Kibbler, Antonio Pagliuca, Katherine Ward, Murat Akova, Raoul Herbrecht, Vincent MalletPatricia Ribaud, Mahmoud Aljurf, Dina Averbuch, Dan Engelhard, Thomas Berg, Oliver Cornely, Olaf Penack, Florian van Boemmel, Marie von Lilienfeld-Toal, Ola Blennow, Per Ljungman, Roger Bruggemann, Peter Donnelly, Bart Jan Kullberg, Willem Melchers, Thierry Calandra, Hans Hirsch, Oscar Marchetti, Christina Orasch, Frederic Tissot, Elio Castagnola, Corrado Girmenia, Malgorzata Mikulska, Livio Pagano, Claudio Viscoli, Rafael De La Camara, Rafael Duarte, Patricia Munoz, Lubos Drgona, Ruth Hargreaves, Petr Hubacek, Michal Kouba, Zdenek Racil, Galina Klyasova, George Pettrikos, Emmanuel Roilides, Anna Skiada, Valérie Rizzi-Puechal, Janos Sinko, Monica Slavin, Jan Styczynski, Lorraine Tweddle, Craig Wood

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185 Citaten (Scopus)

Samenvatting

The Fifth European Conference on Infections in Leukaemia (ECIL-5) convened a meeting to establish evidencebased 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 b-D-glucan in serum can contribute to the diagnosis but not the follow-up of PCP (A-II). A negative serum b-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.

Originele taal-2Engels
Pagina's (van-tot)2386-2396
Aantal pagina's11
TijdschriftJournal of Antimicrobial Chemotherapy
Volume71
Nummer van het tijdschrift9
DOI's
StatusGepubliceerd - 1 sep. 2016

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