Pneumocystis jiroveci, Molecular Detection, PCR, Varies (PNRP)

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Marshfield Clinic Public WebSite

Test Code: PNRPSO

Overview
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Useful For

Preferred test for detection of Pneumocystis

Specimen Requirements

Submit only 1 of the following specimens:
Specimen Type	Preferred Container/Tube	Acceptable Container/Tube	Specimen Volume	Specimen Minimum Volume (allows for 1 repeat)	Pediatric Minimum Volume (no repeat)
Body fluid Sources: Pleural	Sterile container		1 mL	0.5 mL
Respiratory Sources: Bronchoalveolar lavage, bronchial washing, tracheal secretions, or sputum			1 mL	0.5 mL
Tissue Sources: Respiratory			5-10 mm	5 mm
NALC/NaOH-digested respiratory specimens Sources: Lavage fluid, bronchial washing, respiratory fluid, sputum, or tracheal secretion			2 mL	0.5 mL

Collection Processing Instructions

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

Specimen Required: The high sensitivity of amplification by PCR requires the specimen to be processed in an environment in which contamination of the specimen by Pneumocystis species DNA is unlikely.

Necessary Information: Specimen source is required.

Specimen Type: Tissue:

1. Submit fresh tissue.

2. Keep tissue moist with sterile water or sterile saline

Specimen Stability Information

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

Rejection Criteria

Body fluid other than pleural fluid, blood, bone, nonrespiratory tissue, bone marrow, organ tissues other than lung, paraffin-embedded tissue Specimen in anaerobe vial or viral transport medium Feces Swab Tissue in formalin fluid Urine Specimen >7 days old.

Interference

Test results should be used as an aid in diagnosis and should not be considered diagnostic in themselves. The literature indicates that Pneumocystis can cause asymptomatic colonization of healthy and immunocompromised individuals. Therefore, test results should be correlated with patient symptoms and clinical presentation.

A negative result does not rule out the presence of Pneumocystis or active disease because the organism may be present at undetectable levels.

Performing Laboratory Information

Performing Location	Day(s) Test Performed	Analytical Time	Methodology/Instrumentation
Mayo Clinic Laboratories	Monday through Sunday	1 to 3 days	Real-Time Polymerase Chain Reaction (PCR)

Reference Lab

Mayo Clinic Laboratories

Test Information

Pneumocystis pneumonia is an important cause of opportunistic infection in immunocompromised patients, 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. Unfortunately, stains often lack sensitivity and require expertise on the part of the reader in order to differentiate Pneumocystis jiroveci from staining artifacts and other fungi. This real-time PCR assay provides sensitive (21% more sensitive than direct detection using fluorescent calcofluor white stain), specific, and objective detection of Pneumocystis from bronchoalveolar lavage fluid and other specimens.

Reference Range Information

Not applicable

Interpretation

A positive result indicates the presence of Pneumocystis DNA.

A negative result indicates the absence of detectable Pneumocystis DNA.

Outreach CPTs

CPT	Modifier (if needed)	Quantity	Description	Comments
87798		1	amplified probe technique, each organism

Ordering Applications

Ordering Application	Description
COM	Pneumocystis jiroveci, Mol Det PCR (PNRP)
Cerner	Pneumocystis jiroveci, Molecular Detection, PCR, Varies (PNRP)

If the ordering application you are looking for is not listed, contact your local laboratory for assistance.