Hospital Universitario San Ignacio, Departamento de Medicina Interna, Unidad de Neumología, Bogotá, Colombia; Pontificia Universidad Javeriana, Escuela de Medicina, Bogotá, Colombia.
Pontificia Universidad Javeriana, Escuela de Medicina, Bogotá, Colombia; Hospital Universitario San Ignacio, Departamento de Medicina Interna, Unidad de Medicina Interna, Bogotá, Colombia.
Braz J Infect Dis. 2019 Sep-Oct;23(5):352-357. doi: 10.1016/j.bjid.2019.08.008. Epub 2019 Sep 20.
Exposure to Pneumocystis jirovecii (P. jirovecii) can lead to a wide variety of presenting features ranging from colonization in immunocompetent patients with lung disease, to invasive infections in immunocompromised hosts. Colonization by this fungus in patients with chronic obstructive pulmonary disease (COPD) could be associated with higher rates of exacerbations and impaired lung function in these patients. Our objective was to determine whether colonization by P. jirovecii in patients with COPD is associated with increased exacerbations and deterioration of lung function. This was a prospective cohort study on patients with COPD. All participants meeting selection criteria underwent clinical and microbiological assessments and were then classified as colonized vs. non-colonized patients. Chi-squared tests were performed and multivariate logistic models were fitted in order to obtain risk ratios (RR) with 95% confidence intervals (CI). We documented a frequency of colonization by P. jirovecii of 32.3%. Most patients were categorized as having GOLD B and D COPD. The history of significant exacerbations in the last year, health status impairment (COPD Assesment Tool ≥10), airflow limitation (percent of post-bronchodilator FEV1), and BODEx score (≥5) were similar between groups. After a 52-week follow-up period, the rate of adjusted significant exacerbations did not differ between groups. However, a decrease in FEVI was found in both groups.
耶氏肺孢子菌（Pneumocystis jirovecii，P. jirovecii）暴露可导致多种表现特征，范围从免疫功能正常伴有肺部疾病的患者的定植，到免疫功能低下宿主的侵袭性感染。这种真菌在慢性阻塞性肺疾病（COPD）患者中的定植可能与这些患者更高的加重率和肺功能受损相关。我们的目的是确定 COPD 患者中耶氏肺孢子菌的定植是否与加重率增加和肺功能恶化有关。这是一项针对 COPD 患者的前瞻性队列研究。所有符合入选标准的参与者均进行了临床和微生物学评估，然后分为定植和非定植患者。进行了卡方检验，并拟合了多变量逻辑模型，以获得具有 95%置信区间（CI）的风险比（RR）。我们记录了耶氏肺孢子菌定植的频率为 32.3%。大多数患者被归类为 GOLD B 和 D COPD。在过去一年中发生过显著加重的病史、健康状况受损（COPD 评估工具≥10）、气流受限（支气管扩张剂后 FEV1 的百分比）和 BODEx 评分（≥5）在两组之间相似。在 52 周的随访期间，两组调整后的显著加重率没有差异。然而，两组的 FEV1 都有下降。
