Skip to main content
Top
Published in: BMC Infectious Diseases 1/2011

Open Access 01-12-2011 | Research article

Clinical characteristics of Pneumocystis pneumonia in non-HIV patients and prognostic factors including microbiological genotypes

Authors: Yasufumi Matsumura, Yuichiro Shindo, Yoshitsugu Iinuma, Masaki Yamamoto, Michinori Shirano, Aki Matsushima, Miki Nagao, Yutaka Ito, Shunji Takakura, Yoshinori Hasegawa, Satoshi Ichiyama

Published in: BMC Infectious Diseases | Issue 1/2011

Login to get access

Abstract

Background

The number of patients with non-HIV Pneumocystis pneumonia (PCP) is increasing with widespread immunosuppressive treatment. We investigated the clinical characteristics of non-HIV PCP and its association with microbiological genotypes.

Methods

Between January 2005 and March 2010, all patients in 2 university hospitals who had been diagnosed with PCP by PCR were enrolled in this study. Retrospective chart review of patients, microbiological genotypes, and association with 30-day mortality were examined.

Results

Of the 82 adult patients investigated, 50 patients (61%) had inflammatory diseases, 17 (21%) had solid malignancies, 12 (15%) had hematological malignancies, and 6 (7%) had received transplantations. All patients received immunosuppressive agents or antitumor chemotherapeutic drugs. Plasma (1→3) β-D-glucan levels were elevated in 80% of patients, and were significantly reduced after treatment in both survivors and non-survivors. However, β-D-glucan increased in 18% of survivors and was normal in only 33% after treatment. Concomitant invasive pulmonary aspergillosis was detected in 5 patients. Fifty-six respiratory samples were stored for genotyping. A dihydropteroate synthase mutation associated with trimethoprim-sulfamethoxazole resistance was found in only 1 of the 53 patients. The most prevalent genotype of mitochondrial large-subunit rRNA was genotype 1, followed by genotype 4. The most prevalent genotype of internal transcribed spacers of the nuclear rRNA operon was Eb, followed by Eg and Bi. Thirty-day mortality was 24%, in which logistic regression analysis revealed association with serum albumin and mechanical ventilation, but no association with genotypes.

Conclusions

In non-HIV PCP, poorer general and respiratory conditions at diagnosis were independent predictors of mortality. β-D-glucan may not be useful for monitoring the response to treatment, and genotypes were not associated with mortality.
Appendix
Available only for authorised users
Literature
1.
go back to reference Mansharamani N, Garland R, Delaney D, Koziel H: Management and outcome patterns for adult Pneumocystis carinii pneumonia, 1985 to 1995: comparison of HIV-associated cases to other immunocompromised states. Chest. 2000, 118: 704-711.CrossRefPubMed Mansharamani N, Garland R, Delaney D, Koziel H: Management and outcome patterns for adult Pneumocystis carinii pneumonia, 1985 to 1995: comparison of HIV-associated cases to other immunocompromised states. Chest. 2000, 118: 704-711.CrossRefPubMed
2.
go back to reference Kelley C, Checkley W, Mannino D, Franco-Paredes C, Del Rio C, Holguin F: Trends in hospitalizations for AIDS-associated Pneumocystis jirovecii Pneumonia in the United States (1986 to 2005). Chest. 2009, 136: 190-197.CrossRefPubMed Kelley C, Checkley W, Mannino D, Franco-Paredes C, Del Rio C, Holguin F: Trends in hospitalizations for AIDS-associated Pneumocystis jirovecii Pneumonia in the United States (1986 to 2005). Chest. 2009, 136: 190-197.CrossRefPubMed
3.
go back to reference Limper A, Offord K, Smith T, Martin Wn: Pneumocystis carinii pneumonia. Differences in lung parasite number and inflammation in patients with and without AIDS. Am Rev Respir Dis. 1989, 140: 1204-1209.CrossRefPubMed Limper A, Offord K, Smith T, Martin Wn: Pneumocystis carinii pneumonia. Differences in lung parasite number and inflammation in patients with and without AIDS. Am Rev Respir Dis. 1989, 140: 1204-1209.CrossRefPubMed
4.
go back to reference Azoulay E, Bergeron A, Chevret S, Bele N, Schlemmer B, Menotti J: Polymerase chain reaction for diagnosing pneumocystis pneumonia in non-HIV immunocompromised patients with pulmonary infiltrates. Chest. 2009, 135: 655-661.CrossRefPubMed Azoulay E, Bergeron A, Chevret S, Bele N, Schlemmer B, Menotti J: Polymerase chain reaction for diagnosing pneumocystis pneumonia in non-HIV immunocompromised patients with pulmonary infiltrates. Chest. 2009, 135: 655-661.CrossRefPubMed
5.
go back to reference Procop GW, Haddad S, Quinn J, Wilson ML, Henshaw NG, Reller LB, Artymyshyn RL, Katanik MT, Weinstein MP: Detection of Pneumocystis jiroveci in respiratory specimens by four staining methods. J Clin Microbiol. 2004, 42: 3333-3335.CrossRefPubMedPubMedCentral Procop GW, Haddad S, Quinn J, Wilson ML, Henshaw NG, Reller LB, Artymyshyn RL, Katanik MT, Weinstein MP: Detection of Pneumocystis jiroveci in respiratory specimens by four staining methods. J Clin Microbiol. 2004, 42: 3333-3335.CrossRefPubMedPubMedCentral
6.
go back to reference Krajicek BJ, Thomas CF, Limper AH: Pneumocystis pneumonia: current concepts in pathogenesis, diagnosis, and treatment. Clin Chest Med. 2009, 30: 265-278.CrossRefPubMed Krajicek BJ, Thomas CF, Limper AH: Pneumocystis pneumonia: current concepts in pathogenesis, diagnosis, and treatment. Clin Chest Med. 2009, 30: 265-278.CrossRefPubMed
8.
go back to reference Morris A, Wei K, Afshar K, Huang L: Epidemiology and clinical significance of pneumocystis colonization. J Infect Dis. 2008, 197: 10-17.CrossRefPubMed Morris A, Wei K, Afshar K, Huang L: Epidemiology and clinical significance of pneumocystis colonization. J Infect Dis. 2008, 197: 10-17.CrossRefPubMed
9.
go back to reference Jiancheng W, Minjun H, Yi-jun A, Lan S, Zengzhu G, Jianrong S, Xixiong K: Screening Pneumocystis carinii pneumonia in non-HIV-infected immunocompromised patients using polymerase chain reaction. Diagn Microbiol Infect Dis. 2009, 64: 396-401.CrossRefPubMed Jiancheng W, Minjun H, Yi-jun A, Lan S, Zengzhu G, Jianrong S, Xixiong K: Screening Pneumocystis carinii pneumonia in non-HIV-infected immunocompromised patients using polymerase chain reaction. Diagn Microbiol Infect Dis. 2009, 64: 396-401.CrossRefPubMed
10.
go back to reference Watanabe T, Yasuoka A, Tanuma J, Yazaki H, Honda H, Tsukada K, Honda M, Gatanaga H, Teruya K, Kikuchi Y, et al: Serum (1→3)-β-D-glucan as a noninvasive adjunct marker for the diagnosis of Pneumocystis pneumonia in patients with AIDS. Clin Infect Dis. 2009, 49: 1128-1131.CrossRefPubMed Watanabe T, Yasuoka A, Tanuma J, Yazaki H, Honda H, Tsukada K, Honda M, Gatanaga H, Teruya K, Kikuchi Y, et al: Serum (1→3)-β-D-glucan as a noninvasive adjunct marker for the diagnosis of Pneumocystis pneumonia in patients with AIDS. Clin Infect Dis. 2009, 49: 1128-1131.CrossRefPubMed
11.
go back to reference Tasaka S, Hasegawa N, Kobayashi S, Yamada W, Nishimura T, Takeuchi T, Ishizaka A: Serum indicators for the diagnosis of pneumocystis pneumonia. Chest. 2007, 131: 1173-1180.CrossRefPubMed Tasaka S, Hasegawa N, Kobayashi S, Yamada W, Nishimura T, Takeuchi T, Ishizaka A: Serum indicators for the diagnosis of pneumocystis pneumonia. Chest. 2007, 131: 1173-1180.CrossRefPubMed
12.
go back to reference Shimizu Y, Sunaga N, Dobashi K, Fueki M, Fueki N, Makino S, Mori M: Serum markers in interstitial pneumonia with and without Pneumocystis jirovecii colonization: a prospective study. BMC Infect Dis. 2009, 9: 47-CrossRefPubMedPubMedCentral Shimizu Y, Sunaga N, Dobashi K, Fueki M, Fueki N, Makino S, Mori M: Serum markers in interstitial pneumonia with and without Pneumocystis jirovecii colonization: a prospective study. BMC Infect Dis. 2009, 9: 47-CrossRefPubMedPubMedCentral
13.
go back to reference Beard C, Roux P, Nevez G, Hauser P, Kovacs J, Unnasch T, Lundgren B: Strain typing methods and molecular epidemiology of Pneumocystis pneumonia. Emerg Infect Dis. 2004, 10: 1729-1735.CrossRefPubMedPubMedCentral Beard C, Roux P, Nevez G, Hauser P, Kovacs J, Unnasch T, Lundgren B: Strain typing methods and molecular epidemiology of Pneumocystis pneumonia. Emerg Infect Dis. 2004, 10: 1729-1735.CrossRefPubMedPubMedCentral
14.
go back to reference Miller R, Wakefield A: Pneumocystis carinii genotypes and severity of pneumonia. Lancet. 1999, 353: 2039-2040.CrossRefPubMed Miller R, Wakefield A: Pneumocystis carinii genotypes and severity of pneumonia. Lancet. 1999, 353: 2039-2040.CrossRefPubMed
15.
go back to reference Helweg-Larsen J, Benfield T, Eugen-Olsen J, Lundgren J, Lundgren B: Effects of mutations in Pneumocystis carinii dihydropteroate synthase gene on outcome of AIDS-associated P. carinii pneumonia. Lancet. 1999, 354: 1347-1351.CrossRefPubMed Helweg-Larsen J, Benfield T, Eugen-Olsen J, Lundgren J, Lundgren B: Effects of mutations in Pneumocystis carinii dihydropteroate synthase gene on outcome of AIDS-associated P. carinii pneumonia. Lancet. 1999, 354: 1347-1351.CrossRefPubMed
16.
go back to reference Alvarez-Martínez M, Moreno A, Miró J, Valls M, Rivas P, de Lazzari E, Sued O, Benito N, Domingo P, Ribera E, et al: Pneumocystis jirovecii pneumonia in Spanish HIV-infected patients in the combined antiretroviral therapy era: prevalence of dihydropteroate synthase mutations and prognostic factors of mortality. Diagn Microbiol Infect Dis. 2008, 62: 34-43.CrossRefPubMed Alvarez-Martínez M, Moreno A, Miró J, Valls M, Rivas P, de Lazzari E, Sued O, Benito N, Domingo P, Ribera E, et al: Pneumocystis jirovecii pneumonia in Spanish HIV-infected patients in the combined antiretroviral therapy era: prevalence of dihydropteroate synthase mutations and prognostic factors of mortality. Diagn Microbiol Infect Dis. 2008, 62: 34-43.CrossRefPubMed
17.
go back to reference Vincent J, de Mendonça A, Cantraine F, Moreno R, Takala J, Suter P, Sprung C, Colardyn F, Blecher S: Use of the SOFA score to assess the incidence of organ dysfunction/failure in intensive care units: results of a multicenter, prospective study. Working group on "sepsis-related problems" of the European Society of Intensive Care Medicine. Crit Care Med. 1998, 26: 1793-1800.CrossRefPubMed Vincent J, de Mendonça A, Cantraine F, Moreno R, Takala J, Suter P, Sprung C, Colardyn F, Blecher S: Use of the SOFA score to assess the incidence of organ dysfunction/failure in intensive care units: results of a multicenter, prospective study. Working group on "sepsis-related problems" of the European Society of Intensive Care Medicine. Crit Care Med. 1998, 26: 1793-1800.CrossRefPubMed
18.
go back to reference De Pauw B, Walsh T, Donnelly J, Stevens D, Edwards J, Calandra T, Pappas P, Maertens J, Lortholary O, Kauffman C, et al: Revised definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) Consensus Group. Clin Infect Dis. 2008, 46: 1813-1821.CrossRefPubMedPubMedCentral De Pauw B, Walsh T, Donnelly J, Stevens D, Edwards J, Calandra T, Pappas P, Maertens J, Lortholary O, Kauffman C, et al: Revised definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) Consensus Group. Clin Infect Dis. 2008, 46: 1813-1821.CrossRefPubMedPubMedCentral
19.
go back to reference Wakefield A, Pixley F, Banerji S, Sinclair K, Miller R, Moxon E, Hopkin J: Detection of Pneumocystis carinii with DNA amplification. Lancet. 1990, 336: 451-453.CrossRefPubMed Wakefield A, Pixley F, Banerji S, Sinclair K, Miller R, Moxon E, Hopkin J: Detection of Pneumocystis carinii with DNA amplification. Lancet. 1990, 336: 451-453.CrossRefPubMed
20.
go back to reference Esteves F, Montes-Cano M, de la Horra C, Costa M, Calderón E, Antunes F, Matos O: Pneumocystis jirovecii multilocus genotyping profiles in patients from Portugal and Spain. Clin Microbiol Infect. 2008, 14: 356-362.CrossRefPubMed Esteves F, Montes-Cano M, de la Horra C, Costa M, Calderón E, Antunes F, Matos O: Pneumocystis jirovecii multilocus genotyping profiles in patients from Portugal and Spain. Clin Microbiol Infect. 2008, 14: 356-362.CrossRefPubMed
21.
go back to reference Beser J, Hagblom P, Fernandez V: Frequent in vitro recombination in internal transcribed spacers 1 and 2 during genotyping of Pneumocystis jirovecii. J Clin Microbiol. 2007, 45: 881-886.CrossRefPubMedPubMedCentral Beser J, Hagblom P, Fernandez V: Frequent in vitro recombination in internal transcribed spacers 1 and 2 during genotyping of Pneumocystis jirovecii. J Clin Microbiol. 2007, 45: 881-886.CrossRefPubMedPubMedCentral
22.
go back to reference Hosoya N, Takahashi T, Wada M, Endo T, Nakamura T, Sakashita H, Kimura K, Ohnishi K, Nakamura Y, Mizuochi T, et al: Genotyping of Pneumocystis carinii f. sp. hominis isolates in Japan based on nucleotide sequence variations in internal transcribed spacer regions of rRNA genes. Microbiol Immunol. 2000, 44: 591-596.CrossRefPubMed Hosoya N, Takahashi T, Wada M, Endo T, Nakamura T, Sakashita H, Kimura K, Ohnishi K, Nakamura Y, Mizuochi T, et al: Genotyping of Pneumocystis carinii f. sp. hominis isolates in Japan based on nucleotide sequence variations in internal transcribed spacer regions of rRNA genes. Microbiol Immunol. 2000, 44: 591-596.CrossRefPubMed
23.
go back to reference Totet A, Pautard J, Raccurt C, Roux P, Nevez G: Genotypes at the internal transcribed spacers of the nuclear rRNA operon of Pneumocystis jiroveci in nonimmunosuppressed infants without severe pneumonia. J Clin Microbiol. 2003, 41: 1173-1180.CrossRefPubMedPubMedCentral Totet A, Pautard J, Raccurt C, Roux P, Nevez G: Genotypes at the internal transcribed spacers of the nuclear rRNA operon of Pneumocystis jiroveci in nonimmunosuppressed infants without severe pneumonia. J Clin Microbiol. 2003, 41: 1173-1180.CrossRefPubMedPubMedCentral
24.
go back to reference Lee C, Helweg-Larsen J, Tang X, Jin S, Li B, Bartlett M, Lu J, Lundgren B, Lundgren J, Olsson M, et al: Update on Pneumocystis carinii f. sp. hominis typing based on nucleotide sequence variations in internal transcribed spacer regions of rRNA genes. J Clin Microbiol. 1998, 36: 734-741.PubMedPubMedCentral Lee C, Helweg-Larsen J, Tang X, Jin S, Li B, Bartlett M, Lu J, Lundgren B, Lundgren J, Olsson M, et al: Update on Pneumocystis carinii f. sp. hominis typing based on nucleotide sequence variations in internal transcribed spacer regions of rRNA genes. J Clin Microbiol. 1998, 36: 734-741.PubMedPubMedCentral
25.
go back to reference Siripattanapipong S, Worapong J, Mungthin M, Leelayoova S, Tan-ariya P: Genotypic study of Pneumocystis jirovecii in human immunodeficiency virus-positive patients in Thailand. J Clin Microbiol. 2005, 43: 2104-2110.CrossRefPubMedPubMedCentral Siripattanapipong S, Worapong J, Mungthin M, Leelayoova S, Tan-ariya P: Genotypic study of Pneumocystis jirovecii in human immunodeficiency virus-positive patients in Thailand. J Clin Microbiol. 2005, 43: 2104-2110.CrossRefPubMedPubMedCentral
26.
go back to reference Kovacs JA, Hiemenz JW, Macher AM, Stover D, Murray HW, Shelhamer J, Lane HC, Urmacher C, Honig C, Longo DL: Pneumocystis carinii pneumonia: a comparison between patients with the acquired immunodeficiency syndrome and patients with other immunodeficiencies. Ann Intern Med. 1984, 100: 663-671.CrossRefPubMed Kovacs JA, Hiemenz JW, Macher AM, Stover D, Murray HW, Shelhamer J, Lane HC, Urmacher C, Honig C, Longo DL: Pneumocystis carinii pneumonia: a comparison between patients with the acquired immunodeficiency syndrome and patients with other immunodeficiencies. Ann Intern Med. 1984, 100: 663-671.CrossRefPubMed
27.
go back to reference Helweg-Larsen J, Jensen J, Benfield T, Svendsen U, Lundgren J, Lundgren B: Diagnostic use of PCR for detection of Pneumocystis carinii in oral wash samples. J Clin Microbiol. 1998, 36: 2068-2072.PubMedPubMedCentral Helweg-Larsen J, Jensen J, Benfield T, Svendsen U, Lundgren J, Lundgren B: Diagnostic use of PCR for detection of Pneumocystis carinii in oral wash samples. J Clin Microbiol. 1998, 36: 2068-2072.PubMedPubMedCentral
28.
go back to reference Yale S, Limper A: Pneumocystis carinii pneumonia in patients without acquired immunodeficiency syndrome: associated illness and prior corticosteroid therapy. Mayo Clin Proc. 1996, 71: 5-13.CrossRefPubMed Yale S, Limper A: Pneumocystis carinii pneumonia in patients without acquired immunodeficiency syndrome: associated illness and prior corticosteroid therapy. Mayo Clin Proc. 1996, 71: 5-13.CrossRefPubMed
29.
go back to reference Roblot F, Godet C, Le Moal G, Garo B, Faouzi Souala M, Dary M, De Gentile L, Gandji J, Guimard Y, Lacroix C, et al: Analysis of underlying diseases and prognosis factors associated with Pneumocystis carinii pneumonia in immunocompromised HIV-negative patients. Eur J Clin Microbiol Infect Dis. 2002, 21: 523-531.CrossRefPubMed Roblot F, Godet C, Le Moal G, Garo B, Faouzi Souala M, Dary M, De Gentile L, Gandji J, Guimard Y, Lacroix C, et al: Analysis of underlying diseases and prognosis factors associated with Pneumocystis carinii pneumonia in immunocompromised HIV-negative patients. Eur J Clin Microbiol Infect Dis. 2002, 21: 523-531.CrossRefPubMed
30.
go back to reference Komano Y, Harigai M, Koike R, Sugiyama H, Ogawa J, Saito K, Sekiguchi N, Inoo M, Onishi I, Ohashi H, et al: Pneumocystis jiroveci pneumonia in patients with rheumatoid arthritis treated with infliximab: a retrospective review and case-control study of 21 patients. Arthritis Rheum. 2009, 61: 305-312.CrossRefPubMed Komano Y, Harigai M, Koike R, Sugiyama H, Ogawa J, Saito K, Sekiguchi N, Inoo M, Onishi I, Ohashi H, et al: Pneumocystis jiroveci pneumonia in patients with rheumatoid arthritis treated with infliximab: a retrospective review and case-control study of 21 patients. Arthritis Rheum. 2009, 61: 305-312.CrossRefPubMed
31.
go back to reference Rodriguez M, Fishman J: Prevention of infection due to Pneumocystis spp. in human immunodeficiency virus-negative immunocompromised patients. Clin Microbiol Rev. 2004, 17: 770-782.CrossRefPubMedPubMedCentral Rodriguez M, Fishman J: Prevention of infection due to Pneumocystis spp. in human immunodeficiency virus-negative immunocompromised patients. Clin Microbiol Rev. 2004, 17: 770-782.CrossRefPubMedPubMedCentral
32.
go back to reference Iikuni N, Kitahama M, Ohta S, Okamoto H, Kamatani N, Nishinarita M: Evaluation of Pneumocystis pneumonia infection risk factors in patients with connective tissue disease. Mod Rheumatol. 2006, 16: 282-288.CrossRefPubMed Iikuni N, Kitahama M, Ohta S, Okamoto H, Kamatani N, Nishinarita M: Evaluation of Pneumocystis pneumonia infection risk factors in patients with connective tissue disease. Mod Rheumatol. 2006, 16: 282-288.CrossRefPubMed
33.
go back to reference Saito K, Nakayamada S, Nakano K, Tokunaga M, Tsujimura S, Nakatsuka K, Adachi T, Tanaka Y: Detection of Pneumocystis carinii by DNA amplification in patients with connective tissue diseases: re-evaluation of clinical features of P. carinii pneumonia in rheumatic diseases. Rheumatology (Oxford). 2004, 43: 479-485.CrossRef Saito K, Nakayamada S, Nakano K, Tokunaga M, Tsujimura S, Nakatsuka K, Adachi T, Tanaka Y: Detection of Pneumocystis carinii by DNA amplification in patients with connective tissue diseases: re-evaluation of clinical features of P. carinii pneumonia in rheumatic diseases. Rheumatology (Oxford). 2004, 43: 479-485.CrossRef
34.
go back to reference Held J, Koch M, Reischl U, Danner T, Serr A: Serum (1→3)-β-D-glucan measurement as early indicator for Pneumocystis jiroveciipneumonia and evaluation of its prognostic value. Clin Microbiol Infect. Held J, Koch M, Reischl U, Danner T, Serr A: Serum (1→3)-β-D-glucan measurement as early indicator for Pneumocystis jiroveciipneumonia and evaluation of its prognostic value. Clin Microbiol Infect.
35.
go back to reference de Boer MG, Gelinck LB, van Zelst BD, van de Sande WW, Willems LN, van Dissel JT, de Jonge R, Kroon FP: β-D-glucan and S-adenosylmethionine serum levels for the diagnosis of Pneumocystis pneumonia in HIV-negative Patients: A prospective study. J Infect. 2010, 62: 93-100.CrossRefPubMed de Boer MG, Gelinck LB, van Zelst BD, van de Sande WW, Willems LN, van Dissel JT, de Jonge R, Kroon FP: β-D-glucan and S-adenosylmethionine serum levels for the diagnosis of Pneumocystis pneumonia in HIV-negative Patients: A prospective study. J Infect. 2010, 62: 93-100.CrossRefPubMed
36.
go back to reference Segal BH, Walsh TJ: Current approaches to diagnosis and treatment of invasive aspergillosis. Am J Respir Crit Care Med. 2006, 173: 707-717.CrossRefPubMed Segal BH, Walsh TJ: Current approaches to diagnosis and treatment of invasive aspergillosis. Am J Respir Crit Care Med. 2006, 173: 707-717.CrossRefPubMed
37.
go back to reference Aoki Y, Iwamoto M, Kamata Y, Nagashima T, Yoshio T, Okazaki H, Minota S: Prognostic indicators related to death in patients with Pneumocystis pneumonia associated with collagen vascular diseases. Rheumatol Int. 2009, 29: 1327-1330.CrossRefPubMed Aoki Y, Iwamoto M, Kamata Y, Nagashima T, Yoshio T, Okazaki H, Minota S: Prognostic indicators related to death in patients with Pneumocystis pneumonia associated with collagen vascular diseases. Rheumatol Int. 2009, 29: 1327-1330.CrossRefPubMed
38.
go back to reference Takahashi T, Hosoya N, Endo T, Nakamura T, Sakashita H, Kimura K, Ohnishi K, Nakamura Y, Iwamoto A: Relationship between mutations in dihydropteroate synthase of Pneumocystis carinii f. sp. hominis isolates in Japan and resistance to sulfonamide therapy. J Clin Microbiol. 2000, 38: 3161-3164.PubMedPubMedCentral Takahashi T, Hosoya N, Endo T, Nakamura T, Sakashita H, Kimura K, Ohnishi K, Nakamura Y, Iwamoto A: Relationship between mutations in dihydropteroate synthase of Pneumocystis carinii f. sp. hominis isolates in Japan and resistance to sulfonamide therapy. J Clin Microbiol. 2000, 38: 3161-3164.PubMedPubMedCentral
39.
go back to reference Kazanjian P, Armstrong W, Hossler P, Burman W, Richardson J, Lee C, Crane L, Katz J, Meshnick S: Pneumocystis carinii mutations are associated with duration of sulfa or sulfone prophylaxis exposure in AIDS patients. J Infect Dis. 2000, 182: 551-557.CrossRefPubMed Kazanjian P, Armstrong W, Hossler P, Burman W, Richardson J, Lee C, Crane L, Katz J, Meshnick S: Pneumocystis carinii mutations are associated with duration of sulfa or sulfone prophylaxis exposure in AIDS patients. J Infect Dis. 2000, 182: 551-557.CrossRefPubMed
40.
go back to reference van Hal S, Gilgado F, Doyle T, Barratt J, Stark D, Meyer W, Harkness J: Clinical significance and phylogenetic relationship of novel Australian Pneumocystis jirovecii genotypes. J Clin Microbiol. 2009, 47: 1818-1823.CrossRefPubMedPubMedCentral van Hal S, Gilgado F, Doyle T, Barratt J, Stark D, Meyer W, Harkness J: Clinical significance and phylogenetic relationship of novel Australian Pneumocystis jirovecii genotypes. J Clin Microbiol. 2009, 47: 1818-1823.CrossRefPubMedPubMedCentral
41.
go back to reference Olsson M, Eriksson B, Elvin K, Strandberg M, Wahlgren M: Genotypes of clustered cases of Pneumocystis carinii pneumonia. Scand J Infect Dis. 2001, 33: 285-289.CrossRefPubMed Olsson M, Eriksson B, Elvin K, Strandberg M, Wahlgren M: Genotypes of clustered cases of Pneumocystis carinii pneumonia. Scand J Infect Dis. 2001, 33: 285-289.CrossRefPubMed
42.
go back to reference Montes-Cano M, de la Horra C, Martin-Juan J, Varela J, Torronteras R, Respaldiza N, Medrano F, Calderón E: Pneumocystis jiroveci genotypes in the Spanish population. Clin Infect Dis. 2004, 39: 123-128.CrossRefPubMed Montes-Cano M, de la Horra C, Martin-Juan J, Varela J, Torronteras R, Respaldiza N, Medrano F, Calderón E: Pneumocystis jiroveci genotypes in the Spanish population. Clin Infect Dis. 2004, 39: 123-128.CrossRefPubMed
43.
go back to reference Miller RF, Lindley AR, Copas A, Ambrose HE, Davies RJ, Wakefield AE: Genotypic variation in Pneumocystis jirovecii isolates in Britain. Thorax. 2005, 60: 679-682.CrossRefPubMedPubMedCentral Miller RF, Lindley AR, Copas A, Ambrose HE, Davies RJ, Wakefield AE: Genotypic variation in Pneumocystis jirovecii isolates in Britain. Thorax. 2005, 60: 679-682.CrossRefPubMedPubMedCentral
44.
go back to reference Beard CB, Carter JL, Keely SP, Huang L, Pieniazek NJ, Moura IN, Roberts JM, Hightower AW, Bens MS, Freeman AR, et al: Genetic variation in Pneumocystis carinii isolates from different geographic regions: implications for transmission. Emerg Infect Dis. 2000, 6: 265-272.CrossRefPubMedPubMedCentral Beard CB, Carter JL, Keely SP, Huang L, Pieniazek NJ, Moura IN, Roberts JM, Hightower AW, Bens MS, Freeman AR, et al: Genetic variation in Pneumocystis carinii isolates from different geographic regions: implications for transmission. Emerg Infect Dis. 2000, 6: 265-272.CrossRefPubMedPubMedCentral
45.
go back to reference Beard CB, Fox MR, Lawrence GG, Guarner J, Hanzlick RL, Huang L, del Rio C, Rimland D, Duchin JS, Colley DG: Genetic differences in Pneumocystis isolates recovered from immunocompetent infants and from adults with AIDS: Epidemiological Implications. J Infect Dis. 2005, 192: 1815-1818.CrossRefPubMed Beard CB, Fox MR, Lawrence GG, Guarner J, Hanzlick RL, Huang L, del Rio C, Rimland D, Duchin JS, Colley DG: Genetic differences in Pneumocystis isolates recovered from immunocompetent infants and from adults with AIDS: Epidemiological Implications. J Infect Dis. 2005, 192: 1815-1818.CrossRefPubMed
46.
go back to reference Valerio A, Tronconi E, Mazza F, Fantoni G, Atzori C, Tartarone F, Duca P, Cargnel A: Genotyping of Pneumocystis jiroveci pneumonia in Italian AIDS patients. Clinical outcome is influenced by dihydropteroate synthase and not by internal transcribed spacer genotype. J Acquir Immune Defic Syndr. 2007, 45: 521-528.CrossRefPubMed Valerio A, Tronconi E, Mazza F, Fantoni G, Atzori C, Tartarone F, Duca P, Cargnel A: Genotyping of Pneumocystis jiroveci pneumonia in Italian AIDS patients. Clinical outcome is influenced by dihydropteroate synthase and not by internal transcribed spacer genotype. J Acquir Immune Defic Syndr. 2007, 45: 521-528.CrossRefPubMed
47.
go back to reference Helweg-Larsen J, Tsolaki A, Miller R, Lundgren B, Wakefield A: Clusters of Pneumocystis carinii pneumonia: analysis of person-to-person transmission by genotyping. QJM. 1998, 91: 813-820.CrossRefPubMed Helweg-Larsen J, Tsolaki A, Miller R, Lundgren B, Wakefield A: Clusters of Pneumocystis carinii pneumonia: analysis of person-to-person transmission by genotyping. QJM. 1998, 91: 813-820.CrossRefPubMed
48.
go back to reference Robberts FJ, Liebowitz LD, Chalkley LJ: Genotyping and coalescent phylogenetic analysis of Pneumocystis jiroveci from South Africa. J Clin Microbiol. 2004, 42: 1505-1510.CrossRefPubMedPubMedCentral Robberts FJ, Liebowitz LD, Chalkley LJ: Genotyping and coalescent phylogenetic analysis of Pneumocystis jiroveci from South Africa. J Clin Microbiol. 2004, 42: 1505-1510.CrossRefPubMedPubMedCentral
Metadata
Title
Clinical characteristics of Pneumocystis pneumonia in non-HIV patients and prognostic factors including microbiological genotypes
Authors
Yasufumi Matsumura
Yuichiro Shindo
Yoshitsugu Iinuma
Masaki Yamamoto
Michinori Shirano
Aki Matsushima
Miki Nagao
Yutaka Ito
Shunji Takakura
Yoshinori Hasegawa
Satoshi Ichiyama
Publication date
01-12-2011
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2011
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/1471-2334-11-76

Other articles of this Issue 1/2011

BMC Infectious Diseases 1/2011 Go to the issue
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

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.