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The prevalence of Pneumocystis jirovecii among patients with different chronic pulmonary disorders in Ahvaz, Iran.

ABSTRACT: BACKGROUND AND OBJECTIVES:Pneumocystis jirovecii pneumonia (PJP) is a chronic fungal infection that caused by P. jirovecii. Disease is more prevalent among the HIV-infected patients. The colonization of pneumocystis in human respiratory system is associated with the airway inflammation and obstruction. The current study was conducted to identify the prevalence of P. jirovecii among the patients with chronic pulmonary disorders in Ahvaz, Iran. MATERIALS AND METHODS:In the present study, 115 bronchoalveolar lavage (BAL) specimens were collected from patients. Samples were subjected to Nested-PCR with specific primers. The second PCR products were used for sequencing analysis. RESULTS:Our findings demonstrated that 31(27.0%) of samples were positive for P. jirovecii. Nine patients (29%) have tuberculosis (TB) followed by, 1(3.2%) HIV positive and 21(67.7%) miscellaneous pulmonary disorders. Our results show that there was no significant differences between sex (male:female ratio, 17:14), TB, HIV and P. jirovecii in BAL samples (P>0.05). CONCLUSION:The current study is the first report from Ahvaz and it showed a relatively high frequency (27%) of P. jirovecii among patients with different pulmonary disorders. In addition Nested-PCR might be reliable technique for diagnosis of P. jirovecii, while the Grocott's methenamine silver (GMS) have a low sensitivity, which only two positive patients were identified.

SUBMITTER: Aboualigalehdari E

PROVIDER: S-EPMC4752688 | biostudies-literature | 2015 Dec

REPOSITORIES: biostudies-literature

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The prevalence of Pneumocystis jirovecii among patients with different chronic pulmonary disorders in Ahvaz, Iran.

Aboualigalehdari Elham E Zarei Mahmoudabadi Ali A Fatahinia Mahnaz M Idani Esmaeil E

Iranian journal of microbiology 20151201 6

<h4>Background and objectives</h4>Pneumocystis jirovecii pneumonia (PJP) is a chronic fungal infection that caused by P. jirovecii. Disease is more prevalent among the HIV-infected patients. The colonization of pneumocystis in human respiratory system is associated with the airway inflammation and obstruction. The current study was conducted to identify the prevalence of P. jirovecii among the patients with chronic pulmonary disorders in Ahvaz, Iran.<h4>Materials and methods</h4>In the present s ...[more]

PMID: 26885334

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Project description:BackgroundConcurrent infection may be found in Pneumocystis jirovecii pneumonia (PJP) of non-acquired immunodeficiency syndrome (AIDS) patients, however, its impact on immune dysregulation of PJP in non-AIDS patients remains unknown.MethodsWe measured pro-inflammatory cytokines including tumor necrosis factor (TNF)-?, interleukin (IL)-1?, IL-8, IL-17, monocyte chemoattractant protein-1 (MCP-1) and anti-inflammatory cytokines including IL-10 and transforming growth factor (TGF)-?1 and IL-1 receptor antagonist (IL-1RA) and inflammatory markers including high mobility group box 1, Krebs von den Lungen-6, receptor for advanced glycation end product, advanced glycation end product, surfactant protein D in bronchoalveolar lavage fluid (BALF) and blood in 47 pure PcP and 18 mixed PJP and other pulmonary infections (mixed PJP) in non-AIDS immunocompromised patients and explored their clinical relevance. The burden of Pneumocystis jirovecii in the lung was determined by counting number of clusters of Pneumocystis jirovecii per slide and the concentration of ?-D-glucan in BALF. PJP severity was determined by arterial oxygen tension/fraction of inspired oxygen concentration ratio, the need of mechanical ventilation and death.ResultsCompared with pure PJP group, mixed PJP group had significantly higher BALF levels of IL-1?, TNF-? and IL-8 and significantly higher blood levels of IL-8. The BALF ratios of TNF-?/IL-10, IL-8/IL-10, IL-1?/IL-10, TNF-?/TGF-?1, IL-8/TGF-?1, IL-1?/TGF-?1 and IL-1?/IL-1RA were significantly higher in mixed than in pure PJP patients. There was no significant difference in clinical features and outcome between pure and mixed PJP groups, including inflammatory biomarkers and the fungal burden. In pure PJP patients, significantly higher BALF levels of IL-8 and the ratios of IL-8/IL-10, IL-1?/TGF-?1, MCP-1/TGF-?1, MCP-1/IL1RA and IL-8/TGF-?1 were found in the patients requiring mechanical ventilation and in non-survivors.ConclusionsIn summary, concurrent pulmonary infection might enhance immune dysregulation of PJP in non-AIDS immunocompromised patients, but did not affect the outcome as evidenced by morbidity and mortality. Because of limited number of cases studied, further studies with larger populations are needed to verify these issues.

Dataset Information

The prevalence of Pneumocystis jirovecii among patients with different chronic pulmonary disorders in Ahvaz, Iran.

Publications

The prevalence of Pneumocystis jirovecii among patients with different chronic pulmonary disorders in Ahvaz, Iran.

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