DETECTION OF PHEUMOCYSTIS IN SPUTUM BY FLUORESCENT ANTIDY AND STAINS

因为肺炎，人们正在制作多张痰标本。一 一组幻灯片由Giemsa染色并在SFGH阅读，其中 由于经常使用这种染料，Giemsa的专业知识是最好的 在过去的几年里，对于个人电脑来说。只要有可能，多放两张幻灯片 被送往NIH，在那里有一个被染上了 另一种是用单抗间接荧光法 抗体染色。真阳性痰是指那些1) 3种方法中的2种阳性，或2)单独用TBO阳性 但具有非常好的PC或3)阳性的形态簇 TBO本身，但通过随后的积极灌洗来证实 同样的肺炎发作。使用这些标准，结果是 IFA显示59/60或98.3%的敏感性，52/60或86.7%的敏感性 Giemsa，TBO为43/47或91.5%。有29个是真正的阴性 29份标本经三种方法检测均为阴性。 在提交评估的91份连续痰标本中，60/91份或66% 都是PC阳性，这表明痰检查可以是一种 实用的诊断技术，侵袭性极低。IFA使用 J.K.研制的单抗阳性率为98.3%，其中1 假阴性反应。相比之下，Giemsa和 总有效率为91.5%。这三种方法的特异性都很好， 没有假阳性发生。

Multiple slides of sputa were being worked up for pneumonia. One set of slides was stained by Giemsa and read at SFGH where expertise with Giemsa was optimal due to regular use of this stain for PC over the past few years. Whenever possible, 2 extra slides from each patient were sent to NIH where one was stained by TBO and the other by a monoclonal antibody indirect florescent antibody stain. True positive sputa were those that were 1) positive by and 2 of the 3 methods, or 2) positive by TBO alone but with a very good morphologic cluster of PC or 3) positive by TBO alone but verified by a subsequent positive lavage within that same episode of pneumonia. Using these criteria, the results showed 59/60 or 98.3% sensitivity by IFA, 52/60 or 86.7% by Giemsa, and 43/47 or 91.5% by TBO. There were 29 true negative specimens and all 29 were negative by the three methods. Of 91 consecutive sputa submitted for evaluation, 60/91 or 66% were positive for PC, suggesting that sputum exam can be a useful diagnostic technique with very low invasiveness. IFA using monoclonal antibodies developed by J.K. detected 98.3%, with 1 false negative reaction. This compared to 86.7 by Giemsa and 91.5% by TBO. Specificity of all three methods was excellent, with no false positive occurrences.