Pneumocystis colonisation is common among hospitalised HIV infected patients with non-Pneumocystis pneumonia
Pneumocystis colonisation is common among hospitalised HIV infected patients with non-Pneumocystis pneumonia
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DOI：
10.1136/thx.2007.088104
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发表时间：
2008-04-01
期刊：
影响因子：
10
通讯作者：
Huang, L.
中科院分区：
文献类型：
--
作者：
Davis, J. L.;Welsh, D. A.;Huang, L.
背景资料：当从没有肺孢子虫肺炎（PCP）的患者的呼吸道标本中回收肺孢子虫DNA时，患者被称为肺孢子虫定植，尽管这种状态的意义尚不清楚。了解定植的风险因素和结果可能有助于深入了解耶氏肺孢子虫的生命周期和传播动力学。方法：我们对172例HIV感染者肺孢子虫定植的患病率和临床预测因素进行了横断面研究，2003年至2009年期间，在新奥尔良路易斯安那州医学中心接受183次肺炎诊断评价的PCP阴性住院患者2000年至2005年在旧金山弗朗西斯科总医院工作。从痰液和支气管肺泡灌洗液标本中提取DNA，并在线粒体大亚基（18 S）核糖体RNA位点使用巢式PCR检测进行扩增。如果肺孢子虫DNA经凝胶电泳和直接DNA测序鉴定，则认为存在定殖。结果：68%（117/172）的患者被肺孢子虫定殖。任何人口统计学因素均未发现与殖民化的强相关性。在临床因素中，具有CD 4 + T细胞计数
Background: When Pneumocystis DNA is recovered from respiratory specimens of patients without Pneumocystis pneumonia (PCP), patients are said to be colonised with Pneumocystis, although the significance of this state is unknown. Understanding risk factors for and outcomes of colonisation may provide insights into the life cycle and transmission dynamics of Pneumocystis jirovecii.Methods: We performed a cross sectional study of the prevalence and clinical predictors of Pneumocystis colonisation in 172 HIV infected, PCP negative inpatients undergoing diagnostic evaluation of 183 episodes of pneumonia at either the Medical Center of Louisiana at New Orleans between 2003 and 2005 or San Francisco General Hospital between 2000 and 2005. DNA was extracted from sputum and bronchoalveolar lavage specimens and amplified using a nested PCR assay at the mitochondrial large subunit (18S) ribosomal RNA locus. Colonisation was deemed present if Pneumocystis DNA was identified by both gel electrophoresis and direct DNA sequencing.Results: 68% (117/172) of all patients were colonised with Pneumocystis. No strong associations with colonisation were identified for any demographic factors. Among clinical factors, having a CD4+ T cell count