{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T18:40:01Z","timestamp":1785091201188,"version":"3.55.0"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,12,22]],"date-time":"2021-12-22T00:00:00Z","timestamp":1640131200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Differentiating <jats:italic>Pneumocystis jirovecii<\/jats:italic> infection from colonisation is crucial for appropriate therapy administration. In this study, we evaluated the performance of bronchoalveolar lavage fluid (BAL) metagenomic next-generation sequencing (mNGS) and serum 1,3-\u03b2-D-glucan (BDG) tests in differentiating colonisation and infection with <jats:italic>P. jirovecii.<\/jats:italic><\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>From January 2018 to March 2021, 47 patients were enrolled in this study at the Hunan Provincial People\u2019s Hospital. The final diagnosis was used as a reference, and cases were classified into the <jats:italic>P. jirovecii<\/jats:italic> pneumonia (PJP) group or the <jats:italic>P. jirovecii<\/jats:italic> colonisation (PJC) group. Clinical data were recorded. The performances of mNGS and BDG were compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>Result<\/jats:title><jats:p>The fungal load significantly differed between patients with PJP and PJC, with median reads of 3,215.79 \u00b1 1,797 <jats:italic>vs<\/jats:italic>. 5.61 \u00b1 0.88 in the PJP and PJC groups, respectively (<jats:italic>P<\/jats:italic> &amp;lt; 0.0001). BDG also significantly differed between the two groups, with a median titre of 233.60 \u00b1 39.65 pg\/ml in the PJP group and 68.48 \u00b1 19.21 pg\/ml in the PJC group (<jats:italic>P =<\/jats:italic> 0.0006). The area under the curve was 0.973 (95%CI: 0.868\u20131.007) for mNGS of the BAL and 0.879 (95%CI: 0.769\u20130.989) for the serum BDG. The optimal threshold value for discriminating <jats:italic>P. jirovecii<\/jats:italic> infection from colonisation appeared to be 14 reads (sensitivity, 83.3%; specificity, 95.7%; positive likelihood ratio, 19.2) and BDG = 88.6 pg\/ml (sensitivity, 79.2%; specificity, 92.9%; positive likelihood ratio, 18.2). No correlation between mNGS reads and the BDG titre was found in mNGS-positive patients (<jats:italic>r<\/jats:italic><jats:sup>2<\/jats:sup> = 0.0076, <jats:italic>P<\/jats:italic> = 0.583). The levels of lactate dehydrogenase and C-reactive protein were significantly higher in the PJP group than in the PJC group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>BAL mNGS and serum BDG are useful adjunct tests that can assist with differentiating between colonisation and infection of <jats:italic>P. jirovecii<\/jats:italic>.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcimb.2021.784236","type":"journal-article","created":{"date-parts":[[2021,12,22]],"date-time":"2021-12-22T05:34:02Z","timestamp":1640151242000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":44,"title":["Clinical Performance of BAL Metagenomic Next-Generation Sequence and Serum (1,3)-\u03b2-D-Glucan for Differential Diagnosis of Pneumocystis jirovecii Pneumonia and Pneumocystis jirovecii Colonisation"],"prefix":"10.3389","volume":"11","author":[{"given":"Li","family":"Liu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingjuan","family":"Yuan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Shi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Su","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,12,22]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"2386","DOI":"10.1093\/jac\/dkw156","article-title":"ECIL Guidelines for the Diagnosis of Pneumocystis Jirovecii Pneumonia in Patients With Haematological Malignancies and Stem Cell Transplant Recipients","volume":"71","author":"Alanio","year":"2016","journal-title":"J. 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