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 |title=[[Has title::Nocardia polymerase chain reaction (PCR)-based assay performed on bronchoalveolar lavage fluid after lung transplantation: A prospective pilot study.]]}}<!--
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;Authors:[[Has first author::Julien Coussement]]{{Link to affiliation|l1=1}}, [[Has author::David Lebeaux]]{{Link to affiliation|l1=2}}, [[Has author::Najla El Bizri]]{{Link to affiliation|l1=3}}, [[Has author::Vincent Claes]]{{Link to affiliation|l1=3}}, [[Has author::Michel Kohnen]]{{Link to affiliation|l1=3}}, [[Has author::Deborah Steensels]]{{Link to affiliation|l1=3}}, [[Has author::Isabelle Étienne]]{{Link to affiliation|l1=4}}, [[Has author::Hélène Salord]]{{Link to affiliation|l1=5}}, [[Has author::Emmanuelle Bergeron]]{{Link to affiliation|l1=6}}, [[Has author::Veronica Rodriguez-Nava]]{{Link to affiliation|l1=6}}
;Affiliations:
* {{Affiliation anchor|l=1}} Department of Infectious Diseases, CUB-Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium.
* {{Affiliation anchor|l=2}} Service de Microbiologie, Unité Mobile de Microbiologie Clinique, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.
* {{Affiliation anchor|l=3}} Department of Microbiology, CUB-Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium.
* {{Affiliation anchor|l=4}} Lung Transplantation Unit, CUB-Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium.
* {{Affiliation anchor|l=5}} Laboratoire de Bactériologie, Hôpital de la Croix-Rousse, Lyon, France.
* {{Affiliation anchor|l=6}} Research Group on Bacterial Opportunistic Pathogens and Environment, UMR CNRS5557, INRA1418 Écologie Microbienne, Observatoire Français des Nocardioses, Hospices Civils de Lyon, France, Université de Lyon 1, VetAgro Sup, Lyon, France.
;In:[[Is in journal::PloS one (journal)|PloS one]], ([[Publishing date::2019]])
;On line:
}}
==Abstract==
;BACKGROUND:
Transplant recipients are at risk of pulmonary nocardiosis, a life-threatening opportunistic infection caused by Nocardia species. Given the limitations of conventional diagnostic techniques (i.e., microscopy and culture), a polymerase chain reaction (PCR)-based assay was developed to detect Nocardia spp. on clinical samples. While this test is increasingly being used by transplant physicians, its performance characteristics are not well documented. We evaluated the performance characteristics of this test on bronchoalveolar lavage (BAL) fluid samples from lung transplant recipients (LTRs).

;METHODS:
We prospectively included all BAL samples from LTRs undergoing bronchoscopy at our institution between December 2016 and June 2017 (either surveillance or clinically-indicated bronchoscopies). Presence of microbial pathogens was assessed using techniques available locally (including microscopy and 10-day culture for Nocardia). BAL samples were also sent to the French Nocardiosis Observatory (Lyon, France) for the Nocardia PCR-based assay. Transplant physicians and patients were blinded to the Nocardia PCR results.

;RESULTS:
We included 29 BAL samples from 21 patients (18 surveillance and 11 clinically-indicated bronchoscopies). Nocardiosis was not diagnosed in any of these patients by conventional techniques. However, Nocardia PCR was positive in five BAL samples from five of the patients (24%, 95% confidence interval: 11-45%); four were asymptomatic and undergoing surveillance bronchoscopy, and one was symptomatic and was later diagnosed with influenza virus infection. None of the five PCR-positive patients died or were diagnosed with nocardiosis during the median follow-up of 21 months after the index bronchoscopy (range: 20-23 months).

;CONCLUSIONS:
In this prospective study, Nocardia PCR was positive on BAL fluid from one fourth of the LTRs. Nocardia PCR-based assays should be used with caution on respiratory samples from LTRs because of the possible detection of airway colonization using this technique. Larger studies are required to determine the usefulness of the Nocardia PCR-based assay in transplant recipients.
==See also==
;External links:
* [https://pubmed.ncbi.nlm.nih.gov/30802260/ Link toward PubMed]
[[Category:Adult (MeSH)]]
[[Category:Aged (MeSH)]]
[[Category:Belgium (MeSH)]]
[[Category:Bronchoalveolar Lavage Fluid (microbiology)]]
[[Category:Female (MeSH)]]
[[Category:Humans (MeSH)]]
[[Category:Lung Transplantation (adverse effects)]]
[[Category:Middle Aged (MeSH)]]
[[Category:Nocardia (genetics)]]
[[Category:Nocardia (isolation &amp; purification)]]
[[Category:Nocardia Infections (diagnosis)]]
[[Category:Opportunistic Infections (microbiology)]]
[[Category:Pilot Projects (MeSH)]]
[[Category:Polymerase Chain Reaction (MeSH)]]
[[Category:Prospective Studies (MeSH)]]
[[Category:RNA, Ribosomal, 16S (genetics)]]
[[Category:RNA, Viral (genetics)]]
[[Category:Sensitivity and Specificity (MeSH)]]
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[[fr:PLoS ONE (2019) Coussement]]