Detection of Pneumocystis jirovecii in oral wash from immunosuppressed patients as a diagnostic tool

Autor: Allan Sørensen, Mette Yde Dam, Jens Frederik Dahlerup, Cecilie Juul Hviid, Bente Jespersen, Svend Ellermann Eriksen, Thomas Benfield, Sanne Jespersen, Alex Lund Laursen, Marianne Lund, Lars Østergaard
Rok vydání: 2017
Předmět:
PNEUMONIA
RNA viruses
Male
0301 basic medicine
Pneumocystis carinii/genetics
ASYMPTOMATIC CARRIAGE
Denmark
lcsh:Medicine
HIV Infections
Artificial Gene Amplification and Extension
Blood Donors
Disease
Pneumocystis carinii
Pathology and Laboratory Medicine
Polymerase Chain Reaction
Gastroenterology
DNA
Fungal/genetics
COLONIZATION
0302 clinical medicine
Immunodeficiency Viruses
Renal Transplantation
Ethnicities
030212 general & internal medicine
REAL-TIME PCR
DNA
Fungal
lcsh:Science
Multidisciplinary
biology
Pneumonia
Pneumocystis
Kidney Transplantation/adverse effects
Fungal Diseases
Fungal genetics
Viral Load
Middle Aged
Danes
PULMONARY INFECTIONS
DNA AMPLIFICATION
Africa
Western
Medical Microbiology
Viral Pathogens
Viruses
Infectious diseases
Pathogens
medicine.symptom
Viral load
Research Article
Adult
medicine.medical_specialty
POLYMERASE-CHAIN-REACTION
030106 microbiology
Surgical and Invasive Medical Procedures
HIV Infections/complications
Viremia
Viral diseases
Research and Analysis Methods
Microbiology
Asymptomatic
BRONCHOALVEOLAR LAVAGE
Urinary System Procedures
Immunocompromised Host
03 medical and health sciences
IMMUNOCOMPROMISED PATIENTS
Virology
Internal medicine
Retroviruses
medicine
Humans
Pneumocystis jirovecii
CLINICAL-SIGNIFICANCE
Molecular Biology Techniques
Molecular Biology
Microbial Pathogens
Medicine and health sciences
Transplantation
Pneumocystis
business.industry
Lentivirus
lcsh:R
Organisms
Biology and Life Sciences
HIV
Organ Transplantation
biology.organism_classification
medicine.disease
Kidney Transplantation
Pneumonia
Pneumocystis/complications
Health Care
Pneumonia
Carriage
Immunocompromised Host/genetics
People and Places
Immunology
Population Groupings
lcsh:Q
business
Viral Transmission and Infection
Zdroj: Hviid, C J, Ellermann-Eriksen, S, Jespersen, B, Dam, M Y, Dahlerup, J F, Benfield, T, Jespersen, S, Østergaard, L J & Laursen, A L 2017, ' Detection of Pneumocystis jirovecii in oral wash from immunosuppressed patients as a diagnostic tool ', PLOS ONE, vol. 12, no. 3, e0174012 . https://doi.org/10.1371/journal.pone.0174012
PLoS ONE, Vol 12, Iss 3, p e0174012 (2017)
PLoS ONE
Hviid, C J, Lund, M, Sørensen, A, Ellermann-Eriksen, S, Jespersen, B, Dam, M Y, Dahlerup, J F, Benfield, T, Jespersen, S, Østergaard, L J, Laursen, A L & Bissau HIV Cohort Study Group 2017, ' Detection of Pneumocystis jirovecii in oral wash from immunosuppressed patients as a diagnostic tool ', P L o S One, vol. 12, no. 3, e0174012 . https://doi.org/10.1371/journal.pone.0174012
ISSN: 1932-6203
DOI: 10.1371/journal.pone.0174012
Popis: BACKGROUND: Diagnosis of Pneumocystis jirovecii (PJ) pneumonia ordinarily requires invasive procedures that could be avoided by PCR methodologies, if these could be designed with adequate cut-off values for confounding background carriage.METHODS: We designed a novel quantitative real-time PCR assay to detect the mitochondrial large subunit rRNA gene of PJ in oral washes. To benchmark levels of PJ carriage versus infection, we tested asymptomatic immunosuppressed patients including Danish (n = 88) and West African HIV-infected (n = 142) patients, renal transplant recipients (n = 51), rheumatologic patients (n = 102), patients with inflammatory bowel diseases (n = 98), and healthy blood donors (controls, n = 50). The fungal burden in patients with PJ pneumonia (PCP, n = 7) was also investigated.RESULTS: Danish HIV-infected patients (with viremia/low CD4) and recent transplant recipients were at most risk of being carriers (prevalence of 23% and 16.7% respectively), whereas PJ was rarely detected among rheumatologic patients, patients with inflammatory bowel diseases, and untreated West African HIV patients. PJ was not detected among healthy controls. The fungal burden in patients with PCP fell rapidly on treatment.CONCLUSIONS: The quantitative PCR method described could conceivably discriminate between carriage and disease, given suitable threshold values for the former, and predict treatment efficacy by measures of the fungal burden in daily oral washes.
Databáze: OpenAIRE
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