{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T22:19:46Z","timestamp":1792189186525,"version":"4.4.0"},"reference-count":26,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T00:00:00Z","timestamp":1760572800000},"content-version":"vor","delay-in-days":15,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004359","name":"Vetenskapsr\u00e5det","doi-asserted-by":"publisher","award":["81248"],"award-info":[{"award-number":["81248"]}],"id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004063","name":"Knut och Alice Wallenbergs Stiftelse","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004063","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Mycoses"],"published-print":{"date-parts":[[2025,10]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n \n Pneumocystis jirovecii<\/jats:italic>\n pneumonia (PCP) is a severe opportunistic infection affecting immunocompromised patients. Quantitative polymerase chain reaction (qPCR) is widely used for the detection of\n P. jirovecii<\/jats:italic>\n in respiratory samples. However, the diagnosis of PCP remains challenging and the high prevalence of\n P. jirovecii<\/jats:italic>\n airway colonisation complicates the interpretation of positive results. The aim of this study was to assess the utility of\n P. jirovecii<\/jats:italic>\n PCR Quantification Cycle (Cq) values in differentiating between PCP and colonisation in PCR\u2010positive respiratory samples from immunocompromised patients.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Adult patients with\n P. jirovecii<\/jats:italic>\n detected by qPCR in respiratory samples (bronchoalveolar lavage (BAL), sputum and oral wash) collected between 2017 and 2023 were retrospectively enrolled in the study. Patients were classified as having PCP or\n P. jirovecii<\/jats:italic>\n colonisation and Cq values were compared between the groups. Receiver\u2010operating characteristics (ROC) curve analyses were used to assess the performance of Cq values to distinguish between PCP and colonisation, and to establish Cq cut\u2010off values for the different sample types.\n <\/jats:p>\n <\/jats:sec>\n \n Result<\/jats:title>\n \n Of 520 included participants, 247 patients (47.5%) were classified as PCP and 273 (52.5%) as colonised. The median Cq value was significantly lower in the PCP group compared to colonised patients in BAL (33.0 vs. 36.6,\n p<\/jats:italic>\n \u2009<\u20090.001) and sputum (33.4 vs. 36.0,\n p<\/jats:italic>\n \u2009<\u20090.0001), yielding a ROC area under the curve of 0.75 and 0.73, respectively. Cq levels for oral wash did not differ between PCP and colonisation and lacked discriminatory power with a ROC AUC of 0.45. A Cq cut\u2010off level at 31 for BAL and sputum could predict PCP with a positive predictive value of >\u200985% while Cq\u2009<\u200938 provided a negative predictive value of 89% for BAL and 73% for sputum.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Different Cq cut\u2010off values in BAL and sputum may support discrimination between PCP and colonisation and assist physicians in their clinical management of PCP.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/myc.70120","type":"journal-article","created":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T13:10:30Z","timestamp":1760620230000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Performance of Quantitative\n PCR<\/scp>\n to Distinguish\n Pneumocystis jirovecii<\/i>\n Pneumonia From Colonisation in Immunocompromised Patients"],"prefix":"10.1111","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-8887-3617","authenticated-orcid":false,"given":"Sara","family":"Cederwall","sequence":"first","affiliation":[{"name":"Department of Clinical Sciences Lund, Division of Infection Medicine Lund University Lund Sweden"},{"name":"Division of Infectious Diseases Sk\u00e5ne University Hospital Lund Sweden"},{"name":"Wallenberg Centre for Molecular Medicine Lund University Lund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"Ottander","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences Lund, Division of Infection Medicine Lund University Lund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Bj\u00f6rkhem","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences Lund, Division of Infection Medicine Lund University Lund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl","family":"Oldberg","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences Lund, Division of Infection Medicine Lund University Lund Sweden"},{"name":"Clinical Microbiology Office for Medical Services, Region Sk\u00e5ne Lund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa I.","family":"P\u00e5hlman","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences Lund, Division of Infection Medicine Lund University Lund Sweden"},{"name":"Division of Infectious Diseases Sk\u00e5ne University Hospital Lund Sweden"},{"name":"Wallenberg Centre for Molecular Medicine Lund University Lund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,16]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/jof9040414"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/mmy\/myaa024"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciac386"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2010.03400.x"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/imj.12599"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1128\/Spectrum.00026-21"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2023.116168"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1159\/000487713"},{"key":"e_1_2_10_10_1","unstructured":"F.Charles J.Thomas andA. H.Limper \u201cEpidemiology Clinical Manifestations and Diagnosis of Pneumocystis Pneumonia in Patients Without HIV \u201d(2024) https:\/\/www.uptodate.com\/contents\/epidemiology\u2010clinical\u2010manifestations\u2010and\u2010diagnosis\u2010of\u2010pneumocystis\u2010pneumonia\u2010in\u2010patients\u2010without\u2010hiv?search=pneumocystis&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1."},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.03174-15"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2014.07.010"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa1805"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid1102.040487"},{"issue":"3","key":"e_1_2_10_15_1","first-page":"298","article-title":"Pneumocystis Jirovecii Colonization in Non\u2010HIV\u2010Infected Patients Based on Nested\u2010PCR Detection in Bronchoalveolar Lavage Samples","volume":"42","author":"Khodadadi H.","year":"2013","journal-title":"Iranian Journal of Public Health"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1080\/14787210.2017.1305887"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkw158"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1080\/14656566.2021.1915989"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciae239"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1159\/000448626"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pathol.2021.03.006"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1099\/jmm.0.001190"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mimet.2005.01.001"},{"key":"e_1_2_10_24_1","volume-title":"Advances in PCR Detection of Pneumocystis Jiroveci in Immunocompromised Patients\u2014Count Seems to Be Important","author":"Lochmanova J.","year":"2006"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics14010114"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12010316"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmii.2019.08.012"}],"container-title":["Mycoses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/myc.70120","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T10:13:04Z","timestamp":1761819184000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/myc.70120"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10]]},"references-count":26,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["10.1111\/myc.70120"],"URL":"https:\/\/doi.org\/10.1111\/myc.70120","archive":["Portico"],"relation":{},"ISSN":["0933-7407","1439-0507"],"issn-type":[{"value":"0933-7407","type":"print"},{"value":"1439-0507","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10]]},"assertion":[{"value":"2025-02-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-14","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-16","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70120"}}