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2049. Pneumocystis jiroveci Detection by Nested PCR in HIV-Infected Peruvian Patients

BACKGROUND: Pneumocystis jiroveci (PJ) is considered a common cause of pneumonia in HIV-AIDS patients. PJ detection now is facilitated by molecular techniques using non-invasive samples; however, there are few PJ colonization studies in HIV population using these techniques. The study aim was to eva...

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Autores principales: Camargo, Jimmy, Bustamante, Beatriz, Neyra, Edgar, Ochoa, Theresa, Alvarez, Fiorela, Garcia, Coralith
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6252712/
http://dx.doi.org/10.1093/ofid/ofy210.1705
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author Camargo, Jimmy
Bustamante, Beatriz
Neyra, Edgar
Ochoa, Theresa
Alvarez, Fiorela
Garcia, Coralith
author_facet Camargo, Jimmy
Bustamante, Beatriz
Neyra, Edgar
Ochoa, Theresa
Alvarez, Fiorela
Garcia, Coralith
author_sort Camargo, Jimmy
collection PubMed
description BACKGROUND: Pneumocystis jiroveci (PJ) is considered a common cause of pneumonia in HIV-AIDS patients. PJ detection now is facilitated by molecular techniques using non-invasive samples; however, there are few PJ colonization studies in HIV population using these techniques. The study aim was to evaluate the frequency and factors related to PJ colonization among HIV-patients with CD4 account <500 cells/mm(3). METHODS: We performed a cross-sectional study evaluating HIV patients older than 18 years old with or without respiratory symptoms with CD4 account <500 cells/mm(3) who attended Hospital Cayetano Heredia in Lima, Peru during May 2017–March 2018. After patients signed an inform consent, clinical information was obtained from the medical chart and a non-induced sputum sample was collected. If patient did not have cough, an oral wash sample using saline was obtained. PJ detection was based on the amplification of the mitochondrial large subunit ribosomal RNA (mtLSU rRNA) in two stages. First, single round PCR was done using external primers (pAZ102E and pAZ102H); then, PCR products were amplified (nested PCR) using internal primers (pAZ102X and pAZ102Y). If the single round PCR was positive in a patient with respiratory symptoms, it was considered a PJ infection. If only the nested PCR was positive, this was considered as PJ colonization. RESULTS: A total of 177 patients were included, 75 (42.4%) with respiratory symptoms. Three cases were considered PJ infections. A total of 15 cases (8.6%) were colonized by PJ, 7/72 (9.7%) cases with respiratory symptoms and 8/102 (7.8%) among asymptomatic patients. A higher proportion of colonization was seen in patients in whom an oral wash was obtained (14/156, 9.0%) compared with those in whom a non-induced sputum was analyzed (1/18, 5.5%). The frequency of PJ colonization based on CD4 account was 6.5 and 10.3% among patients with ≤200 and >200 cells/mm(3), respectively. CONCLUSION: PJ colonization was seen in 8.6% of HIV patients. The proportion of PJ detection was higher when oral wash was analyzed compared with non-induced sputum. Patients with lower CD4 account did not show a higher proportion of colonization. DISCLOSURES: All authors: No reported disclosures.
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spelling pubmed-62527122018-11-28 2049. Pneumocystis jiroveci Detection by Nested PCR in HIV-Infected Peruvian Patients Camargo, Jimmy Bustamante, Beatriz Neyra, Edgar Ochoa, Theresa Alvarez, Fiorela Garcia, Coralith Open Forum Infect Dis Abstracts BACKGROUND: Pneumocystis jiroveci (PJ) is considered a common cause of pneumonia in HIV-AIDS patients. PJ detection now is facilitated by molecular techniques using non-invasive samples; however, there are few PJ colonization studies in HIV population using these techniques. The study aim was to evaluate the frequency and factors related to PJ colonization among HIV-patients with CD4 account <500 cells/mm(3). METHODS: We performed a cross-sectional study evaluating HIV patients older than 18 years old with or without respiratory symptoms with CD4 account <500 cells/mm(3) who attended Hospital Cayetano Heredia in Lima, Peru during May 2017–March 2018. After patients signed an inform consent, clinical information was obtained from the medical chart and a non-induced sputum sample was collected. If patient did not have cough, an oral wash sample using saline was obtained. PJ detection was based on the amplification of the mitochondrial large subunit ribosomal RNA (mtLSU rRNA) in two stages. First, single round PCR was done using external primers (pAZ102E and pAZ102H); then, PCR products were amplified (nested PCR) using internal primers (pAZ102X and pAZ102Y). If the single round PCR was positive in a patient with respiratory symptoms, it was considered a PJ infection. If only the nested PCR was positive, this was considered as PJ colonization. RESULTS: A total of 177 patients were included, 75 (42.4%) with respiratory symptoms. Three cases were considered PJ infections. A total of 15 cases (8.6%) were colonized by PJ, 7/72 (9.7%) cases with respiratory symptoms and 8/102 (7.8%) among asymptomatic patients. A higher proportion of colonization was seen in patients in whom an oral wash was obtained (14/156, 9.0%) compared with those in whom a non-induced sputum was analyzed (1/18, 5.5%). The frequency of PJ colonization based on CD4 account was 6.5 and 10.3% among patients with ≤200 and >200 cells/mm(3), respectively. CONCLUSION: PJ colonization was seen in 8.6% of HIV patients. The proportion of PJ detection was higher when oral wash was analyzed compared with non-induced sputum. Patients with lower CD4 account did not show a higher proportion of colonization. DISCLOSURES: All authors: No reported disclosures. Oxford University Press 2018-11-26 /pmc/articles/PMC6252712/ http://dx.doi.org/10.1093/ofid/ofy210.1705 Text en © The Author(s) 2018. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Abstracts
Camargo, Jimmy
Bustamante, Beatriz
Neyra, Edgar
Ochoa, Theresa
Alvarez, Fiorela
Garcia, Coralith
2049. Pneumocystis jiroveci Detection by Nested PCR in HIV-Infected Peruvian Patients
title 2049. Pneumocystis jiroveci Detection by Nested PCR in HIV-Infected Peruvian Patients
title_full 2049. Pneumocystis jiroveci Detection by Nested PCR in HIV-Infected Peruvian Patients
title_fullStr 2049. Pneumocystis jiroveci Detection by Nested PCR in HIV-Infected Peruvian Patients
title_full_unstemmed 2049. Pneumocystis jiroveci Detection by Nested PCR in HIV-Infected Peruvian Patients
title_short 2049. Pneumocystis jiroveci Detection by Nested PCR in HIV-Infected Peruvian Patients
title_sort 2049. pneumocystis jiroveci detection by nested pcr in hiv-infected peruvian patients
topic Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6252712/
http://dx.doi.org/10.1093/ofid/ofy210.1705
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