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Prevalence and effect of a combined treatment on pneumocystitis pneumonia
Nada A Elnadi1, Alzahraa E Almasry, Mostafa M Abosdera
1Department of Medical Parasitology, Faculty of Medicine, Sohag University, Sohag, Egypt.
Insights
Pneumocystis pneumonia (PCP) in infants can be fatal. This study found routine treatment effective against PCP in intensive care units, though PCR was less effective for diagnosis compared to stained slides.
Area of Science:
- Pediatrics
- Infectious Diseases
- Microbiology
Background:
- Pneumocystis pneumonia (PCP) poses a significant risk to critically ill infants in neonatal and pediatric intensive care units (NICU/PICU).
- Accurate and timely diagnosis of PCP is crucial for effective treatment and improved patient outcomes.
Purpose of the Study:
- To evaluate the efficacy of routine treatment protocols for Pneumocystis jirovecii pneumonia (PCP) in neonates and infants admitted to NICU/PICU.
- To compare the diagnostic accuracy of Giemsa-stained sputum slides versus real-time PCR for detecting Pneumocystis jirovecii.
Main Methods:
- Sucked sputum samples were collected from 21 pneumonic infants for Giemsa staining and real-time PCR analysis, both pre- and post-treatment.
- Serum C-reactive protein (CRP) levels were measured on admission and discharge as an indicator of treatment response.
Main Results:
- Pneumocystis jirovecii was detected in 12 out of 21 (57.1%) infants via sputum examination.
- Routine treatment led to the clearance of P. jirovecii in 10 of the 12 positive cases (83.3%).
- Real-time PCR yielded negative results for all samples, both pre- and post-treatment, contrasting with sputum microscopy findings.
Conclusions:
- Routine treatment regimens appear effective in managing Pneumocystis pneumonia in critically ill infants.
- Giemsa-stained sputum microscopy demonstrated higher sensitivity than real-time PCR in this cohort for diagnosing P. jirovecii.
- Further investigation into optimized diagnostic methods for PCP in infants is warranted.
Abstract:
Pneumocystitis may cause fatal pneumonia in premature, seriously ill infants at intensive care units. The present study evaluated the routine treatment applied at Sohag pediatrics department for neonatal and infantile pneumonia (in NICU & PICU) on PCP and to compare between the stained slides and real time-PCR in diagnosing Pneumocystis jirovecii. Sucked sputum from 21 pneumonic infants was collected, some for Giemsa stain and microscopic examination and the rest for PCR. The same procedure was done after regression of the symptoms and before release from the units. Serum samples were also collected on admission and discharge for CRP readings which was also used as an indicative of the healing process. Out of 21 pneumonic neonates and infants examined, 12 (57.1%) showed P. jirovecii in sputum samples with a significant difference between both groups (p=0.2). 10 of them (83.3%) became negative for P. jirovecii under the routine regimen of treatment. Also 2 cases were infected with microspora, both improved at the end of treatment. While real time PCR was negative in all cases pre and post treatment. CRP levels regressed after treatment in all cases except 2 as one showed post treatment P. jirovecii in the sputum.
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