Vysoký výskyt pneumónie spôsobenej Pneumocystis jirovecii u onkologických pacientov: 19-ročná štúdia
Authors:
V. Boldiš 1,2; F. Ondriska 1,3; Ľ. Kováč 4; J. Steinhübel 1; M. Bastlová 1
Authors‘ workplace:
Department of Parasitology, Medirex Ltd., Galvaniho 17/C, 82016 Bratislava, Slovakia
1; Medirex Group Academy n. p. o., Nitra, Slovakia
2; School of Health Sciences and Social Work, University in Trnava, Trnava, Slovakia
3; Department of Virology, Serology and Molecular biology of infectious diseases, Medirex Ltd., Bratislava, Slovakia
4
Published in:
Epidemiol. Mikrobiol. Imunol. 72, 2023, č. 2, s. 93-98
Category:
Original Papers
Overview
Cieľ: Pneumocystis jirovecii patril v minulosti do skupiny prvokov, ale v súčasnosti je taxonomicky zaradený do ríše húb. P. jirovecii je oportúnny patogén, zodpovedný za pneumocystovú pneumóniu s častými komplikáciami u imunokompromitovaných pacientov. Oneskorené začatie vhodnej liečby zvyšuje riziko úmrtia u pacientov s oslabenou imunitou. Cieľom práce bolo zistiť a zhodnotiť spoľahlivosť metód laboratórnej diagnostiky pneumocystózy používaných v rutinných laboratóriách ako aj výskyt tohto ochorenia u pacientov zo Slovenska za 19 rokov.
Materiál a metódy: Diagnostika je založená na mikroskopickom dôkaze (farbenie podľa Giemsa a Gram-Weigerta) a detekcii DNA parazita klasickou alebo real-time PCR v bronchoalveolárnej laváži a spúte.
Výsledky: Pneumocysty boli zistené u 190 osôb (5,7 %) z celého súboru pacientov. Onkologickí pacienti predstavovali najrizikovejšiu skupinu z hľadiska infekcie pneumocystami, čo sme potvrdili ich najvyšším podielom (57,9 %) z jedincov s pneumocystózou. Na základe binárneho klasifikačného testu sme vyhodnotili 33,7 % citlivosť a 100 % špecifickosť mikroskopického dôkazu v porovnaní s PCR. Molekulárne metódy sú v porovnaní s mikroskopickým dôkazom citlivejšie v detekcii P. jirovecii a v súčasnosti predstavujú spoľahlivý detekčný systém v diagnostike pneumocystózy.
Záver: Vzhľadom na narastajúci počet imunokompromitovaných osôb je diagnostika P. jirovecii u pacientov s pľúcnymi komplikáciami nevyhnutná. To sa potvrdilo aj v našej štúdii, kde v priebehu rokov stúpal počet vyšetrení a záchytov tohto oportúnneho patogénu.
Klíčová slova:
Pneumocystis jirovecii – pneumocystóza – mikroskopický dôkaz – polymerázová reťazová reakcia (PCR)
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Hygiene and epidemiology Medical virology Clinical microbiologyArticle was published in
Epidemiology, Microbiology, Immunology
2023 Issue 2
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