Skip to main content
Top
Published in: Lung 6/2014

01-12-2014

Asymptomatic Carriage of Pneumocystis jirovecii and Cytomegalovirus in Lungs of Immunocompetent Patients

Authors: Michal Shteinberg, Pninit Shaked-Mishan, Amalia Kinarti, Amir Abramovitch, Anat Amital, Assaf Jacobi, Aharon E. Kolup Feldmann, Maayan Shiner, Vladimir Gershtein, Gabriel Weber, Yochai Adir

Published in: Lung | Issue 6/2014

Login to get access

Abstract

Purpose

Pneumocystis jirovecii (PCP) and cytomegalovirus (CMV) are opportunistic pathogens which cause lung infection in immunocompromised individuals. However, scarce data are available regarding the carriage of CMV or PCP in immunocompetent, non critically ill patients.
The purpose of this study was to evaluate the prevalence of PCP and CMV in broncholaveolar lavage of adult immunocompetent, non critically ill patients.

Methods

BAL fluids from immunocompetent patients who underwent bronchoscopy were analyzed by polymerase chain reaction (PCR) for CMV and PCP DNA. We tested CMV antibodies in serum. In patients with positive CMV DNA in lavage fluid, we further analyzed peripheral blood for the presence of CMV DNA.

Results

Ninety three patients were included. We did not detect PCP DNA in BAL in any patient. CMV DNA was found in BAL of 5 of 86 CMV IgG positive patients (5.8 %). Patients who were positive for CMV did not differ from patients with negative PCR for CMV regarding demographic and clinical features.

Conclusion

We did not find PCP colonization in our cohort of patients. However, we found significant prevalence of CMV DNA in BAL from immunocompetent patients, with no evidence of acute CMV infection. This finding may represent colonization by CMV in immunocompetent, non-critically ill individuals.
Literature
1.
2.
go back to reference Waxman AB, Goldie SJ, Brett-Smith H, Matthay RA (1997) Cytomegalovirus as a primary pulmonary pathogen in AIDS. Chest 111:128CrossRefPubMed Waxman AB, Goldie SJ, Brett-Smith H, Matthay RA (1997) Cytomegalovirus as a primary pulmonary pathogen in AIDS. Chest 111:128CrossRefPubMed
3.
go back to reference Kim T, Moon SM, Sung H et al (2012) Outcomes of non-HIV-infected patients with Pneumocystis pneumonia and concomitant pulmonary cytomegalovirus infection. Scand J Infect Dis 44(9):670–677CrossRefPubMed Kim T, Moon SM, Sung H et al (2012) Outcomes of non-HIV-infected patients with Pneumocystis pneumonia and concomitant pulmonary cytomegalovirus infection. Scand J Infect Dis 44(9):670–677CrossRefPubMed
4.
go back to reference Hohenthal U, Itälä M, Salonen J et al (2005) Bronchoalveolar lavage in immunocompromised patients with haematological malignancy–value of new microbiological methods. Eur J Haematol 74(3):203–211CrossRefPubMed Hohenthal U, Itälä M, Salonen J et al (2005) Bronchoalveolar lavage in immunocompromised patients with haematological malignancy–value of new microbiological methods. Eur J Haematol 74(3):203–211CrossRefPubMed
5.
go back to reference Buffone GJ, Frost A, Samo T, Demmler GJ, Cagle PT, Lawrence EC (1993) The diagnosis of CMV pneumonitis in lung and heart/lung transplant patients by PCR compared with traditional laboratory criteria. Transplantation 56(2):342–347CrossRefPubMed Buffone GJ, Frost A, Samo T, Demmler GJ, Cagle PT, Lawrence EC (1993) The diagnosis of CMV pneumonitis in lung and heart/lung transplant patients by PCR compared with traditional laboratory criteria. Transplantation 56(2):342–347CrossRefPubMed
6.
go back to reference Davis JL, Welsh DA, Beard CB et al (2008) Pneumocystis colonisation is common among hospitalised HIV infected patients with non-Pneumocystis pneumonia. Thorax 63:329CrossRefPubMed Davis JL, Welsh DA, Beard CB et al (2008) Pneumocystis colonisation is common among hospitalised HIV infected patients with non-Pneumocystis pneumonia. Thorax 63:329CrossRefPubMed
7.
go back to reference Morris A, Sciurba FC, Lebedeva IP et al (2004) Association of chronic obstructive pulmonary disease severity and Pneumocystis colonization. Am J Respir Crit Care Med 170(4):408–413 Epub 2004 Apr 29CrossRefPubMed Morris A, Sciurba FC, Lebedeva IP et al (2004) Association of chronic obstructive pulmonary disease severity and Pneumocystis colonization. Am J Respir Crit Care Med 170(4):408–413 Epub 2004 Apr 29CrossRefPubMed
9.
go back to reference Beard CB, Carter JL, Keely SP et al (2000) Genetic variation in Pneumocystis carinii isolates from different geographic regions: implications for transmission. Emerg Infect Dis 6(3):265–272PubMedCentralCrossRefPubMed Beard CB, Carter JL, Keely SP et al (2000) Genetic variation in Pneumocystis carinii isolates from different geographic regions: implications for transmission. Emerg Infect Dis 6(3):265–272PubMedCentralCrossRefPubMed
10.
go back to reference Maskell NA, Waine DJ, Lindley A, Pepperell JC, Wakefield AE, Miller RF, Davies RJ (2003) Asymptomatic carriage of Pneumocystis jirovecii in subjects undergoing bronchoscopy: a prospective study. Thorax 58(7):594–597PubMedCentralCrossRefPubMed Maskell NA, Waine DJ, Lindley A, Pepperell JC, Wakefield AE, Miller RF, Davies RJ (2003) Asymptomatic carriage of Pneumocystis jirovecii in subjects undergoing bronchoscopy: a prospective study. Thorax 58(7):594–597PubMedCentralCrossRefPubMed
11.
go back to reference Blanquer José et al (2011) Immunological insights into the pathogenesis of active CMV infection in non‐immunosuppressed critically ill patients. J Med Virol 83.11:1966–1971CrossRef Blanquer José et al (2011) Immunological insights into the pathogenesis of active CMV infection in non‐immunosuppressed critically ill patients. J Med Virol 83.11:1966–1971CrossRef
12.
go back to reference Chilet Marifina et al (2010) Virological and immunological features of active cytomegalovirus infection in nonimmunosuppressed patients in a surgical and trauma intensive care unit. J Med Virol 82.8:1384–1391CrossRef Chilet Marifina et al (2010) Virological and immunological features of active cytomegalovirus infection in nonimmunosuppressed patients in a surgical and trauma intensive care unit. J Med Virol 82.8:1384–1391CrossRef
13.
go back to reference Cook CH, Yenchar JK, Kraner TO et al (1998) Occult herpes family viruses may increase mortality in critically ill surgical patients. Am J Surg 176:357CrossRefPubMed Cook CH, Yenchar JK, Kraner TO et al (1998) Occult herpes family viruses may increase mortality in critically ill surgical patients. Am J Surg 176:357CrossRefPubMed
14.
go back to reference Heininger A, Jahn G, Engel C et al (2001) Human cytomegalovirus infections in nonimmunosuppressed critically ill patients. Crit Care Med 29:541CrossRefPubMed Heininger A, Jahn G, Engel C et al (2001) Human cytomegalovirus infections in nonimmunosuppressed critically ill patients. Crit Care Med 29:541CrossRefPubMed
15.
go back to reference Jaber S, Chanques G, Borry J et al (2005) Cytomegalovirus infection in critically ill patients: associated factors and consequences. Chest 127:233CrossRefPubMed Jaber S, Chanques G, Borry J et al (2005) Cytomegalovirus infection in critically ill patients: associated factors and consequences. Chest 127:233CrossRefPubMed
16.
go back to reference Kalil Andre C, Florescu Diana F (2009) Prevalence and mortality associated with cytomegalovirus infection in nonimmunosuppressed patients in the intensive care unit. Crit Care Med 37(8):2350–2358CrossRefPubMed Kalil Andre C, Florescu Diana F (2009) Prevalence and mortality associated with cytomegalovirus infection in nonimmunosuppressed patients in the intensive care unit. Crit Care Med 37(8):2350–2358CrossRefPubMed
17.
go back to reference Nirel N, Rosen B, Sharon S, Blondheim O, Sherf M, Cohen AD (2011) OFEK virtual medical records: an evaluation of an integrated hospital-community system. Harefuah 150(2):72–78PubMed Nirel N, Rosen B, Sharon S, Blondheim O, Sherf M, Cohen AD (2011) OFEK virtual medical records: an evaluation of an integrated hospital-community system. Harefuah 150(2):72–78PubMed
18.
go back to reference Shteinberg M, Segal-Trabelsy M, Adir Y, Laor A, Vardi M, Bitterman H (2012) Clinical characteristics and outcomes of patients with clinically unsuspected pulmonary embolism versus patients with clinically suspected pulmonary embolism. Respiration 84(6):492–500CrossRefPubMed Shteinberg M, Segal-Trabelsy M, Adir Y, Laor A, Vardi M, Bitterman H (2012) Clinical characteristics and outcomes of patients with clinically unsuspected pulmonary embolism versus patients with clinically suspected pulmonary embolism. Respiration 84(6):492–500CrossRefPubMed
19.
go back to reference Alvarez-Martínez Míriam J et al (2006) Sensitivity and specificity of nested and real-time PCR for the detection of Pneumocystis jirovecii in clinical specimens. Diagn Microbiol Infect Dis 56.2:153–160CrossRef Alvarez-Martínez Míriam J et al (2006) Sensitivity and specificity of nested and real-time PCR for the detection of Pneumocystis jirovecii in clinical specimens. Diagn Microbiol Infect Dis 56.2:153–160CrossRef
21.
go back to reference Calderón EJ, Rivero L, Respaldiza N et al (2007) Systemic inflammation in patients with chronic obstructive pulmonary disease who are colonized with Pneumocystis jirovecii. Clin Infect Dis 45(2):e17–e19 Epub 2007 Jun 6CrossRefPubMed Calderón EJ, Rivero L, Respaldiza N et al (2007) Systemic inflammation in patients with chronic obstructive pulmonary disease who are colonized with Pneumocystis jirovecii. Clin Infect Dis 45(2):e17–e19 Epub 2007 Jun 6CrossRefPubMed
22.
go back to reference Ponce CA, Gallo M, Bustamante R, Vargas SL (2010) Pneumocystis colonization is highly prevalent in the autopsied lungs of the general population. Clin Infect Dis 50:347CrossRefPubMed Ponce CA, Gallo M, Bustamante R, Vargas SL (2010) Pneumocystis colonization is highly prevalent in the autopsied lungs of the general population. Clin Infect Dis 50:347CrossRefPubMed
23.
go back to reference Leigh TR, Kangro HO, Gazzard BG et al (1993) DNA amplification by the polymerase chain reaction to detect sub-clinical Pneumocystis carinii colonization in HIV-positive and HIV-negative male homosexuals with and without respiratory symptoms. Respir Med 87(7):525–529CrossRefPubMed Leigh TR, Kangro HO, Gazzard BG et al (1993) DNA amplification by the polymerase chain reaction to detect sub-clinical Pneumocystis carinii colonization in HIV-positive and HIV-negative male homosexuals with and without respiratory symptoms. Respir Med 87(7):525–529CrossRefPubMed
Metadata
Title
Asymptomatic Carriage of Pneumocystis jirovecii and Cytomegalovirus in Lungs of Immunocompetent Patients
Authors
Michal Shteinberg
Pninit Shaked-Mishan
Amalia Kinarti
Amir Abramovitch
Anat Amital
Assaf Jacobi
Aharon E. Kolup Feldmann
Maayan Shiner
Vladimir Gershtein
Gabriel Weber
Yochai Adir
Publication date
01-12-2014
Publisher
Springer US
Published in
Lung / Issue 6/2014
Print ISSN: 0341-2040
Electronic ISSN: 1432-1750
DOI
https://doi.org/10.1007/s00408-014-9644-z

Other articles of this Issue 6/2014

Lung 6/2014 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine