Test Id : PNRP
Pneumocystis jiroveci, Molecular Detection, PCR, Varies
Useful For
Suggests clinical disorders or settings where the test may be helpful
Preferred test for detection of Pneumocystis
Method Name
A short description of the method used to perform the test
Real-Time Polymerase Chain Reaction (PCR)
NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.
Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test
Specimen Type
Describes the specimen type validated for testing
Varies
Shipping Instructions
Specimen must arrive within 7 days of collection; specimens older than 7 days will be rejected.
Necessary Information
Specimen source is required.
ORDER QUESTIONS AND ANSWERS
| Question ID | Description | Answers |
|---|---|---|
| SRC63 | Specimen Source |
Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing
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.
Forms
If not ordering electronically, complete, print, and send a Microbiology Test Request (T244) with the specimen.
Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the testing laboratory. The minimum volume is sufficient for one attempt at testing.
Body fluid or nondigested respiratory specimen: 0.5 mL; Fresh tissue: 5 mm; NALC-NaOH-digested specimen: 1 mL
Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected
| 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 |
Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Varies | Refrigerated (preferred) | 7 days | |
| Frozen | 7 days |
Useful For
Suggests clinical disorders or settings where the test may be helpful
Preferred test for detection of Pneumocystis
Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
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.
Reference Values
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
Not applicable
Interpretation
Provides information to assist in interpretation of the test results
A positive result indicates the presence of Pneumocystis DNA.
A negative result indicates the absence of detectable
Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
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.
Clinical Reference
Recommendations for in-depth reading of a clinical nature
1. Senecal J, Smyth E, Del Corpo O, et al: Non-invasive diagnosis of Pneumocystis jirovecii pneumonia: a systematic review and meta-analysis. Clin Microbiol Infect. 2022 Jan;28(1):23-30. doi: 10.1016/j.cmi.2021.08.017
2. Apostolopoulou A, Fishman JA: The pathogenesis and diagnosis of Pneumocystis jiroveci pneumonia. J Fungi (Basel). 2022 Nov 5;8(11):1167. doi: 10.3390/jof8111167
3. Fishman JA. Pneumocystis jiroveci. Semin Respir Crit Care Med. 2020 Feb;41(1):141-157. doi: 10.1055/s-0039-3399559
Method Description
Describes how the test is performed and provides a method-specific reference
Nucleic acids are extracted using the MagNA Pure LC Instrument (Roche). The extract is then amplified using the LightCycler real-time polymerase chain reaction (PCR) platform (Roche). The detection of amplicon is based on fluorescence resonance energy transfer (FRET), which utilizes hybridization probes. The presence of the specific organism nucleic acid is confirmed by performing a melting curve analysis of the amplicon.(Arcenas RC, Uhl JR, Buckwalter SP, et al: A real-time PCR assay for detection of Pneumocystis from bronchoalveolar lavage fluid. Diagn Microbiol Infect Dis. 2006 Mar;54(3):169-175)
PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information
Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.
Monday through Sunday
Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.
Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location
Indicates the location of the laboratory that performs the test
Fees :
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.
- Authorized users can sign in to Test Prices for detailed fee information.
- Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
- Prospective clients should contact their account representative. For assistance, contact Customer Service.
Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.
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
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
CPT codes are provided by the performing laboratory.
CPT codes are provided by the performing laboratory.
87594
LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.
| Test Id | Test Order Name | Order LOINC Value |
|---|---|---|
| PNRP | Pneumocystis PCR | 89996-3 |
| Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
|---|---|---|
| SRC63 | Specimen Source | 31208-2 |
| 81698 | Pneumocystis PCR, Result | 89996-3 |
| 24188 | Special Information | 48767-8 |
| 24189 | Report Status | No LOINC Needed |