Asymptomatic carriage of Pneumocystis jiroveci in subjects undergoing bronchoscopy: a prospective study

Maskell, N.A.; Waine, D.J.; Lindley, A.; Pepperell, J.C.T.; Wakefield, A.E.; Miller, R.F.; Davies, R.J.O.
July 2003
Thorax;Jul2003, Vol. 58 Issue 7, p594
Academic Journal
Background: The opportunistic fungus Pneumocystis jiroveci is a common cause of respiratory infection in immunocompromised patients. By contrast, pneumocystis pneumonia (PCP) occurs only rarely in immunocompetent individuals. Asymptomatic colonisation with P jiroveci has recently been described in patients who are either minimally immunosuppressed or who have underlying lung disorders such as bronchiectasis. We sought to determine the prevalence of asymptomatic colonisation by P jiroveci in a cohort of adult patients undergoing diagnostic bronchoscopy. Methods: A prospective observational cohort study was performed in patients who required bronchoscopy and bronchoalveolar lavage (BAL) as part of their routine clinical assessment. All the samples underwent standard microbiological analysis and a Grocott methenamine silver stain was performed where clinically indicated to detect the presence of P jiroveci. Polymerase chain reaction for detection of P jiroveci specific DNA was also performed. Results: Ninety three consecutive BAL fluid samples were analysed, 17 (18%) of which contained P jiroveci DNA. Of the potential predictors examined, only glucocorticoid use was significantly associated with detectable P jiroveci DNA. Eighteen patients were receiving oral glucocorticoids (equivalent to > 20 mg/day prednisolone) at the time of bronchoscopy, of whom eight (44%) had detectable P jiroveci DNA. In contrast, P jiroveci was detected in only nine of 75 patients (12%) who were not receiving glucocorticoids (difference between proportions 32%, 95% CI 8 to 57; p = 0.004, two tailed Fisher's exact test). Conclusions: P jiroveci colonisation, as determined by detection of P jiroveci DNA in BAL fluid, is common in HIV negative patients with primary respiratory disorders undergoing bronchoscopy and BAL. The higher prevalence in patients receiving corticosteroids suggests that oral glucocorticoid therapy is an independent risk factor for colonisation. In contrast, underlying...


Related Articles

  • bronchoscopy:. Huber, Jeffrey T.; Gillaspy, Mary L. // Encyclopedic Dictionary of AIDS-Related Terminology;2000, p42 

    A definition of the term "bronchoscopy" is presented. It refers to a procedure of examining the bronchi and using the results to diagnose pulmonary disorders such as Pneumocystis carinii pneumonia. In bronchoscopy, a bronchoscope is inserted orally for the purpose of taking specimens for culture...

  • Molecular Detection of Pneumocystis Jirovecii in Patients with Respiratory Tract Infections. Terry Alli, Oyebode Armstrong; Ogbolu, David Olusoga; Ademola, Olufunmi; Oyenike, Musiliu Adewale // North American Journal of Medical Sciences;Oct2012, Vol. 4 Issue 10, p479 

    Background: Pneumocystis jirovecii, formerly known as P. carinii, is an opportunistic fungus causing Pneumocystis carinii pneumonia especially in immunocompromised patients. Aim: The aim of this study was to detect P. jirovecii in sputum samples from patients suspected of having respiratory...

  • Pneumocystis jirovecii Pneumonia in Africa: Impact and Implications of Highly Sensitive Diagnostic Technologies. Matos, Olga // North American Journal of Medical Sciences;Oct2012, Vol. 4 Issue 10, p486 

    The author comments on a study published within the issue on using polymerase chain reaction (PCR) as a diagnostic tool for the prevalence of Pneumocystis jirovecii pneumonia (PcP) in sputum samples from patients suspected of having respiratory tract infections (RTI) in south western Nigeria....

  • Immune Modulation with Sulfasalazine Attenuates Immunopathogenesis but Enhances Macrophage-Mediated Fungal Clearance during Pneumocystis Pneumonia.  // PLoS Pathogens;Aug2010, Vol. 6 Issue 8, p1 

    No abstract available.

  • Microbial communities in the respiratory tract of patients with interstitial lung disease. Garzoni, Christian; Brugger, Silvio D.; Weihong Qi; Wasmer, Sarah; Cusini, Alexia; Dumont, Philippe; Gorgievski-Hrisoho, Meri; Mühlemann, Kathrin; von Garnier, Christophe; Hilty, Markus // Thorax;Dec2013, Vol. 68 Issue 12, p1150 

    Background: Molecular methods based on phylogenetic differences in the 16S rRNA gene are able to characterise the microbiota of the respiratory tract in health and disease. Objective:s Our goals were (1) to characterise bacterial communities in lower and upper airways of patients with...

  • Pneumocystis Colonization Is Highly Prevalent in the Autopsied Lungs of the General Population. Ponce, Carolina A.; Gallo, Myriam; Bustamante, Rebeca; Vargas, Sergio L. // Clinical Infectious Diseases;2/1/2010, Vol. 50 Issue 3, p347 

    Background. Increasing reports of Pneumocystis DNA in noninvasive respiratory specimens from immunocompetent asymptomatic adults and the characteristic lung tropism of Pneumocystis suggest that asymptomatic pulmonary infections with Pneumocystis occur after primary infection. However, studies...

  • Lower Respiratory Tract Infection in a Renal Transplant Recipient: Do not Forget Metapneumovirus. Noel, N.; Rammaert, B.; Zuber, J.; Sayre, N.; Mamzer-Bruneel, M. F.; Leruez-Ville, M.; Mascard, L.; Lecuit, M.; Lortholary, O. // Case Reports in Transplantation;2012, p1 

    Humanmetapneumovirus (hMPV) is emerging as a cause of a severe respiratory tract infection in immunocompromised patients. hMPV pneumonia has only been seldom reported in nonpulmonary solid organ transplanted patients, such as renal transplant recipients. We report here a case of a 39-year-old...

  • Pneumocystis Pneumonia - A Novel Complication in a Non-HIV Dengue Patient. ATWAL, SWAPNDEEP SINGH; PURANIK, SWAPNIL; MEHRA, SHIBANI; GARGA, UMESH CHANDRA // Journal of Clinical & Diagnostic Research;Sep2014, Vol. 8 Issue 9, p1 

    The article presents the case history of a 33-year old male, a non-HIV dengue patient with pneumocystis pneumonia, who was presented to the hospital with two days history of high grade fever with chills, headache, generalized body ache and vomiting. Pneumocystis pneumonia is a common fungal...

  • Fatal Pneumonia in an AIDS Patient Coinfected with Adenovirus and Pneumocystis carinii. Koopmann, J.; Dombrowski, F.; Rockstroh, J. K.; Pfeifer, U.; Sauerbruch, T.; Spengler, U. // Infection;Oct2000, Vol. 28 Issue 5, p323 

    Background: Adenovirus infections are common in immunocompromised hosts. However, pulmonary adenovirus infections rarely cause significant morbidity in HIV-infected patients. Patient: Here we describe a 27-year-old man with AIDS who presented with tachypnea, hypoxemia and an infiltrate in the...


Read the Article


Sign out of this library

Other Topics