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Pneumocystis Jirovecii

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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
#1
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
#2
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
#3
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
#4
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
#5
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...
February 20, 2017: Rheumatology
https://www.readbyqxmd.com/read/28321223/abo-incompatible-kidney-transplantation
#6
REVIEW
Christian Morath, Martin Zeier, Bernd Döhler, Gerhard Opelz, Caner Süsal
ABO-incompatible (ABOi) kidney transplantation has long been considered a contraindication to successful kidney transplantation. During the last 25 years, increasing organ shortage enforced the development of strategies to overcome the ABO antibody barrier. In the meantime, ABOi kidney transplantation has become a routine procedure with death-censored graft survival rates comparable to the rates in compatible transplantations. Desensitization is usually achieved by apheresis and B cell-depleting therapies that are accompanied by powerful immunosuppression...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28316430/comparison-of-three-cost-effective-staining-methods-for-detection-of-pneumocystis-jirovecii
#7
Mohamad Mohsen Homayouni, Ali Rostami, Hamed Gholizadeh, Amir Sayed Ali Mehbod, Maryam Ebrahimi, Saeed Mehravar
Pneumocystis pneumonia due to Pneumocystis jirovecii infection is an emerging health problem not only for HIV-infected patients but also for other immunocompromised patients in many countries. We compared Gomori methenamine silver (GMS), Toluidine Blue O (TBO) and Giemsa staining methods using standard procedures. The sensitivity and specificity of GMS were 100 %. The sensitivity and specificity of TBO were 96 and 100 %, respectively. The sensitivity and specificity of Giemsa stain were 84 and 90 %, respectively...
March 2017: Journal of Parasitic Diseases: Official Organ of the Indian Society for Parasitology
https://www.readbyqxmd.com/read/28303545/low-prevalence-of-dhfr-and-dhps-mutations-in-pneumocystis-jirovecii-strains-obtained-from-a-german-cohort
#8
Isabelle Suárez, Lisa Roderus, Edeltraud van Gumpel, Norma Jung, Clara Lehmann, Gerd Fätkenheuer, Pia Hartmann, Georg Plum, Jan Rybniker
BACKGROUND: Pneumocystis pneumonia (PCP) is an opportunistic and potentially life-threatening infection of immunocompromised individuals. A combination of trimethoprim-sulfamethoxazole is widely used for prophylaxis and treatment of PCP. Polymorphisms in the drug targets, the dihydropteroate synthase (DHPS) or the dihydrofolate reductase (DHFR) are presumably a reason for treatment failure. METHODS: We retrospectively examined the prevalence of DHPS and DHFR mutations in Pneumocystis jirovecii isolates obtained from HIV-infected and non-HIV-infected PCP patients...
March 16, 2017: Infection
https://www.readbyqxmd.com/read/28287298/pneumocystis-jirovecii-induced-chronic-interstitial-lung-disease-in-waldenstr%C3%A3-m-s-macroglobulinemia
#9
Wolfram Windisch, Axel Meissner, Axel Goßmann, Michael Brockmann, Verena Schildgen, Oliver Schildgen
Infections with Pneumocystis jirovecii can result in asymptomatic colonization or induce life threatening clinical symptoms. However, there appears to be a 'gray area' between colonization and severe pneumonia that remains underestimated so far. We describe a case with chronic interstitial lung disease and chronic cough that was attributed to P. jirovecii. The patient's history of chronic cough, although very likely being fostered by the underlying Waldenström's macroglobulinemia and interstitial lung disease, was most likely caused by P...
March 2017: Future Microbiology
https://www.readbyqxmd.com/read/28287010/diagnosis-and-management-of-pneumocystis-jirovecii-infection
#10
P Lewis White, Matthijs Backx, Rosemary A Barnes
Pneumocystis jirovecii is a ubiquitous fungus, which causes pneumonia in humans. Diagnosis was hampered by the inability to culture the organism, and based on microscopic examination of respiratory samples or clinical presentation. New assays can assist in the diagnosis and even aid with the emergence of resistant infections. Areas covered: This manuscript will provide background information on Pneumocystis pneumonia (PcP). Diagnosis, from radiological to non-microbiological (e.g. Lactate dehydrogenase) and microbiological investigations (Microscopy, PCR, β-D-Glucan) will be discussed...
March 20, 2017: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/28267082/guidelines-for-the-prophylaxis-of-pneumocystis-jirovecii-pneumonia-pjp-in-children-with-solid-tumors
#11
Rebecca Proudfoot, Bob Phillips, Sophie Wilne
Although it is well-established that children undergoing allogeneic stem cell transplants and treatment for leukemia should be offered prophylaxis against Pneumocystis jirovecii pneumonia, the risk for children with solid malignancies is less certain. This guideline has been developed with the aim of standardizing practice and optimizing the benefit versus risk of prophylactic medication in this group of patients. P. jirovecii pneumonia has a high mortality rate even with prompt antimicrobial treatment. Since prophylaxis with co-trimoxazole is safe, effective, and inexpensive, we suggest that all children with malignancies undergoing immunosuppressive therapy are offered prophylaxis unless there are clear contraindications...
April 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28257752/efficacy-and-safety-of-idelalisib-in-combination-with-ofatumumab-for-previously-treated-chronic-lymphocytic-leukaemia-an-open-label-randomised-phase-3-trial
#12
Jeffrey A Jones, Tadeusz Robak, Jennifer R Brown, Farrukh T Awan, Xavier Badoux, Steven Coutre, Javier Loscertales, Kerry Taylor, Elisabeth Vandenberghe, Malgorzata Wach, Nina Wagner-Johnston, Loic Ysebaert, Lyndah Dreiling, Ronald Dubowy, Guan Xing, Ian W Flinn, Carolyn Owen
BACKGROUND: Idelalisib, a selective inhibitor of PI3Kδ, is approved for the treatment of patients with relapsed chronic lymphocytic leukaemia (CLL) in combination with rituximab. We aimed to assess the efficacy and safety of idelalisib in combination with a second-generation anti-CD20 antibody, ofatumumab, in a similar patient population. METHODS: In this global, open-label, randomised, controlled phase 3 trial, we enrolled patients with relapsed CLL progressing less than 24 months from last therapy...
March 2017: Lancet Haematology
https://www.readbyqxmd.com/read/28243035/infections-in-severe-alcoholic-hepatitis
#13
REVIEW
Eleni Karakike, Christophe Moreno, Thierry Gustot
Severe alcoholic hepatitis (sAH), defined by a modified discriminant function ≥32, is the most severe form of alcohol-induced liver disease and is associated with a 1-month mortality rate of around 30%. Corticosteroid treatment remains the only therapeutic option that improves short-term survival. Infectious complications, occurring in approximately 50% of patients, are the main causes of death, even in patients who benefit from corticosteroids. Liver failure, recent alcohol consumption and immunosuppressive drugs contribute to this infectious risk...
2017: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://www.readbyqxmd.com/read/28223177/pneumocystis-pneumonia-in-patients-with-inflammatory-or-autoimmune-diseases-usefulness-of-lymphocyte-subtyping
#14
Yi Li, Marc Ghannoum, Chuntao Deng, Yanxia Gao, Huadong Zhu, Xuezhong Yu, Valery Lavergne
OBJECTIVES: No consensus currently exists on the indications for Pneumocystis jirovecii prophylaxis in patients with inflammatory or autoimmune diseases. The main objective was to identify biomarkers associated with P. jirovecii pneumonia (PCP) in this population. METHODS: A retrospective study was carried out at Beijing Union Medical College Hospital (2003-2014). All patients with an inflammatory or autoimmune disease presenting with acute onset of fever and respiratory symptoms were included...
February 20, 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/28214275/detection-of-pneumocystis-jirovecii-by-nested-pcr-in-hiv-negative-patients-with-pulmonary-disease
#15
Cristina Rodrigues Santos, Ângela M de Assis, Edson A Luz, Luzia Lyra, Ivan F Toro, José Claudio C Seabra, Dira H Daldin, Tathiane U Marcalto, Marcos T Galasso, Ronaldo F Macedo, Angélica Z Schreiber, Francisco H Aoki
BACKGROUND: Nested PCR can be used to determine the status of Pneumocystis jirovecii infection in other lung diseases. AIMS: This study sought to detect a target DNA fragment (mitochondrial large subunit rRNA or mtL SUrRNA) of P. jirovecii in patients with lung disease who underwent bronchoscopy with collection of bronchoalveolar lavage (BAL). METHODS: The results from toluidine blue staining were compared with those obtained using molecular methods that included an "in house" DNA extraction procedure, PCR and nested PCR...
February 14, 2017: Revista Iberoamericana de Micología
https://www.readbyqxmd.com/read/28193704/pneumocystis-colonization-in-asthmatic-patients-not-receiving-oral-corticosteroid-therapy
#16
Emma L Davey, Rhonda E Colombo, Charles Fiorentino, Gary Fahle, Richard T Davey, Kenneth N Olivier, Joseph A Kovacs
Pneumocystis jirovecii can colonize patients with chronic obstructive pulmonary disease. To determine if colonization occurs in asthma patients, sputum samples from 10 patients with mild asthma, who were not receiving oral corticosteroids, were evaluated by a sensitive real-time PCR assay that targets a multicopy gene of P. jirovecii. 2 patients (20%) had Pneumocystis DNA detected; 1 patient had 3 positive samples over an 11-day period. Thus, Pneumocystis colonization occurs in asthma patients, and further studies are warranted to evaluate its role in airways disease...
February 13, 2017: Journal of Investigative Medicine: the Official Publication of the American Federation for Clinical Research
https://www.readbyqxmd.com/read/28192629/the-effect-of-co-trimoxazole-on-serum-potassium-concentration-safety-evaluation-of-a-randomised-controlled-trial
#17
Wei Yee Chan, Allan B Clark, Andrew M Wilson, Yoon K Loke
AIMS: Co-trimoxazole maintains a well-established role in the treatment of Pneumocystis jirovecii and Toxoplasma gondii, as well as urinary tract infections. Observational studies report hyperkalemia associated with co-trimoxazole which may stem from an amiloride-like potassium sparing effect. Our study reports on changes in serum potassium on patients without acute infections, and the influence of concomitant anti-kaliuretic drugs on this effect. METHODS: Post-hoc analysis of a randomised controlled trial in patients with interstitial lung disease who were assigned to placebo or 960 mg twice daily co-trimoxazole...
February 13, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28185780/corrigendum-to-caspofungin-salvage-therapy-in-pneumocystis-jirovecii-pneumonia-j-microbiol-immunol-infect-2016-pii-s1684-1182-16-30029-9-epub-ahead-of-print
#18
Wen-Sen Lee, Po-Ren Hsueh, Tai-Chin Hsieh, Fu-Lun Chen, Tsong-Yih Ou, Shio-Shin Jean
No abstract text is available yet for this article.
February 6, 2017: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
https://www.readbyqxmd.com/read/28169011/investigation-of-outbreaks-of-pneumocystis-jirovecii-pneumonia-in-two-scottish-renal-units
#19
T Inkster, S Dodd, R Gunson, L Imrie, E Spalding, S Packer, C Deighan, C Daly, J Coia, T Imtiaz, C McGuffie, R Wilson, A M Bal
Pneumocystis jirovecii is recognized as an opportunistic pathogen. In recent years, human-to-human transmission of P. jirovecii has been demonstrated. However, outbreaks of P. jirovecii infections are not well defined because the epidemiological setting that facilitates transmission is not fully understood. This article describes two outbreaks of P. jirovecii pneumonia (PCP) in renal transplant patients in the West of Scotland. In total, 25 patients in two geographically contiguous locations were affected...
November 18, 2016: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28143789/comparison-of-a-commercial-real-time-pcr-assay-realcycler%C3%A2-pjir-kit-progenie-molecular-to-an-in-house-real-time-pcr-assay-for-the-diagnosis-of-pneumocystis-jirovecii-infections
#20
COMPARATIVE STUDY
Thibaud Guillaud-Saumur, Gilles Nevez, Amélie Bazire, Michèle Virmaux, Nicolas Papon, Solène Le Gal
We compared the RealCycler® PJIR kit (Progenie Molecular), available in Europe, to an in-house real-time PCR assay for the diagnosis of Pneumocystis jirovecii infections. Excellent agreement was found (concordance rate, 97.4%; Cohen's kappa, 0.918>0.8) showing that this commercial assay represents an alternative method for the diagnosis of P. jirovecii infections.
April 2017: Diagnostic Microbiology and Infectious Disease
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