Heather D Green1, Rowland J Bright-Thomas2, Ken J Mutton3, Malcolm Guiver4, Andrew M Jones2. 1. Manchester Adult Cystic Fibrosis Centre, University Hospital of South Manchester NHS Foundation Trust, Southmoor Road, Manchester, M23 9LT, UK; University of Manchester, Institute of Inflammation and Repair, UK. Electronic address: heathergreen2@nhs.net. 2. Manchester Adult Cystic Fibrosis Centre, University Hospital of South Manchester NHS Foundation Trust, Southmoor Road, Manchester, M23 9LT, UK; University of Manchester, Institute of Inflammation and Repair, UK. 3. University of Manchester, Institute of Inflammation and Repair, UK; Central Manchester University Hospitals NHS Trust, Clinical Virology Department and PHE Public Health Laboratory, Clinical Sciences Building, Manchester Royal Infirmary, Manchester, M13 9WL, UK. 4. Central Manchester University Hospitals NHS Trust, Clinical Virology Department and PHE Public Health Laboratory, Clinical Sciences Building, Manchester Royal Infirmary, Manchester, M13 9WL, UK.
Abstract
OBJECTIVES: This study examined the prevalence of Pneumocystis jirovecii in the sputum of adults with cystic fibrosis during clinical stability and acute pulmonary exacerbation. METHODS: This was a prospective, longitudinal observational study of patients attending the Manchester Adult Cystic Fibrosis Centre. Sputum samples were analysed for P. jirovecii DNA using PCR at enrolment and up to 5 follow-up visits. Patients were classified as stable or exacerbating using a modified Fuch's pulmonary exacerbation score. RESULTS: 226 samples were tested from 111 patients. P. jirovecii was more likely to be detected in samples at acute pulmonary exacerbation (7/76 (9.2%)) compared with stable visits (3/150 (2%)), p = 0.03. P. jirovecii was detected less frequently if patients had received co-trimoxazole within 3 months of sample collection (0% versus 29.7%, p = 0.03). CONCLUSIONS: Prevalence of P. jirovecii in stable patients is low, but P. jirovecii is detected in approximately 1 in 10 patients experiencing an acute pulmonary exacerbation.
OBJECTIVES: This study examined the prevalence of Pneumocystis jirovecii in the sputum of adults with cystic fibrosis during clinical stability and acute pulmonary exacerbation. METHODS: This was a prospective, longitudinal observational study of patients attending the Manchester Adult Cystic Fibrosis Centre. Sputum samples were analysed for P. jirovecii DNA using PCR at enrolment and up to 5 follow-up visits. Patients were classified as stable or exacerbating using a modified Fuch's pulmonary exacerbation score. RESULTS: 226 samples were tested from 111 patients. P. jirovecii was more likely to be detected in samples at acute pulmonary exacerbation (7/76 (9.2%)) compared with stable visits (3/150 (2%)), p = 0.03. P. jirovecii was detected less frequently if patients had received co-trimoxazole within 3 months of sample collection (0% versus 29.7%, p = 0.03). CONCLUSIONS: Prevalence of P. jirovecii in stable patients is low, but P. jirovecii is detected in approximately 1 in 10 patients experiencing an acute pulmonary exacerbation.
Authors: Ruben Morilla; Francisco J Medrano; Ana Calzada; Esther Quintana; Elena Campano; Vicente Friaza; Enrique J Calderón; Carmen de la Horra Journal: Med Mycol Date: 2021-09-03 Impact factor: 4.076