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J Pediatr Infect Dis 2024; 19(04): 209-216
DOI: 10.1055/s-0044-1787983
Original Article

The Prevalence, Predisposing Factors, and Outcomes of Pneumocystis jirovecii Pneumonia among Pediatric Inpatients, Northeastern Iran

Neginsadat Hosseinikargar 
1   Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
2   Department of Parasitology and Mycology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
,
Hossein Zarrinfar
3   Allergy Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
4   Sinus and Surgical Endoscopic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
,
Seyed Javad Seyedi
5   Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
,
Hassan Mehrad-Majd
6   Cancer Molecular Pathology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
,
Mohammad Javad Najafzadeh
2   Department of Parasitology and Mycology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
› Author Affiliations Funding It was financially supported by the Research Deputy (No. 991032) of Mashhad University of Medical Sciences, Mashhad, Iran.
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Abstract

Objective Pneumocystis jirovecii pneumonia (PJP), caused by Pneumocystis jirovecii, is one of the opportunistic fungal infections that can cause life-threatening pneumonia in children with underlying diseases. Due to the similarity of the symptoms of PJP with other lung infections, such as tuberculosis, differential and accurate diagnosis is necessary. The current study investigated the molecular diagnosis of P. jirovecii, predisposing factors and the outcomes, among pediatric inpatients in Northeastern Iran.

Methods In this study, 180 bronchoalveolar lavage specimens were obtained from hospitalized children with respiratory disorders. The specimens were examined using Giemsa stain, and the genomic DNA was extracted according to the protocol of the AmpliSens kit. A real-time polymerase chain reaction (PCR) technique was used to detect P. jirovecii by the AmpliSens Pneumocystis jirovecii (carinii)-FRT PCR kit.

Results Among the patients studied, 34 (18.9%) were positive and 8 (4.4%) were suspicious of the presence of P. jirovecii. Among the 34 positive cases, 12 (35%) were diagnosed before, and 22 (65%) during the coronavirus 2019 (COVID-19) pandemic. Only two cases (5.88%) among the positive ones detected by the real-time PCR method were observed using Giemsa staining. Also, no correlation was observed between positive cases of infection and the sex, the outcomes, and underlying diseases.

Conclusion The results showed that PJP has a relatively high prevalence among pediatric inpatients with respiratory disorders. Neutropenia is a significant predisposing factor in these patients. However, there is no correlation between PJP cases and outcomes and underlying diseases. Most of the patients with PJP were affected during the COVID-19 pandemic, probably due to treatment with corticosteroids.

Keywords

Pneumocystis jirovecii - real-time PCR - Pneumonia - COVID-19 - pediatric

Authors' Contribution

N. H. collected specimens and performed the project. H. Z. interpreted the data and prepared the manuscript. S. J. S. designed and planned the study. H. M. M. and M. J. N. analyzed the data. All authors read and approved the final manuscript.


Financial Disclosure

The authors declare no financial interests related to the materials of the study.




Publication History

Received: 29 October 2023

Accepted: 05 June 2024

Article published online:
28 June 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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