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Pneumocystis Jirovecii

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https://www.readbyqxmd.com/read/28726611/added-value-of-next-generation-sequencing-for-multilocus-sequence-typing-analysis-of-a-pneumocystis-jirovecii-pneumonia-outbreak1
#1
Elena Charpentier, Cécile Garnaud, Claire Wintenberger, Sébastien Bailly, Jean-Benjamin Murat, John Rendu, Patricia Pavese, Thibault Drouet, Caroline Augier, Paolo Malvezzi, Anne Thiébaut-Bertrand, Marie-Reine Mallaret, Olivier Epaulard, Muriel Cornet, Sylvie Larrat, Danièle Maubon
Pneumocystis jirovecii is a major threat for immunocompromised patients, and clusters of pneumocystis pneumonia (PCP) have been increasingly described in transplant units during the past decade. Exploring an outbreak transmission network requires complementary spatiotemporal and strain-typing approaches. We analyzed a PCP outbreak and demonstrated the added value of next-generation sequencing (NGS) for the multilocus sequence typing (MLST) study of P. jirovecii strains. Thirty-two PCP patients were included...
August 2017: Emerging Infectious Diseases
https://www.readbyqxmd.com/read/28719897/clinical-manifestations-and-prognostic-factors-of-pneumocystis-jirovecii-pneumonia-without-hiv
#2
Nobuhiro Asai, Shinji Motojima, Yoshihiro Ohkuni, Ryo Matsunuma, Takuya Iwasaki, Kei Nakashima, Keiji Sogawa, Tamao Nakashita, Norihiro Kaneko
INTRODUCTION: Pneumocystis jirovecii pneumonia (PCP) can occur in HIV patients but also in those without HIV (non-HIV PCP) but with other causes of immunodeficiency including malignancy or rheumatic diseases. OBJECTIVE AND METHODS: To evaluate the clinical presentation and prognostic factors of non-HIV PCP, we retrospectively reviewed all patients diagnosed as having PCP without HIV at Kameda Medical Center, Chiba, Japan, from January 2005 until June 2012. For the purpose of examining a prognostic factor for non-HIV PCP with 30-day mortality, we compared the characteristics of patients, clinical symptoms, radiological images, Eastern Cooperative Oncology Group performance status (PS), and the time from the onset of respiratory symptoms to the start of therapy, in both survival and fatality groups...
July 19, 2017: Chemotherapy
https://www.readbyqxmd.com/read/28713390/hematopoietic-stem-cell-transplantation-in-an-infant-with-immunodeficiency-centromeric-instability-and-facial-anomaly-syndrome
#3
Katharina L Gössling, Cyrill Schipp, Ute Fischer, Florian Babor, Gerhard Koch, Friedhelm R Schuster, Jutta Dietzel-Dahmen, Dagmar Wieczorek, Arndt Borkhardt, Roland Meisel, Michaela Kuhlen
Immunodeficiency, centromeric instability, and facial anomaly (ICF) syndrome is a rare autosomal recessive genetic condition with severe immunodeficiency, which leads to lethal infections if not recognized and treated in early childhood. Up-to-date treatment regimens consist of prophylactic and supportive treatment of the recurrent infections. Here, we report the case of a 1-year-old boy of Moroccan consanguineous parents, who was diagnosed at 4 months of age with ICF syndrome with a homozygous missense mutation in the DNMT3B gene...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28705464/diversity-of-pneumocystis-jirovecii-across-europe-a-multicentre-observational-study
#4
Alexandre Alanio, Maud Gits-Muselli, Nicolas Guigue, Marie Desnos-Ollivier, Enrique J Calderon, David Di Cave, Damien Dupont, Axel Hamprecht, Philippe M Hauser, Jannik Helweg-Larsen, Marta Kicia, Katrien Lagrou, Martina Lengerova, Olga Matos, Willem J G Melchers, Florent Morio, Gilles Nevez, Anne Totet, Lewis P White, Stéphane Bretagne
Pneumocystis jirovecii is an airborne human-specific ascomycetous fungus responsible for Pneumocystis pneumonia (PCP) in immunocompromised patients, affecting >500,000 patients per year (www.gaffi.org). The understanding of its epidemiology is limited by the lack of standardised culture. Recent genotyping data suggests a limited genetic diversity of P. jirovecii. The objective of the study was to assess the diversity of P. jirovecii across European hospitals and analyse P. jirovecii diversity in respect to clinical data obtained from the patients...
June 29, 2017: EBioMedicine
https://www.readbyqxmd.com/read/28699887/upward-trend-of-dapsone-induced-methemoglobinemia-in-renal-transplant-community%C3%A2
#5
Sohail Abdul Salim, Lakshmi Ramachandran Nair, Venkataraman Palabindala, Iasmina Craici
Dapsone, a sulfone antibiotic, is used for prophylaxis of Pneumocystis jirovecii pneumonia in patients with documented sulfa allergy. Acquired methemoglobinemia caused by dapsone is not uncommon in patients with normal glucose-6-phosphate dehydrogenase (G6PD) levels. Discrepancy between oxygen saturation measured by pulse oximetry and arterial oxygen saturation (SpO2) readings, a phenomenon known as "saturation gap," is noted with cases of methemoglobinemia. Although its prevalence in renal transplant patients is poorly described, there is evidence that its incidence is increasing...
July 12, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28692651/effects-of-clinical-and-environmental-factors-on-bronchoalveolar-antibody-responses-to-pneumocystis-jirovecii-a-prospective-cohort-study-of-hiv-patients
#6
Robert J Blount, Kieran R Daly, Serena Fong, Emily Chang, Katherine Grieco, Meredith Greene, Stephen Stone, John Balmes, Robert F Miller, Peter D Walzer, Laurence Huang
BACKGROUND: Humoral immunity plays an important role against Pneumocystis jirovecii infection, yet clinical and environmental factors that impact bronchoalveolar antibody responses to P. jirovecii remain uncertain. METHODS: From October 2008-December 2011 we enrolled consecutive HIV-infected adults admitted to San Francisco General Hospital (SFGH) who underwent bronchoscopy for suspected Pneumocystis pneumonia (PCP). We used local air quality monitoring data to assign ozone, nitrogen dioxide, and fine particulate matter exposures within 14 days prior to hospital admission...
2017: PloS One
https://www.readbyqxmd.com/read/28688008/pneumocystis-jirovecii-and-cystic-fibrosis-in-brittany-france
#7
Gilles Nevez, Florence Robert-Gangneux, Laurence Pougnet, Michèle Virmaux, Chantal Belleguic, Eric Deneuville, Gilles Rault, Sylviane Chevrier, Sophie Ramel, Jean Le Bihan, Thibaud Guillaud-Saumur, Enrique Calderon, Yohann Le Govic, Jean-Pierre Gangneux, Solène Le Gal
Pneumocystis jirovecii is a transmissible fungus with a high pulmonary tropism. The prevalence of P. jirovecii in patients with cystic fibrosis (CF) has been estimated in Germany at 7.4%, in Spain at 21.5% and in Brazil at 38.2%. Data on the prevalence of P. jirovecii in CF patients in France remain scarce, particularly in Brittany, where the prevalence of CF is high (from 1/1600 to 1/4500). Our objectives were to determine the prevalence of colonization of the airways by P. jirovecii in Brittany in CF patients monitored at the "Centre de Ressources et de Compétences de la Mucoviscidose (CRCM)" of Rennes compared to that previously observed at the CRCM of Roscoff-Brest...
July 7, 2017: Mycopathologia
https://www.readbyqxmd.com/read/28683092/comparison-of-quantitative-real-time-pcr-and-direct-immunofluorescence-for-the-detection-of-pneumocystis-jirovecii
#8
Bhavani Moodley, Stefano Tempia, John Andrew Frean
BACKGROUND: Pneumocystis pneumonia (PCP) is a serious risk for HIV-positive patients. Asymptomatic infection or colonisation with P. jirovecii has been shown to occur frequently. PCR assays frequently identify such cases, due to their high sensitivity. Quantitative real-time PCR (qPCR) gene copy number cut-off values have been suggested to differentiate colonisation and infection; these need to be standardised for routine use. We compared the results of qPCR with an immunofluorescence assay (IFA) to determine a specific cut-off value...
2017: PloS One
https://www.readbyqxmd.com/read/28661231/characteristics-of-hospital-admissions-for-pneumonia-in-hiv-positive-individuals-in-winnipeg-manitoba-a-cross-sectional-retrospective-analysis
#9
S van Gaalen, Michael Duff, Luisa F Arroyave, Zulma Vanessa Rueda, Ken Kasper, Y Keynan
Lung infection in human immunodeficiency virus (HIV)-positive individuals remains an important cause of morbidity and mortality, even in the current antiretroviral therapy era. Pneumonia is the most common cause of admission in HIV-positive individuals in our centre as reported in a previously published study. The objective of this retrospective observational study was to further characterize these admissions, with respect to index of disease severity at presentation, organisms identified, and investigations pursued including bronchoalveolar lavage (BAL)...
January 1, 2017: International Journal of STD & AIDS
https://www.readbyqxmd.com/read/28660636/pulmonary-co-infections-by-pneumocystis-jirovecii-and-aspergillus-fumigatus-in-non-hiv-patients-a-report-of-two-cases-and-literature-review
#10
REVIEW
Anthi-Marina Markantonatou, Aliki Ioakimidou, Kostoula Arvaniti, Eleni Manou, Vassilios Papadopoulos, Parthena Kiriklidou, Konstantinos Samaras, Anna Kioumi, Timoleon-Achilleas Vyzantiadis
Pneumocystis jirovecii is the causative agent of Pneumocystis pneumonia (PcP), a common and often life-threatening opportunistic infection in HIV-infected patients. However, non-HIV, immunocompromised patients are at risk of PcP as well, whereas the mortality appears to be higher among these patients. Pneumocystis co-infections with other microorganisms are less frequent and only sparse reports of combined PcP and invasive pulmonary fungal infections exist in the literature, especially in the non-HIV patients...
June 28, 2017: Mycoses
https://www.readbyqxmd.com/read/28659366/successful-repeat-ecmo-in-a-patient-with-aids-and-ards
#11
Sho Horikita, Masamitsu Sanui, Yuki Fujimoto, Alan Kawarai Lefor
Veno-venous extracorporeal membrane oxygenation (ECMO) is being more commonly used in patients with acute respiratory distress syndrome (ARDS) due to potentially reversible illnesses. Survival from ARDS using ECMO has been reported even in patients with AIDS. However, the indications for ECMO for ARDS due to immune reconstitution inflammatory syndrome (IRIS) in patients with AIDS are unknown. A 23-year-old man with AIDS and Pneumocystis jirovecii pneumonia was admitted to the intensive care unit with severe ARDS refractory to mechanical ventilator support requiring ECMO...
June 28, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28651341/plasma-concentrations-of-atovaquone-given-to-immunocompromised-patients-to-prevent-pneumocystis-jirovecii
#12
Christine Robin, Minh Patrick Lê, Giovanna Melica, Laurent Massias, Rabah Redjoul, Nihel Khoudour, Mathieu Leclerc, Florence Beckerich, Sébastien Maury, Anne Hulin, Catherine Cordonnier
Objectives: Atovaquone is one of the alternatives to trimethoprim/sulfamethoxazole for prophylaxis of Pneumocystis jirovecii pneumonia (PCP) in immunocompromised patients. In volunteers, there was wide inter-individual variability in atovaquone bioavailability. The aim of this study was to assess the plasma concentrations of atovaquone in immunocompromised patients under PCP prophylaxis. Methods: Adult haematology or HIV-positive patients receiving atovaquone (750 mg oral suspension twice a day) for PCP prophylaxis were included...
June 22, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28649366/pneumocystis-jirovecii-detection-in-asymptomatic-patients-what-does-its-natural-history-tell-us
#13
REVIEW
Alexandre Alanio, Stéphane Bretagne
Pneumocystis jirovecii is an unusual ascomycetous fungus that can be detected in the lungs of healthy individuals. Transmission from human to human is one of its main characteristics in comparison with other fungi responsible for invasive infections. P. jirovecii is transmitted through the air between healthy individuals, who are considered to be the natural reservoir, at least transiently. In immunocompromised patients, P. jirovecii multiplies, leading to subacute infections and acute life-threatening pneumonia, called Pneumocystis pneumonia [PCP]...
2017: F1000Research
https://www.readbyqxmd.com/read/28622118/imaging-spectrum-of-invasive-fungal-and-fungal-like-infections
#14
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...
July 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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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