Pneumocystis jirovecii pneumonia in intensive care units: a multicenter study by ESGCIP and EFISG

Table 5 Performance of serum BDG for the diagnosis of PJP*

Population	PJP (TP/total)	No PJP (TN/total)	Sensitivity % (95% CI)	Specificity % (95% CI)	PPV % (95% CI)	NPV % (95% CI)	LR + (95% CI)	LR- (95% CI)
Diagnosis of presumptive/proven PJP
All patients with serum BDG testing**	49/57	192/270	86 (74–94)	71 (65–76)	39 (30–48)	96 (92–98)	3.0 (2.4–3.7)	0.2 (0.1–0.4)
Fungitell test	46/51	169/242	90 (79–97)	70 (64–76)	39 (30–48)	97 (93–99)	3.0 (2.4–3.7)	0.1 (0.1–0.3)
Wako test	3/6	23/28	50 (12–88)	82 (63–94)	38 (9–76)	88 (70–98)	2.8 (0.9–8.7)	0.6 (0.3–1.4)
Diagnosis of proven PJP***
Serum BDG versus microscopy (ref) ****	14/19	58/95	74 (49–91)	61 (51–71)	27 (16–42)	92 (82–97)	1.9 (1.3–2.7)	0.4 (0.2–0.9)

BDG, (1,3)-ß-D-glucan; CI, confidence interval; LR-, negative likelihood ratio; LR + , positive likelihood ratio; NPV, negative predictive value; PJP, Pneumocystis jirovecii pneumonia; PPV, positive predictive value; TN, true negative; TP, true positive
*Patients with neither a “PJP” nor a “no PJP” diagnosis (i.e., “diagnosis inconclusive”, see study methods) were conservatively classified as “no PJP” to reduce overestimation of the diagnostic performance of serum BDG (a higher frequency of positive serum BDG was indeed registered in patients with inconclusive diagnosis than in the entire “no PJP” population)
**A serum BDG value equal or above the manufacturer cut-off (80 pg/mL and 11 pg/mL for the Fungitell assay and Wako assay, respectively) was defined as the criterion for serum BDG positivity. For reference definitions of presumptive and proven PJP see methods
***Evaluated in the subgroup of patients tested for Pneumocystis microscopy (Crystal Violet, May-Grünwald-Giemsa, Wright-Giemsa, Rapid Giemsa-like stains, Direct Fluorescent Antibody, Methenamine Silver, or Toluidine Blue O according to local procedures) on respiratory specimens
****Positivity of microscopy as reference was defined as at least one positive tested sample/s (sputum, tracheal aspirate, and/or bronchoalveolar lavage fluid)

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