Clinical significance of Pneumocystis jiroveci in patients with active tuberculosis

Diagn Microbiol Infect Dis. 2013 Mar;75(3):260-5. doi: 10.1016/j.diagmicrobio.2012.11.016. Epub 2013 Jan 16.

Abstract

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Alanine Transaminase / blood
  • Cohort Studies
  • Coinfection / microbiology
  • Female
  • Humans
  • Limit of Detection
  • Lung / microbiology
  • Lung / pathology
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Mycobacterium tuberculosis
  • Oxygen / administration & dosage
  • Pneumocystis Infections / epidemiology
  • Pneumocystis Infections / microbiology*
  • Pneumocystis Infections / pathology
  • Pneumocystis carinii / isolation & purification*
  • Pulmonary Disease, Chronic Obstructive / microbiology
  • Real-Time Polymerase Chain Reaction
  • Retrospective Studies
  • Tuberculosis / microbiology*
  • Tuberculosis / pathology
  • Young Adult

Substances

  • Alanine Transaminase
  • Oxygen