<i>Pneumocystis</i>Colonization Is Highly Prevalent in the Autopsied Lungs of the General Population

Ponce, Carolina A.; Gallo, Myriam; Bustamante, R.; Vargas, Sergio L.

doi:10.1086/649868

Cited by 145 publications

(112 citation statements)

References 41 publications

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“…During the 2000s, new diagnostic methods, such as molecular biology methods, allowed the detection of P. jirovecii in the sputum of healthy immunocompetent individuals, highlighting the fact that subjects without clinical symptoms of PCP can be colonized by the fungus (11)(12)(13)(14)(15)(16). This colonization of nonimmunocompromised patients has cast doubt on its importance in sudden infant death syndrome, chronic obstructive pulmonary disease, cystic fibrosis, and other pulmonary syndromes (12,15,(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28).…”

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confidence: 99%

“…This colonization of nonimmunocompromised patients has cast doubt on its importance in sudden infant death syndrome, chronic obstructive pulmonary disease, cystic fibrosis, and other pulmonary syndromes (12,15,(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28). Although the clinical conditions and diseases for which P. jirovecii is responsible are unclear, the rate of colonization among individuals is underestimated (29).…”

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Detection of Pneumocystis jirovecii by Quantitative PCR To Differentiate Colonization and Pneumonia in Immunocompromised HIV-Positive and HIV-Negative Patients

et al. 2016

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dPneumocystis jirovecii pneumonia (PCP) is an acute and life-threatening lung disease caused by the fungus Pneumocystis jirovecii. The presentation of PCP in HIV-positive patients is well-known and consists of a triad of dyspnea, fever, and cough, whereas the presentation of PCP in HIV-negative patients is atypical and consists of a sudden outbreak, O 2 desaturation, and a rapid lethal outcome without therapy. Despite the availability of direct and indirect identification methods, the diagnosis of PCP remains difficult. The cycle threshold (C T ) values obtained by quantitative PCR (qPCR) allow estimation of the fungal burden. The more elevated that the fungal burden is, the higher the probability that the diagnosis is pneumonia. The purposes of the present study were to evaluate the C T values to differentiate colonization and pneumonia in a population of immunocompromised patients overall and patients stratified on the basis of their HIV infection status. Testing of bronchoalveolar lavage (BAL) fluid samples from the whole population of qPCR-positive patients showed a mean C T value for patients with PCP of 28 (95% confidence interval [CI], 26 to 30) and a mean C T value for colonized patients of 35 (95% CI, 34 to 36) (P < 10 ؊3 ). For the subgroup of HIV-positive patients, we demonstrated that a C T value below 27 excluded colonization and a C T value above 30 excluded PCP with a specificity of 100% and a sensitivity of 80%, respectively. In the subgroup of HIV-negative patients, we demonstrated that a C T value below 31 excluded colonization and a C T value above 35 excluded PCP with a specificity of 80% and a sensitivity of 80%, respectively. Thus, qPCR of BAL fluid samples is an important tool for the differentiation of colonization and pneumonia in P. jirovecii-infected immunocompromised patients and patients stratified on the basis of HIV infection status with different C T values.

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Detection of Pneumocystis jirovecii by Quantitative PCR To Differentiate Colonization and Pneumonia in Immunocompromised HIV-Positive and HIV-Negative Patients

et al. 2016

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“…En la literatura científica se reportan incidencias de colonización de hasta 20%, independiente de la situación inmunitaria 30,31 e incluso mayores a 60% en estudios anatomo-patológicos 32 . La verdadera implicancia de una colonización por P. jiroveci no está clara.…”

Section: Vih/sidaunclassified

Características clínicas, diagnósticas y pronosticas de pacientes con neumonía por Pneumocystis jiroveci en individuos infectados por virus de inmunodeficiencia humana e individuos inmunocomprometidos por otra etiología: comparative study of cases in HIV-infected patients and immunocompromised non-HIV-infected patients

Cerón¹,

Rabagliati

Langhaus

et al. 2014

Rev. chil. infectol.

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“…Previously named Pneumocystis carinii, this fungus is asymptomatically present in the lungs of up to 65% of adults (16) and only leads to clinical disease and tissue damage in the setting of cell-mediated immune dysfunction, predominantly CD4 T lymphocytes.…”

Section: Pcp Infection: Background and Risk Factorsmentioning

confidence: 99%

Recent‐onset systemic lupus erythematosus complicated by acute respiratory failure

Demoruelle

Kahr

Verilhac

et al. 2013

Arthritis Care & Research

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PneumocystisColonization Is Highly Prevalent in the Autopsied Lungs of the General Population

Cited by 145 publications

References 41 publications

Detection of Pneumocystis jirovecii by Quantitative PCR To Differentiate Colonization and Pneumonia in Immunocompromised HIV-Positive and HIV-Negative Patients

Detection of Pneumocystis jirovecii by Quantitative PCR To Differentiate Colonization and Pneumonia in Immunocompromised HIV-Positive and HIV-Negative Patients

Recent‐onset systemic lupus erythematosus complicated by acute respiratory failure

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