STUDY OF THE DISTRIBUTION OF PNEUMOCYSTOSIS IN BULGARIA BETWEEN SEPTEMBER 2017 AND APRIL 2019 BY USING REAL- TIME PCR

Authors

  • Aleksandra Ivanova National Centre of Infectious and Parasitic Diseases Author
  • Nina Tsvetkova National Centre of Infectious and Parasitic Diseases Author
  • Assoc. Prof. Rumen Harizanov, MD, PhD National Centre of Infectious and Parasitic Diseases Author
  • Raina Borisova, MD National Centre of Infectious and Parasitic Diseases Author

DOI:

https://doi.org/10.58395/pipd.v47i2.8

Keywords:

Pneumocystis jirovecii, real-time PCR, compromised immunity

Abstract

Pneumocystis jirovecii is an opportunistic organism that inhabits predominantly the human pulmonary alveoli. The fully sequenced genome of P. jirovecii was first reported in 2012. According to some authors, P. jirovecii is an obligate pathogen because genes encoding virulence factors and most enzymes for amino acid biosynthesis were not found in the genome. This suggests that the microorganism normally colonises the human lungs but causes disease only in immunocompromised persons. Pneumocystis pneumonia (PCP) is one of the most common opportunistic infections in patients developing acquired immune deficiency syndrome (AIDS). The use of conventional microscopic methods in diagnosis is associated with considerable limitations. Therefore, detection of Pneumocystis DNA in clinical samples by PCR techniques leads to significant advances in the diagnosis of PCP.

The aim of this study is to determine the importance of PCR-based methods in the diagnosis of human pneumocystosis and to evaluate their diagnostic value in comparison with conventional microscopy methods. For a period of 20 months in the National Reference Laboratory “Diagnosis of Parasitic Diseases” at the National Centre of Infectious and Parasitic Diseases 33 patients were tested by real-time PCR and 11 of them were found positive for the presence of P. jirovecii DNA. Eight of the patients (72.7%) were HIV-infected. Although limited in extent, this is the first real-time PCR study on the distribution of human pneumocystosis in Bulgaria. Our data shows that PCR techniques have higher sensitivity and specificity than microscopic methods and provide new opportunities for the diagnosis of Pneumocystis pneumonia.

Downloads

Download data is not yet available.

Author Biographies

  • Aleksandra Ivanova, National Centre of Infectious and Parasitic Diseases

    Department of Parasitology and Tropical Medicine

  • Nina Tsvetkova, National Centre of Infectious and Parasitic Diseases

    Department of Parasitology and Tropical Medicine

  • Assoc. Prof. Rumen Harizanov, MD, PhD, National Centre of Infectious and Parasitic Diseases

    Department of Parasitology and Tropical Medicine

  • Raina Borisova, MD, National Centre of Infectious and Parasitic Diseases

    Department of Parasitology and Tropical Medicine

References

Kovacs JA, Masur H. Evolving health effects of Pneumocystis: one hundred years of progress in diagnosis and treatment. JAMA. 2009; 301:2578-2585. DOI: https://doi.org/10.1001/jama.2009.880

Huang L, Cattamanchi A, Davis JL, Boon S, Kovacs J, Meshnick S, Miller RF, Walzer PD, Worodria W, Masur H. HIV associated Pneumocystis pneumonia. Proc Am Thorac Soc. 2011; 8(3):294-300. DOI: https://doi.org/10.1513/pats.201009-062WR

Tasaka S. Pneumocystis pneumonia in Human Immunodeficiency Virus-infected adults and adolescents: Current concepts and future directions. Clin Med Insights Circ Respir Pulm Med. 2015; 9(Suppl 1):19-28. DOI: https://doi.org/10.4137/CCRPM.S23324

Song Y, Ren Y, Wang X, Li R. Recent Advances in the Diagnosis of Pneumocystis Pneumonia. Med Mycol J. 2016; 57(4):111-116. DOI: https://doi.org/10.3314/mmj.16-00019

Gigliotti F, Limper AH, Wright T. Pneumocystis. Cold Spring Harb Perspect Med. 2014; 4:a019828. DOI: https://doi.org/10.1101/cshperspect.a019828

Carmona EM, Limper AH. Update on the diagnosis and treatment of Pneumocystis pneumonia. Ther Adv Respir Dis. 2011; 5:41-59. DOI: https://doi.org/10.1177/1753465810380102

Calderón EJ, Gutiérrez-Rivero S, Durand-Joly I, Dei-Cas E. Pneumocystis infection in humans: diagnosis and treatment. Expert Rev Anti Infect Ther. 2010; 8:683–701. DOI: https://doi.org/10.1586/eri.10.42

Cissé OH, Pagni M, Hauser PM. De novo assembly of the Pneumocystis jirovecii genome from a single bronchoalveolar lavage fluid specimen from a patient. MBio. 2012; 4:e428-12. DOI: https://doi.org/10.1128/mBio.00428-12

Moodley B, Tempia S, Frean JA. Comparison of quantitative real-time PCR and direct immunofluorescence for the detection of Pneumocystis jirovecii. PLoS ONE. 2017; 12(7):e0180589. DOI: https://doi.org/10.1371/journal.pone.0180589

Sasso M, Chastang-Dumas E, Bastide S, Alonso S, Lechiche C, Bourgeois N, Lachaud L. Performances of four real-time PCR assays for diagnosis of Pneumocystis jirovecii pneumonia. J Clin Microbiol. 2015; 54:625-630. DOI: https://doi.org/10.1128/JCM.02876-15

Doyle L, Vogel S, Procop GW. Pneumocystis PCR: It Is Time to Make PCR the Test of Choice. Open Forum Infect Dis. 2017; 4(4):ofx193. DOI: https://doi.org/10.1093/ofid/ofx193

Kurdova R. (ed.) Laboratory diagnosis of parasitic infections in humans. Sofia, “Arso”, 2009, 254 p. (in Bulgarian)

Ding CH, Yusoff H, Muttaqillah NAS, Tang YL, Tan TL, Periyasamy P, Ban AYL. The crucial role of molecular testing to facilitate the diagnosis of pneumocystis pneumonia during pregnancy. Malaysian J Pathol. 2018; 40(1):69-72.

Kurdova R, Marinova T, Jordanova D, Ivanova M, Tsvetkova N, Rainova I. Opportunistic Parasitic Diseases Associated with HIV Infection in Bulgaria. EMOP IX, 2004.

Centers for Disease Control and Prevention. Pneumocystis pneumonia Statistics 2012.

Fillaux J, Malvy S, Alvarez M, Fabre R, Cassaing S, Marchou B, Linas MD, Berry A. Accuracy of a routine real-time PCR assay for the diagnosis of Pneumocystis jirovecii pneumonia. J Microbiol Methods. 2008; 75(2):258-261. DOI: https://doi.org/10.1016/j.mimet.2008.06.009

Downloads

Published

2019-12-30

Issue

Section

Articles

How to Cite

(1)
Ivanova, A.; Tsvetkova, N.; Harizanov, R.; Borisova, R. STUDY OF THE DISTRIBUTION OF PNEUMOCYSTOSIS IN BULGARIA BETWEEN SEPTEMBER 2017 AND APRIL 2019 BY USING REAL- TIME PCR. Probl Infect Parasit Dis 2019, 47 (2), 24-27. https://doi.org/10.58395/pipd.v47i2.8.

Most read articles by the same author(s)