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Pneumocystis Jirovecii

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https://www.readbyqxmd.com/read/28622118/imaging-spectrum-of-invasive-fungal-and-fungal-like-infections
#1
Hilary L P Orlowski, Sebastian McWilliams, Vincent M Mellnick, Sanjeev Bhalla, Meghan G Lubner, Perry J Pickhardt, Christine O Menias
Invasive fungal and fungal-like infections contribute to substantial morbidity and mortality in immunocompromised individuals. The incidence of these infections is increasing-largely because of rising numbers of immunocompromised patients, including those with neutropenia, human immunodeficiency virus, chronic immunosuppression, indwelling prostheses, burns, and diabetes mellitus, and those taking broad-spectrum antibiotics. Invasive fungal pathogens include primary mycotic organisms such as Histoplasma capsulatum, Coccidioides immitis, Blastomyces dermatitidis, and Paracoccidioides brasiliensis, which are true pathogens and inherently virulent...
June 16, 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28619423/acute-respiratory-distress-syndrome-following-alemtuzumab-therapy-for-relapsing-multiple-sclerosis
#2
Keh Yann, Fran Jackson, Nazar Sharaf, Tatiana Mihalova, Paul Talbot, David Rog, Adrian Pace
We present the case of a 54 year old woman with known relapsing-remitting multiple sclerosis who presented with acute respiratory deterioration five weeks after a first course of alemtuzumab. Imaging showed bilateral ground glass changes and extensive investigations confirmed chest infection with dual pathogens - Pneumocystis jirovecii and Cytomegalovirus. She responded to standard anti-PJP and CMV therapy and was discharged on oral prophylaxis. Opportunistic infections in the weeks immediately following alemtuzumab therapy remain an uncommon complication but one that requires clinical vigilance, careful monitoring and appropriate prophylactic therapy...
May 2017: Multiple Sclerosis and related Disorders
https://www.readbyqxmd.com/read/28590928/diagnosis-of-pneumocystis-jirovecii-pneumonia-with-serum-cell-free-dna-in-non-hiv-infected-immunocompromised-patients
#3
Dong Wang, Yang Hu, Ting Li, Heng-Mo Rong, Zhao-Hui Tong
Conventional respiratory tract specimens, such as bronchoalveolar lavage (BAL) fluid and induced sputum for diagnosing Pneumocystis jirovecii pneumonia (PCP) in immunocompromised patients are difficult to obtain. Besides, bronchoscopy is an invasive procedure that carries the risk of causing rapidly progressive respiratory insufficiency. By contrast, serum cell-free DNA (cfDNA) is easy to obtain and has been proven useful in diagnosing cancer, pregnancy associated complications, parasite infection and sepsis...
May 20, 2017: Oncotarget
https://www.readbyqxmd.com/read/28583135/outcomes-and-prognostic-factors-of-non-hiv-patients-with-pneumocystis-jirovecii-pneumonia-and-pulmonary-cmv-co-infection-a-retrospective-cohort-study
#4
Qing Yu, Peng Jia, Li Su, Hong Zhao, Chengli Que
BACKGROUND: Pneumocystis jirovecii pneumonia (PJP) and pulmonary cytomegalovirus (CMV) infection are common opportunistic infections among immunocompromised patients. However, few studies have evaluated their co-infection, especially among non-HIV patients. Therefore, we aimed to evaluate the outcomes and prognostic factors among non-HIV patients with PJP according to their CMV infection status. METHODS: This retrospective study evaluated non-HIV patients who were diagnosed with PJP between January 2009 and January2016...
June 5, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28575367/colonization-density-of-the-upper-respiratory-tract-as-a-predictor-of-pneumonia-haemophilus-influenzae-moraxella-catarrhalis-staphylococcus-aureus-and-pneumocystis-jirovecii
#5
Daniel E Park, Henry C Baggett, Stephen R C Howie, Qiyuan Shi, Nora L Watson, W Abdullah Brooks, Maria Deloria Knoll, Laura L Hammitt, Karen L Kotloff, Orin S Levine, Shabir A Madhi, David R Murdoch, Katherine L O'Brien, J Anthony G Scott, Donald M Thea, Dilruba Ahmed, Martin Antonio, Vicky L Baillie, Andrea N DeLuca, Amanda J Driscoll, Wei Fu, Caroline W Gitahi, Emmanuel Olutunde, Melissa M Higdon, Lokman Hossain, Ruth A Karron, Abdoul Aziz Maiga, Susan A Maloney, David P Moore, Susan C Morpeth, John Mwaba, Musaku Mwenechanya, Christine Prosperi, Mamadou Sylla, Somsak Thamthitiwat, Scott L Zeger, Daniel R Feikin
Background.: There is limited information on the association between colonization density of upper respiratory tract colonizers and pathogen-specific pneumonia. We assessed this association for Haemophilus influenzae, Moraxella catarrhalis, Staphylococcus aureus, and Pneumocystis jirovecii. Methods.: In 7 low- and middle-income countries, nasopharyngeal/oropharyngeal swabs from children with severe pneumonia and age-frequency matched community controls were tested using quantitative polymerase chain reaction (PCR)...
June 15, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28573186/lifelong-prophylaxis-with-trimethoprim-sulfamethoxazole-for-prevention-of-outbreak-of-pneumocystis-jirovecii-pneumonia-in-kidney-transplant-recipients
#6
Norihiko Goto, Ai Takahashi-Nakazato, Kenta Futamura, Manabu Okada, Takayuki Yamamoto, Makoto Tsujita, Takahisa Hiramitsu, Shunji Narumi, Kiyoto Tsuchiya, Hiroyuki Gatanaga, Yoshihiko Watarai, Shinichi Oka
BACKGROUND: Outbreaks of Pneumocystis jirovecii pneumonia (PCP) in kidney transplant recipients are frequently reported worldwide. However, the general guidelines propose only short-term prophylaxis with trimethoprim-sulfamethoxazole after kidney transplantation. We experienced 3 PCP outbreaks in the last 10 years despite providing the recommended prophylaxis. The purpose of this study was to find a prophylaxis regimen that could successfully prevent future PCP outbreaks in immunosuppressed kidney transplant recipients...
May 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28567422/risk-factors-for-the-mortality-of-pneumocystis-jirovecii-pneumonia-in-non-hiv-patients-who-required-mechanical-ventilation-a-retrospective-case-series-study
#7
Toru Kotani, Shinshu Katayama, Yuya Miyazaki, Satoshi Fukuda, Yoko Sato, Koichi Ohsugi
BACKGROUND: The risk factors for the mortality rate of Pneumocystis jirovecii pneumonia (PCP) who required mechanical ventilation (MV) remained unknown. METHODS: A retrospective chart review was performed of all PCP patients admitted to our intensive care unit and treated for acute hypoxemic respiratory failure to assess the risk factors for the high mortality. RESULTS: Twenty patients without human immunodeficiency virus infection required mechanical ventilation; 19 received noninvasive ventilation; and 11 were intubated...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28549105/outbreak-of-pneumocystis-jirovecii-infection-among-heart-transplant-recipients-molecular-investigation-and-management-of-an-inter-human-transmission
#8
William Vindrios, Nicolas Argy, Solène Le Gal, François-Xavier Lescure, Laurent Massias, Minh Patrick Le, Michel Wolff, Yazdan Yazdanpanah, Gilles Nevez, Sandrine Houze, Richard Dorent, Jean-Christophe Lucet
Background: An outbreak of Pneumocystis jirovecii pneumonia (PCP) occurred among heart transplant recipients (HTR) at the outpatient clinic of a university hospital, from March to September 2015. Clinical, therapeutic, biological and molecular data were analyzed to determine its origin and control the outbreak. Methods: Clinical and biological data regarding all HTR followed in the outpatient clinic were collected. PCP diagnosis was based on microscopy and real-time PCR...
May 26, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28539558/a-case-of-new-onset-rheumatoid-vasculitis-becoming-evident-in-the-course-of-treatment-for-pneumocystis-jirovecii-pneumonia
#9
Daisuke Ikuma, Kazuhiro Yokota, Kojiro Sato, Toshihide Mimura
  When patients with autoimmune diseases, such as rheumatoid arthritis (RA), are treated with potent immunosuppressive therapy, the risk of opportunistic diseases inevitably increases. If patients have the misfortune to suffer from both opportunistic and active autoimmune diseases, correct diagnosis could sometimes be difficult since both diseases have inflammatory nature. The choice of treatment is another challenge in that aggressive immunosuppressive therapy can fuel the opportunistic infection. Here we report a case of RA patient with new onset rheumatoid vasculitis that was diagnosed in the process of treatment of Pneumocystis jirovecii pneumonia...
2017: Nihon Rinshō Men'eki Gakkai Kaishi, Japanese Journal of Clinical Immunology
https://www.readbyqxmd.com/read/28520902/early-acquisition-of-pneumocystis-jirovecii-colonization-and-potential-association-with-respiratory-distress-syndrome-in-preterm-newborn-infants
#10
Pilar Rojas, Vicente Friaza, Elisa Garcia, Carmen de la Horra, Sergio L Vargas, Enrique J Calderón, Antonio Pavón
Background: Pneumocystis pneumonia is a well-recognized lung disease of premature and malnourished babies. Even though, serologic studies have shown that children are exposed to Pneumocystis jirovecii early in life the epidemiology of human P. jirovecii infection and the host-microorganism relationship in infancy remain poorly understood. The aim of the present study was to investigate the prevalence of P. jirovecii colonization in preterm infants and its possible association with medical complications...
May 17, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28515602/respiratory-multiplex-polymerase-chain-reaction-an-important-diagnostic-tool-in-immunocompromised-patients
#11
Amarjeet Kaur, Navin Kumar, Sharmila Sengupta, Yatin Mehta
BACKGROUND: Viruses and atypical pathogens can cause significant respiratory illness in immunocompromised patients. Multiplex polymerase chain reaction (MPCR) has improved the diagnostic yield of pathogens, and it is easier to identify the co-infections also. The present study was done to evaluate the performance of MPCR on bronchoalveolar lavage (BAL) samples in immunocompromised patients. METHODS: Atotal of 177 BAL specimens collected over a 19 months period from immunocompromised patients with respiratory illness were analyzed with the MPCR and aerobic culture...
April 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28491889/infections-in-hematopoietic-cell-transplant-recipients-results-from-the-organ-transplant-infection-project-a-multicenter-prospective-cohort-study
#12
Mindy G Schuster, Angela A Cleveland, Erik R Dubberke, Carol A Kauffman, Robin K Avery, Shahid Husain, David L Paterson, Fernanda P Silveira, Tom M Chiller, Kaitlin Benedict, Kathleen Murphy, Peter G Pappas
BACKGROUND: Infection is a major cause of morbidity and mortality after allogeneic hematopoietic cell transplantation (HCT). Our object was to better define the epidemiology and outcomes of infections after HCT. METHODS: This was a prospective, multicenter cohort study of HCT recipients and conducted from 2006 to 2011. The study included 4 US transplant centers and 444 HCT recipients. Data were prospectively collected for up to 30 months after HCT using a standardized data collection tool...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/28490578/investigating-clinical-issues-by-genotyping-of-medically-important-fungi-why-and-how
#13
REVIEW
Alexandre Alanio, Marie Desnos-Ollivier, Dea Garcia-Hermoso, Stéphane Bretagne
Genotyping studies of medically important fungi have addressed elucidation of outbreaks, nosocomial transmissions, infection routes, and genotype-phenotype correlations, of which secondary resistance has been most intensively investigated. Two methods have emerged because of their high discriminatory power and reproducibility: multilocus sequence typing (MLST) and microsatellite length polymorphism (MLP) using short tandem repeat (STR) markers. MLST relies on single-nucleotide polymorphisms within the coding regions of housekeeping genes...
July 2017: Clinical Microbiology Reviews
https://www.readbyqxmd.com/read/28484441/molecular-demonstration-of-a-pneumocystis-outbreak-in-stem-cell-transplant-patients-evidence-for-transmission-in-the-daycare-center
#14
Christine Robin, Alexandre Alanio, Maud Gits-Muselli, Giulia la Martire, Frédéric Schlemmer, Françoise Botterel, Cécile Angebault, Mathieu Leclerc, Florence Beckerich, Rabah Redjoul, Cécile Pautas, Andrea Toma, Sébastien Maury, Stéphane Bretagne, Catherine Cordonnier
Pneumocystis jirovecii pneumonia (PCP) is a life-threatening infection in hematology. Although occasionally reported, the role of interhuman transmission of P. jirovecii in PCP, compared to that of reactivation, remains an unresolved question; the recommendation to isolate PCP patients in the hematology ward are not well evidence-based. Following an unexpected increase in the number of febrile pneumonia patients with P. jirovecii DNA detected in respiratory samples in our hematology ward, we explored 12 consecutive patients from November 2015 to May 2016...
2017: Frontiers in Microbiology
https://www.readbyqxmd.com/read/28484270/risk-factors-for-pneumocystis-jirovecii-pneumonia-pjp-in-kidney-transplantation-recipients
#15
Su Hwan Lee, Kyu Ha Huh, Dong Jin Joo, Myoung Soo Kim, Soon Il Kim, Juhan Lee, Moo Suk Park, Young Sam Kim, Se Kyu Kim, Joon Chang, Yu Seun Kim, Song Yee Kim
Pneumocystis jirovecii pneumonia (PJP) is a potentially life-threatening infection that occurs in immunocompromised patients. The aim of this study was to evaluate risk factors for PJP in kidney transplantation recipients. We conducted a retrospective analysis of patient data from 500 consecutive kidney transplants performed at Severance Hospital between April 2011 and April 2014. Eighteen kidney transplantation recipients (3.6%) were diagnosed with PJP. In the univariate analysis, acute graft rejection, CMV infection, use of medication for diabetes mellitus, and lowest lymphocyte count were associated with PJP...
May 8, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28425200/high-dose-calcineurin-inhibitor-free-everolimus-as-a-maintenance-regimen-for-heart-transplantation-may-be-a-risk-factor-for%C3%A2-pneumocystis-pneumonia
#16
Yu-Ning Hu, Nan-Yao Lee, Jun-Neng Roan, Chi-Hsin Hsu, Chwan-Yao Luo
BACKGROUND: Everolimus reduces the incidence of cardiac-allograft vasculopathy (CAV) and is less renally toxic than are calcineurin inhibitors (CNIs). We evaluated the safety of CNI-free everolimus for post-heart transplant (HTx) patients. METHODS: We retrospectively reviewed the records of 36 consecutive patients who had undergone an HTx between January 2006 and December 2013 in National Cheng Kung University Hospital. All patients initially had been treated with the standard tacrolimus regimen...
April 20, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28401321/circulating-genotypes-of-pneumocystis-jirovecii-and-its-clinical-correlation-in-patients-from-a-single-tertiary-center-in-india
#17
Y Singh, B R Mirdha, R Guleria, S Khalil, A Panda, R Chaudhry, A Mohan, S K Kabra, L Kumar, S K Agarwal
The present study was carried out with the objectives of genotyping Pneumocystis jirovecii at three distinct loci, to identify the single nucleotide polymorphisms (SNPs), and to study its clinical implications in patients with Pneumocystis pneumonia (PCP). Analysis of genetic diversity in P. jirovecii from immunocompromised patients was carried out by genotyping at three distinct loci encoding mitochondrial large subunit rRNA (mtLSU rRNA), cytochrome b (CYB), and superoxide dismutase (SOD) using polymerase chain reaction (PCR) assays followed by direct DNA sequencing...
April 11, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28378239/usefulness-of-1-3-beta-d-glucan-detection-in-non-hiv-immunocompromised-mechanical-ventilated-critically-ill-patients-with-ards-and-suspected-pneumocystis-jirovecii-pneumonia
#18
Tobias Lahmer, Clarissa Prazeres da Costa, Jürgen Held, Sebastian Rasch, Ursula Ehmer, Roland M Schmid, Wolfgang Huber
INTRODUCTION: Pneumocystis jirovecii pneumonia (PCP) is a major cause of disease in immunocompromised individuals. Diagnosis is typically obtained by microscopy and/or PCR. For ambiguous PCR results, we evaluated the new biomarker 1,3-Beta-D-Glucan (BDG). METHODS: BDG serum levels were assessed and correlated to PCR results in immunosuppressed patients with ARDS. RESULTS: 11 (22%) out of 50 patients had suspected PCP. APACHE II (26 vs. 24; p < 0...
April 4, 2017: Mycopathologia
https://www.readbyqxmd.com/read/28358900/detection-of-pneumocystis-jirovecii-in-oral-wash-from-immunosuppressed-patients-as-a-diagnostic-tool
#19
Cecilie Juul Hviid, Marianne Lund, Allan Sørensen, Svend Ellermann-Eriksen, Bente Jespersen, Mette Yde Dam, Jens Frederik Dahlerup, Thomas Benfield, Sanne Jespersen, Lars Jørgen Østergaard, Alex Lund Laursen
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)...
2017: PloS One
https://www.readbyqxmd.com/read/28339745/chronic-nasal-staphylococcus-aureus-carriage-identifies-a-subset-of-newly-diagnosed-granulomatosis-with-polyangiitis-patients-with-high-relapse-rate
#20
Anna Salmela, Niels Rasmussen, Jan Willem Cohen Tervaert, David R W Jayne, Agneta Ekstrand
Objective.: The aim of this study was to evaluate whether chronic nasal carriage of Staphylococcus aureus (SA) is related to relapses in patients with newly diagnosed ANCA-associated vasculitis (AAV). Methods.: In two clinical trials (n = 200), for early systemic (n = 83) and generalized (n = 117) AAV, nasal swabs were obtained monthly and at the time of a relapse. Chronic nasal SA carriage (CNSAC) was defined as ⩾ 75% of cultures being SA positive, with non-carriers being SA negative in all cultures and remaining patients being intermittent carriers...
June 1, 2017: Rheumatology
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