{
  "abstract": "Background: Pneumocystis pneumonia (PCP) is increasingly common in human immunodeficiency virus (HIV)-negative immunocompromised patients, who generally have low fungal burdens. Bronchoalveolar lavage (BAL) may be poorly tolerated in fragile patients and oral wash (OW) could be an interesting alternative, but its effectiveness remains underexplored in these patients.\n\nMethods: A prospective multicenter cohort study was conducted to assess polymerase chain reaction (PCR) on OW in HIV-negative patients undergoing BAL to document respiratory symptoms. Beta-1-3-D-glucan (BDG) was also measured on blood samples. Patients were classified by a multidisciplinary committee as having definite PCP, colonization, possible PCP, or without Pneumocystis. Positive predictive value (PPV), negative predictive value (NPV), and receiver operating characteristic (ROC) analysis were determined for each test. Agreement between BAL PCR, OW PCR, and BDG was assessed.\n\nResults: Statistical analyses were performed on 369 patients: 76 with PCP, 55 colonized, 214 without Pneumocystis, and 24 possible PCP. PCR in OW was positive in 81.6%, 30.9%, 0%, and 45.8% of patients with PCP, colonization, no PCP, and possible PCP, respectively. Mean fungal loads in OW were 4251 ± 15 501 and 3 ± 8.5 copies/mL in patients with PCP and colonized patients, respectively (P < .0001). The PPV and NPV of OW PCR were 78.5% and 73.1%, respectively. The ROC analysis identified a threshold of 7 copies/mL for OW to achieve a PPV of 90%, with a sensitivity of 73.5%. Agreement between OW PCR and BDG was poor (κ < 0.4), but the combination of BDG+/OW PCR+ yielded a PPV of 92%.\n\nConclusions: PCR on OW is a useful noninvasive tool for diagnosing PCP in HIV-negative patients.\n\nClinical Trials Registration: PNEUMOQUANT, clinical trial no. NCT 02648256.",
  "abstract_shown": true,
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  "authors": [
    {
      "name": "Florence Robert-Gangneux",
      "orcid": "0000-0003-4493-596X"
    },
    {
      "name": "Gilles Nevez"
    },
    {
      "name": "Céline Damiani"
    },
    {
      "name": "Yannick Le Guen"
    },
    {
      "name": "Christophe Gut-Gobert"
    },
    {
      "name": "Amélie Bazire"
    },
    {
      "name": "Anne Totet",
      "orcid": "0000-0002-9784-575X"
    },
    {
      "name": "Vincent Jounieaux",
      "orcid": "0000-0003-2131-6429"
    },
    {
      "name": "Rozenn Le Berre"
    },
    {
      "name": "Fanny Thepault"
    },
    {
      "name": "Pierre Tattevin",
      "orcid": "0000-0003-3617-5411"
    },
    {
      "name": "Aude Barnier"
    },
    {
      "name": "Stéphane Jouneau"
    },
    {
      "name": "Florian Reizine",
      "orcid": "0000-0002-9871-636X"
    },
    {
      "name": "Mallorie Kerjouan"
    },
    {
      "name": "Pierre Chauvin",
      "orcid": "0000-0002-0838-9212"
    },
    {
      "name": "Chloé Rousseau",
      "orcid": "0000-0003-2466-4445"
    },
    {
      "name": "Ronan Garlantézec",
      "orcid": "0000-0001-7420-6341"
    },
    {
      "name": "Jean-Pierre Gangneux"
    },
    {
      "name": "Christophe Camus"
    },
    {
      "name": "Solène Le Gal"
    }
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  "doi": "10.1093/cid/ciag356",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13715969/",
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  "pmcid": "PMC13715969",
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  "published": "2026-06-11",
  "publisher": "Oxford University Press (OUP)",
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  "title": "Oral Wash PCR Improves the Diagnosis of Pneumocystis Pneumonia in Immunocompromised Patients Without HIV: A Prospective Multicenter Study",
  "title_text": "Oral Wash PCR Improves the Diagnosis of Pneumocystis Pneumonia in Immunocompromised Patients Without HIV: A Prospective Multicenter Study",
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  "venue": "Clinical Infectious Diseases",
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