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Test Code PNRP Pneumocystis jiroveci, Molecular Detection, PCR, Varies

Reporting Name

Pneumocystis PCR

Useful For

Preferred test for detection of Pneumocystis

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

Varies


Additional Testing Requirements


This test should always be performed in conjunction with fungal culture; order FGEN / Fungal Culture, Routine.



Shipping Instructions


Specimen must arrive within 7 days of collection; specimens older than 7 days will be rejected.



Necessary Information


Specimen source is required.



Specimen Required


The high sensitivity of amplification by polymerase chain reaction requires the specimen to be processed in an environment in which contamination of the specimen by Pneumocystis species DNA is unlikely.

 

Preferred Specimens: Pleural, respiratory (eg, bronchoalveolar lavage [BAL], bronchial washing, sputum), or fresh tissue

 

Acceptable Specimens: If no fresh specimen is available, digested respiratory specimens treated with N-acetyl-L-cysteine-sodium hydroxide (NALC/NaOH) are acceptable (eg, BAL, bronchial washing, respiratory fluid, sputum, or tracheal secretion)

 

Submit only 1 of the following specimens:

 

Preferred 

Specimen Type: Body fluid

Sources: Pleural

Container/Tube: Sterile container

Specimen Volume: 1 mL

Additional Information: Only fresh, non-NALC/NaOH-digested body fluid is acceptable.

 

Specimen Type: Respiratory

Sources: BAL, bronchial washing, tracheal secretions, or sputum

Container/Tube: Sterile container

Specimen Volume: 1 mL if only PCR ordered or 3 mL if PCR ordered with smear and culture

 

Specimen Type: Tissue

Sources: Respiratory

Container/Tube: Sterile container

Specimen Volume: 5-10 mm

Collection Instructions:

1. Submit fresh tissue.

2. Keep tissue moist with sterile water or sterile saline

 

Acceptable

Specimen Type: NALC/NaOH-digested respiratory specimens

Sources: BAL, bronchial washing, respiratory fluid, sputum, or tracheal secretion

Container/Tube: Sterile container

Specimen Volume: 2 mL

Collection Instructions:

1. Submit digested specimen treated with NALC/NaOH.

2. Clearly indicate on container and order form that specimen is a digested specimen.

 


Specimen Minimum Volume

Body fluid or nondigested respiratory specimen: 0.5 mL; Fresh tissue: 5 mm; NALC-NaOH-digested specimen: 1 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Varies Refrigerated (preferred) 7 days
  Frozen  7 days

Day(s) Performed

Monday through Sunday

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information

87798

LOINC Code Information

Test ID Test Order Name Order LOINC Value
PNRP Pneumocystis PCR 89996-3

 

Result ID Test Result Name Result LOINC Value
SRC63 Specimen Source 31208-2
81698 Pneumocystis PCR, Result 89996-3
24188 Special Information 48767-8
24189 Report Status No LOINC Needed

Clinical Information

Pneumocystis pneumonia is an important cause of opportunistic infection in patients who are immunocompromised, particularly those with HIV. The causative agent, Pneumocystis jiroveci, cannot be cultured in vitro, and, therefore, laboratory detection has historically relied upon microscopic identification directly from patient specimens using fluorescent stains or antibodies. Stains often lack sensitivity and require expertise on the part of the reader to differentiate Pneumocystis jiroveci from staining artifacts and other fungi. This real-time polymerase chain reaction assay provides a sensitive and specific detection of Pneumocystis from bronchoalveolar lavage fluid and other respiratory specimens.

Cautions

Test results should be used as an aid in diagnosis and should not be considered diagnostic in themselves. The literature indicates that Pneumocystis can cause asymptomatic colonization of healthy individuals and those who are immunocompromised. Therefore, test results should be correlated with patient symptoms and clinical presentation.

 

A negative result does not rule out the presence of Pneumocystis or active disease because the organism may be present at undetectable levels.

Report Available

1 to 3 days

Specimen Retention Time

7 days

Reject Due To

Body fluid other than pleural fluid
Blood
Bone
Nonrespiratory tissue
Bone marrow
Organ tissues other than lung
Paraffin-embedded tissue
Specimen in anaerobe vial or viral transport medium
Feces
Swab
Tissue in formalin fluid
Urine
Reject

Method Name

Real-Time Polymerase Chain Reaction (PCR)

Forms

If not ordering electronically, complete, print, and send a Microbiology Test Request (T244) with the specimen.

Secondary ID

81698