Pulmonology Institute, Carmel Medical Center, 7 Michal St, 34362, Haifa, Israel,
Lung. 2014 Dec;192(6):875-9. doi: 10.1007/s00408-014-9644-z. Epub 2014 Sep 9.
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.
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.
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.
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.
卡氏肺孢子虫(PCP)和巨细胞病毒(CMV)是机会性病原体,可导致免疫功能低下个体肺部感染。然而,关于免疫功能正常、非重症患者中 CMV 或 PCP 的携带情况,数据十分有限。本研究旨在评估成人免疫功能正常、非重症患者支气管肺泡灌洗液中 PCP 和 CMV 的流行率。
对接受支气管镜检查的免疫功能正常患者的支气管肺泡灌洗液进行聚合酶链反应(PCR)检测 CMV 和 PCP DNA。我们还检测了血清中的 CMV 抗体。对于灌洗液中 CMV DNA 阳性的患者,我们进一步分析了外周血中 CMV DNA 的存在情况。
共纳入 93 例患者。我们在任何患者的 BAL 中均未检测到 PCP DNA。86 例 CMV IgG 阳性患者中有 5 例(5.8%)的 BAL 中检测到 CMV DNA。CMV DNA 阳性患者与 CMV PCR 阴性患者在人口统计学和临床特征方面无差异。
我们在研究队列中未发现 PCP 定植。然而,我们发现免疫功能正常的患者中存在显著比例的 CMV DNA,且无急性 CMV 感染的证据。这一发现可能代表 CMV 在免疫功能正常、非重症个体中的定植。