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      The prevalence of Pneumocystis jirovecii among patients with different chronic pulmonary disorders in Ahvaz, Iran

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          Abstract

          Background and Objectives:

          Pneumocystis jirovecii pneumonia (PJP) is a chronic fungal infection that caused by P. jirovecii. Disease is more prevalent among the HIV-infected patients. The colonization of pneumocystis in human respiratory system is associated with the airway inflammation and obstruction. The current study was conducted to identify the prevalence of P. jirovecii among the patients with chronic pulmonary disorders in Ahvaz, Iran.

          Materials and Methods:

          In the present study, 115 bronchoalveolar lavage (BAL) specimens were collected from patients. Samples were subjected to Nested-PCR with specific primers. The second PCR products were used for sequencing analysis.

          Results:

          Our findings demonstrated that 31(27.0%) of samples were positive for P. jirovecii. Nine patients (29%) have tuberculosis (TB) followed by, 1(3.2%) HIV positive and 21(67.7%) miscellaneous pulmonary disorders. Our results show that there was no significant differences between sex (male:female ratio, 17:14), TB, HIV and P. jirovecii in BAL samples (P>0.05).

          Conclusion:

          The current study is the first report from Ahvaz and it showed a relatively high frequency (27%) of P. jirovecii among patients with different pulmonary disorders. In addition Nested-PCR might be reliable technique for diagnosis of P. jirovecii, while the Grocott’s methenamine silver (GMS) have a low sensitivity, which only two positive patients were identified.

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          Most cited references23

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          Pneumocystis pneumonia.

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            Epidemiology and clinical significance of pneumocystis colonization.

            Pneumocystis pneumonia has long been recognized as a cause of morbidity and mortality in immunocompromised populations, particularly those with HIV infection. Pneumocystis colonization-that is, detection of the organism or its DNA, without signs or symptoms of pneumonia-has recently been described, and accumulating evidence suggests that it may be an important clinical phenomenon. Sensitive molecular techniques such as polymerase chain reaction are frequently used to identify Pneumocystis colonization. Low levels of Pneumocystis in the lungs may stimulate pulmonary inflammation and may play a role in the development of lung diseases such as chronic obstructive pulmonary disease. In this review, we discuss evidence for the occurrence of Pneumocystis colonization in animals as well as the epidemiology and risk factors for Pneumocystis colonization in various human populations. We also evaluate the clinical significance of Pneumocystis colonization and its relationship to lung disease.
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              Evolving health effects of Pneumocystis: one hundred years of progress in diagnosis and treatment.

              2009 marks the 100th anniversary of the first description of Pneumocystis, an organism that was ignored for much of its first 50 years but that has subsequently been recognized as an important pathogen of immunocompromised patients, especially patients infected with human immunodeficiency virus (HIV). We present a patient with chronic lymphocytic leukemia who died from Pneumocystis pneumonia (PCP) despite appropriate anti-Pneumocystis therapy. Although substantial advances in diagnosis, treatment, and prevention of PCP have decreased its frequency and improved prognosis, PCP continues to be seen in both HIV-infected patients and patients receiving immunosuppressive medications. Pneumocystis species comprise a family of fungi, each of which appears to be able to infect only 1 host species. Pneumocystis has a worldwide distribution. Immunocompetent hosts clear infection without obvious clinical consequences. Pneumocystis has been identified in patients with other diseases such as chronic obstructive pulmonary disease, although its clinical impact is uncertain. Immunocompromised patients develop disease as a consequence of reinfection and possibly reactivation of latent infection. In patients with HIV infection, the CD4 count is predictive of the risk for developing PCP, but such reliable markers are not available for other immunocompromised populations. In the majority of patients with PCP, multiple Pneumocystis strains can be identified using recently developed typing techniques. Because Pneumocystis cannot be cultured, diagnosis relies on detection of the organism by colorimetric or immunofluorescent stains or by polymerase chain reaction. Trimethoprim-sulfamethoxazole is the preferred drug regimen for both treatment and prevention of PCP, although a number of alternatives are also available. Corticosteroids are an important adjunct for hypoxemic patients.
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                Author and article information

                Journal
                Iran J Microbiol
                Iran J Microbiol
                IJM
                IJM
                Iranian Journal of Microbiology
                Tehran University of Medical Sciences
                2008-3289
                2008-4447
                December 2015
                : 7
                : 6
                : 333-337
                Affiliations
                [1 ]Department of Medical Mycology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
                [2 ]Health Research Institute, Infectious and Tropical Diseases Research Centre, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
                [3 ]Department of Internal Medicine, Division of Pulmonology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
                Author notes
                [* ]Corresponding author: Prof. Ali Zarei Mahmoudabadi, Health Research Institute, Infectious and Tropical Diseases Research Centre, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Tel: +986133330074, Fax: +986133332036, E-mail: zarei40@ 123456hotmail.com
                Article
                ijm-7-333
                4752688
                26885334
                8f8afcd2-64ba-4f8a-bfd4-3e6a82e49702
                Copyright© 2015 Iranian Neuroscience Society

                This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.

                History
                : June 2015
                : October 2015
                Categories
                Original Article

                Microbiology & Virology
                pneumocystis jirovecii pneumonia,hiv-infected patients,tuberculosis,ahvaz-iran

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