Clinical significance of Pneumocystis jiroveci in patients with active tuberculosis.

Kelvin K W To, Ivan F N Hung, Ting Xu, Rosana W S Poon, Whitney C T Ip, Patrick T W Li, Clara P Y Li, Susanna K P Lau, Wing-Cheong Yam, Kwok-Hung Chan, Kwok-Yung Yuen

Research Centre of Infection and Immunology, The University of Hong Kong, Pokfulam Road, Pokfulam, Hong Kong Special Administrative Region, China.

Diagnostic microbiology and infectious disease 2013 Mar

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Pneumocystis colonization has been associated with airway inflammation and obstruction. We conducted a retrospective cohort study to investigate the clinical significance of Pneumocystis in the airway of patients with active tuberculosis. Of the 108 respiratory specimens tested positive for M. tuberculosis by polymerase chain reaction (PCR), 11 (10.2%) were also positive for Pneumocystis by PCR. Compared with patients tested negative for Pneumocystis, those with Pneumocystis had a higher serum alanine transaminase level, a greater likelihood of requiring oxygen supplementation, and a worse 30-day mortality. The proportion of patients with chronic obstructive pulmonary disease was not significantly different between the 2 groups, but lung malignancy was more prevalent among patients with Pneumocystis. Multivariate analysis showed that Pneumocystis was independently associated with oxygen supplementation. Our study has shown an association between the detection of Pneumocystis in lower respiratory tract specimens and greater impairment of pulmonary function among patients with active tuberculosis. Copyright © 2013 Elsevier Inc. All rights reserved.

Citation

Kelvin K W To, Ivan F N Hung, Ting Xu, Rosana W S Poon, Whitney C T Ip, Patrick T W Li, Clara P Y Li, Susanna K P Lau, Wing-Cheong Yam, Kwok-Hung Chan, Kwok-Yung Yuen. Clinical significance of Pneumocystis jiroveci in patients with active tuberculosis. Diagnostic microbiology and infectious disease. 2013 Mar;75(3):260-5