使用诱导痰来确定免疫功能低下的肺炎儿童中耶氏肺孢子菌的患病率。

Use of Induced sputum to determine the prevalence of Pneumocystis jirovecii in immunocompromised children with pneumonia.

作者信息

Das Chandan K, Mirdha Bijay R, Singh Sundeep, Seth Rachna, Bagga Arvind, Lodha Rakesh, Kabra Sushil K

机构信息

Department of Pediatrics, All India Institute of Medical Sciences, New Delhi 110029, India.

Department of Microbiology, All India Institute of Medical Sciences, New Delhi 110029, India.

出版信息

J Trop Pediatr. 2014 Jun;60(3):216-22. doi: 10.1093/tropej/fmt112. Epub 2014 Jan 13.

DOI:10.1093/tropej/fmt112

PMID:24425204

Abstract

BACKGROUND

Information on prevalence of Pneumocystis jirovecii pneumonia (PCP) in immunocompromised children with pneumonia in Southeast Asia is limited.

METHODS

Immunocompromised children hospitalized with radiographic pneumonia were investigated for PCP by testing induced sputum by using polymerase chain reaction (PCR).

RESULTS

Ninety-four immunocompromised children (mean age 74.5 ± 43.7 months, boys 69) with pneumonia were investigated for PCP. Underlying disease included solid tumors and hematological malignancy in 57, HIV infection in 14, primary immune deficiency in 11 and other immune deficiency disorders in 12 children. PCR could detect P. jirovecii in 14 children. Prevalence of PCP in HIV-infected children was 43% (6 of 14), renal disease on immunosuppressants 45% (4 of 9), primary immune deficiency 19% (2 of 11) and malignancies on chemotherapy 4% (2 of 57). Three of 14 children died from PCP.

CONCLUSIONS

PCP is responsible for pneumonia in 14% of children with underlying immunocompromised state; PCR on induced sputum improves diagnosis.

摘要

背景

东南亚免疫功能低下的肺炎儿童中耶氏肺孢子菌肺炎（PCP）的患病率信息有限。

方法

对因影像学肺炎住院的免疫功能低下儿童，采用聚合酶链反应（PCR）检测诱导痰来调查PCP。

结果

对94例免疫功能低下的肺炎儿童（平均年龄74.5±43.7个月，男69例）进行了PCP调查。基础疾病包括57例实体瘤和血液系统恶性肿瘤、14例HIV感染、11例原发性免疫缺陷以及12例其他免疫缺陷疾病患儿。PCR能在14例儿童中检测到耶氏肺孢子菌。HIV感染儿童中PCP的患病率为43%（14例中的6例），接受免疫抑制剂治疗的肾病患儿中为45%（9例中的4例），原发性免疫缺陷患儿中为19%（11例中的2例），化疗的恶性肿瘤患儿中为4%（57例中的2例）。14例儿童中有3例死于PCP。