{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T03:51:25Z","timestamp":1791258685792,"version":"4.1.0"},"reference-count":24,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T00:00:00Z","timestamp":1779840000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T00:00:00Z","timestamp":1779840000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2026,9]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Lung transplant recipients (LTRs) are susceptible to opportunistic infections, including invasive nocardiosis (IN) and invasive mucormycosis (IM). Polymerase chain reaction (PCR) testing of bronchoalveolar lavage (BAL) fluid offers rapid pathogen detection, but its clinical utility in LTRs is understudied.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n We conducted a single\u2010center, retrospective cohort study of adult LTRs who underwent BAL PCR testing for\n Nocardia<\/jats:italic>\n spp. or Mucorales spp. (January 2020\u2013December 2024); samples from both surveillance and \u201cfor\u2010cause\u201d bronchoscopies were included. The primary outcome was development of clinical infection within 6 months of PCR testing. We calculated sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Patient\u2010level analyses were performed for PCR\u2010positive LTRs. Fisher's exact and Mann\u2013Whitney\n U<\/jats:italic>\n tests were used for calculating\n p<\/jats:italic>\n \u2010values.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Of 4279\n Nocardia<\/jats:italic>\n and 3588 Mucorales BAL PCR tests, 1.7% and 1.4% of samples were positive, respectively. Sensitivity, specificity, PPV, and NPV were 92.3%, 98.6%, 16.7%, and 99.98% for\n Nocardia<\/jats:italic>\n and 76.2%, 99.1%, 32.0%, and 99.9% for Mucorales. Abnormal chest CT findings and for\u2010cause bronchoscopy increased the PPV to 34.3% for\n Nocardia<\/jats:italic>\n and 68.2% for Mucorales. At the patient level, both IN and IM were associated with abnormal imaging and for\u2010cause bronchoscopy.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n BAL PCR testing for\n Nocardia<\/jats:italic>\n and Mucorales demonstrates excellent specificity and NPV but low PPV. Meaningful PPV was observed primarily in patients undergoing for\u2010cause bronchoscopy with radiographic abnormalities. PCR results can be useful adjuncts in appropriate clinical settings, but have little utility among LTRs with normal imaging undergoing surveillance testing.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/tid.70249","type":"journal-article","created":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T06:38:51Z","timestamp":1779950331000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Utility of Bronchoalveolar Lavage PCR for\n Nocardia<\/i>\n and Mucorales in Lung Transplant Recipients: A Retrospective Cohort Study"],"prefix":"10.1111","volume":"28","author":[{"given":"Shoaib","family":"Ahmad","sequence":"first","affiliation":[{"name":"Division of Transplant Pulmonology Norton Thoracic Institute Dignity Health St. Joseph's Hospital and Medical Center Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3207-9089","authenticated-orcid":false,"given":"Christine","family":"Pham","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Services St. Joseph's Hospital and Medical Center Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Curt","family":"Bay","sequence":"additional","affiliation":[{"name":"Department of Interdisciplinary Health Sciences A.T. Still University Mesa Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leena","family":"Pawar","sequence":"additional","affiliation":[{"name":"Division of Transplant Pulmonology Norton Thoracic Institute Dignity Health St. Joseph's Hospital and Medical Center Phoenix Arizona USA"},{"name":"School of Medicine Creighton University, Phoenix Regional Health Sciences Campus Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kendra","family":"McAnally","sequence":"additional","affiliation":[{"name":"Division of Transplant Pulmonology Norton Thoracic Institute Dignity Health St. Joseph's Hospital and Medical Center Phoenix Arizona USA"},{"name":"School of Medicine Creighton University, Phoenix Regional Health Sciences Campus Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Nailor","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Services St. Joseph's Hospital and Medical Center Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kellie J.","family":"Goodlet","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice Midwestern University College of Pharmacy Glendale Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2821-8776","authenticated-orcid":false,"given":"Sofya","family":"Tokman","sequence":"additional","affiliation":[{"name":"Division of Transplant Pulmonology Norton Thoracic Institute Dignity Health St. Joseph's Hospital and Medical Center Phoenix Arizona USA"},{"name":"School of Medicine Creighton University, Phoenix Regional Health Sciences Campus Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,27]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.thorsurg.2021.12.002"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00064807"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.3390\/jof10100727"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.21037\/jtd\u20102021\u201012"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.111.2.377"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2020.07.006"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw241"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1128\/jcm.00289\u201018"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0211989"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/mmy\/myae006"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.13478"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.70077"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.13774"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.13525"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2023.10.008"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.13989"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofac646"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiaa394"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1128\/jcm.01602\u201010"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/s1473\u20103099(19)30312\u20103"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocpiqo.2022.11.002"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.2147\/idr.S249761"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10096\u2010019\u201003796\u20105"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.13509"}],"container-title":["Transplant Infectious 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