Sheikholeslami Maryam Fatemeh, Sadraei Javid, Farnia Parissa, Forozandeh Mehdi, Emadi Kochak Hamid, Tabarsi Payam, Nadji Seyed Alireza, Pirestani Majid, Masjedi Mohammad Reza, Velayati AliAkbar
Mycobacteriology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran ; Tarbiat Modares University, Medical Faculty, Parasitology department, Tehran, Iran.
Tarbiat Modares University, Medical Faculty, Parasitology department, Tehran, Iran.
Iran J Microbiol. 2013 Dec;5(4):411-7.
With increasing rate of immunodeficiency diseases in the world, opportunistic micro-organism such as Pneumocystis jirovecii (P. jirovecii) become more important. Little information is available on prevalence of this life-threatening microorganism in Iran. This study was designed to determine the colonization and the rate of active disease caused by P. jirovecii in two groups of Iranian immunosuppressed patients.
Two hundred and fifty five pulmonary samples were collected from two groups of immunosuppressed patients to detect a 260bp fragment of mt LSU rRNA gene of P. jirovecii by nested PCR. The first group was COPD patients consumed oral, inhaled or injectable corticosteroid and the second group was patients with malignancies under chemotherapy. Both groups were referred to National Research Institute of Tuberculosis and Lung Disease and Imam Khomeini hospital because of pulmonary symptoms. All patients introduced to this project were confirmed HIV sera-negative by ELISA and western blot test.
The mean age of COPD patients was 66.5 ± 11 (41-88) years and all of them were men. The mean age of patients with malignancy (PMs) was 43 ± 11 (23-65) years and 51.6% were men. The P. jirovecii was colonized in 7 of 89 COPD patients (7.9%) and its DNA was isolated from 11 of 153 PMs (7.2%). The microorganism could cause active disease in 7 of 67 (10.5%) PMs who suffered from pneumonia.
The study showed that P. jirovecii was one of colonizing agents in the COPD patients, but it could cause active disease in PMs. Generally, the microorganism can exist in the lung of non-HIV(+) immunosuppressed patients. Therefore, it should be considered as a potential infective agent in non-HIV(+) immunocompromised patients.
随着全球免疫缺陷疾病发病率的上升,诸如耶氏肺孢子菌(P. jirovecii)等机会性微生物变得愈发重要。关于这种危及生命的微生物在伊朗的流行情况,目前所知甚少。本研究旨在确定两组伊朗免疫抑制患者中耶氏肺孢子菌的定植情况及活动性疾病发生率。
从两组免疫抑制患者中采集了255份肺部样本,通过巢式PCR检测耶氏肺孢子菌线粒体大亚基核糖体RNA(mt LSU rRNA)基因的260bp片段。第一组为使用口服、吸入或注射用皮质类固醇的慢性阻塞性肺疾病(COPD)患者,第二组为接受化疗的恶性肿瘤患者。两组患者均因肺部症状转诊至国家结核病和肺部疾病研究所及伊玛目霍梅尼医院。所有参与本项目的患者经酶联免疫吸附测定(ELISA)和蛋白质印迹法检测,确认HIV血清学阴性。
COPD患者的平均年龄为66.5±11(41 - 88)岁,均为男性。恶性肿瘤患者(PMs)的平均年龄为43±11(23 - 65)岁,51.6%为男性。89例COPD患者中有7例(7.9%)定植了耶氏肺孢子菌,153例PMs中有11例(7.2%)分离出其DNA。在67例患肺炎的PMs中,该微生物可导致7例(10.5%)发生活动性疾病。
该研究表明,耶氏肺孢子菌是COPD患者的定植病原体之一,但可在PMs中引起活动性疾病。总体而言,这种微生物可存在于非HIV(+)免疫抑制患者的肺部。因此,应将其视为非HIV(+)免疫功能低下患者的潜在感染病原体。