Molecular detection of Pneumocystis jirovecii in patients with respiratory tract infections

Alli, O. A. Terry; Ogbolu, David Olusoga; Ademola, Olufunmi; Oyenike, Musiliu A.

doi:10.4103/1947-2714.101993

Cited by 6 publications

(3 citation statements)

References 22 publications

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“…Another study from the same centre on hospitalised HIV-infected patients, demonstrated that cryptococcal meningitis accounted for 8.8% of all OIs with a 12% case-fatality ratio 18 . PJP accounted for 1% of all AIDS-related mycotic infections in the present study, this is lower than 13% reported from a study in Western Nigeria 31 . While diagnosis in the index study was made clinically; in the study cited above, PJP was diagnosed using a PCR assay.…”

Section: Discussioncontrasting

confidence: 82%

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Opportunistic fungal infections in persons living with advanced HIV disease in Lagos, Nigeria; a 12-year retrospective study

Oladele¹,

Ogunsola²,

Stocking³

et al. 2020

Afr H. Sci.

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Introduction: Nigeria has a large estimated burden of AIDS-related mycoses. We aimed to determine the proportion of pa- tients with AIDS-related opportunistic fungal infections (OFIs) at an urban antiretroviral treatment (ART) centre in Nigeria. Methods: A retrospective analysis of a cohort of ART-naïve, HIV-infected patients, assessed for ART eligibility and ART- experience at the PEPFAR outpatient clinic at Lagos University Teaching Hospital over a 12-year period (April 2004-Feb- ruary 2016) was conducted. Results: During this period, 7,034 patients visited the clinic: 4,797 (68.2%) were female; 6161 patients had a recorded base- line CD4 count, and the median CD4 count was 184 cells/µl (IQR, 84-328). A baseline HIV-1 viral load (VL) was recorded for 5,908 patients; the median VL was 51,194 RNA copies/ml (IQR, 2,316-283,508) and 6,179/7046(88%) had initiated ART. Some 2,456 (34.9%) had a documented opportunistic infections, of whom 1,306 (18.6%) had an opportunistic fungal infection. The total number of OFI episodes was 1,632: oral candidiasis (n=1,473, 90.3%), oesophageal candidiasis (n=118; 8%), superficial mycoses (n=23; 1.6%), Pneumocystis pneumonia (PJP) (n=13; 0.8%), and cryptococcal meningitis(CM) (n=5; 0.4%). 113 (1.6%) were known to have died in the cohort. Conclusion: Approximately 1 in 5 HIV-infected patients in this retrospective cohort, most of whom had initiated ART, were clinically diagnosed with an OFI. Improved access to simple accurate diagnostic tests for CM and PJP should be pri- oritised for this setting. Keywords: Opportunistic fungal infections; ART Adherence; Advanced HIV disease.

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Section: Discussioncontrasting

confidence: 82%

“…PJP accounted for 1% of all AIDS-related mycotic infections in the present study, this is lower than 13% reported from a study in Western Nigeria 31 . While diagnosis in the index study was made clinically; in the study cited above, PJP was diagnosed using a PCR assay.…”

Section: Discussioncontrasting

confidence: 82%

Opportunistic fungal infections in persons living with advanced HIV disease in Lagos, Nigeria; a 12-year retrospective study

Oladele¹,

Ogunsola²,

Stocking³

et al. 2020

Afr H. Sci.

View full text Add to dashboard Cite

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“…For instance in a study in hospitals from the south-western region of Nigeria where 230 acid fast bacilli negative sputum samples from 230 patients presenting with respiratory tract infections, cysts of Pneumocystis jirovecii, formerly known as P. carinii were observed in 15 (6.5%) samples and polymerase chain reaction was positive for 29 (12.6%) samples out of 230 samples examined. The author concluded that P. jirovecii should be included in diagnosis of these infections in that part of the world [11]. In The Gambia, a study looking at healthy young individuals concluded that infection with P. carinii was common [12].…”

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confidence: 99%

Pathogenic Fungi - Neglected Infectious Agents? A Commentary on the Gambian Situation

Lawal¹

2015

J Med Microb Diagn

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Diagnosing Pneumocystis jirovecii pneumonia: A review of current methods and novel approaches

2020

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Pneumocystis jirovecii can cause life-threatening pneumonia in immunocompromised patients. Traditional diagnostic testing has relied on staining and direct visualization of the life-forms in bronchoalveolar lavage fluid. This method has proven insensitive, and invasive procedures may be needed to obtain adequate samples. Molecular methods of detection such as polymerase chain reaction (PCR), loop-mediated isothermal amplification (LAMP), and antibody-antigen assays have been developed in an effort to solve these problems. These techniques are very sensitive and have the potential to detect Pneumocystis life-forms in noninvasive samples such as sputum, oral washes, nasopharyngeal aspirates, and serum. This review evaluates 100 studies that compare use of various diagnostic tests for Pneumocystis jirovecii pneumonia (PCP) in patient samples. Novel diagnostic methods have been widely used in the research setting but have faced barriers to clinical implementation including: interpretation of low fungal burdens, standardization of techniques, integration into resource-poor settings, poor understanding of the impact of host factors, geographic variations in the organism, heterogeneity of studies, and limited clinician recognition of PCP. Addressing these barriers will require identification of phenotypes that progress to PCP and diagnostic cut-offs for colonization, generation of life-form specific markers, comparison of commercial PCR assays, investigation of cost-effective point of care options, evaluation of host factors such as HIV status that may impact diagnosis, and identification of markers of genetic diversity that may be useful in diagnostic panels. Performing high-quality studies and educating physicians will be crucial to improve the rates of diagnosis of PCP and ultimately to improve patient outcomes.

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Molecular detection of Pneumocystis jirovecii in patients with respiratory tract infections

Cited by 6 publications

References 22 publications

Opportunistic fungal infections in persons living with advanced HIV disease in Lagos, Nigeria; a 12-year retrospective study

Opportunistic fungal infections in persons living with advanced HIV disease in Lagos, Nigeria; a 12-year retrospective study

Pathogenic Fungi - Neglected Infectious Agents? A Commentary on the Gambian Situation

Diagnosing Pneumocystis jirovecii pneumonia: A review of current methods and novel approaches

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