SynthesisEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology2025
Diagnostic tests performance in detecting Pneumocystis jirovecii: A systematic review and meta-analysis.
Synthesis in European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
8 citing papers in PubMed.
- Biomarkers in Invasive Pulmonary Fungal Infections: Where Do We Stand?Journal of fungi (Basel, Switzerland) · 2026Review
- Performance Characteristics of Real-Time Quantitative PCR and Cycle Threshold (Ct) Values for the Diagnosis ofInfection and drug resistance · 2026Article
- Advances in pathogen detection ofInfectious medicine · 2025Review
- Clinical characteristics ofJournal of thoracic disease · 2025Article
- Review
- CRISPR-Cas12 Application for the Detection ofInternational journal of molecular sciences · 2025Article
- Clinical Value of Metagenomic Next-Generation Sequencing From Blood Samples to IdentifyOpen forum infectious diseases · 2025Article
- Combined multiplex polymerase chain reaction-based targeted next-generation sequencing and serum 1, 3-β-D-glucan for differential diagnosis ofFrontiers in cellular and infection microbiology · 2025Article
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
BACKGROUND AND
objectivePneumocystis jirovecii (Pj) pneumonia (PJP) is a life-threatening opportunistic infection primarily affecting immunocompromised individuals. Detecting Pj is challenging, particularly in distinguishing between Pj colonization (PJC) and infection. We aimed to systematically evaluate the diagnostic accuracy of various tests in differentiating Pj colonization from infection.
methodsSystematic reviews and meta-analyses were performed. Searches were conducted in PubMed, Embase, and Web of Science. Original clinical studies reporting sensitivity and specificity data for diagnostic tests such as quantitative polymerase chain reaction (qPCR), nested PCR, (1,3)-Beta-D glucan (BDG), metagenomic next-generation sequencing (mNGS), and digital PCR (ddPCR) to differentiate PJC from PJP were included. Quality assessment was performed using QUADAS-2 tool, and data processing followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Diagnostic performance was evaluated using either a random-effects or fixed-effects model.
resultsTwenty-eight studies (2,550 patients, 1,445 with PJP) were included, with moderate methodological quality. The pooled sensitivity of these diagnostic tests was 0.80 (95% CI 0.77-0.82) and specificity was 0.83 (95% CI 0.81-0.85), with a diagnostic odds ratio (DOR) of 23.12. Among the individual tests, BDG (5 studies) showed high pooled sensitivity (0.83, 95% CI 0.77-0.88) but lower specificity (0.78, 95% CI 0.69-0.85). mNGS (3 studies) had the highest performance, with pooled sensitivity and specificity both at 0.87 (95% CI 0.80-0.92 and 95% CI 0.77-0.94, respectively), and the highest DOR of 41.57. qPCR (19 studies) demonstrated adequate pooled sensitivity (0.78, 95% CI 0.76-0.81) and high specificity (0.83, 95% CI 0.81-0.86), with a DOR of 20.44.
conclusionWhile BDG has low specificity and mNGS is costly with no standardized interpretation, along with the limited number of relevant studies in BDG and mNGS, this meta-analysis concluded that qPCR remains valuable for distinguishing P. jirovecii infection from colonization. A well-designed randomized clinical trial that standardizes the technical aspects of the qPCR protocol is needed to assess its effectiveness and provide a solid basis for clinical diagnosis.
Indexed as
Identifiers
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.