{"id":2377,"date":"2022-02-09T12:34:37","date_gmt":"2022-02-09T11:34:37","guid":{"rendered":"https:\/\/www.newslab.sk\/dokaz-dna-pneumocystis-jirovecii-verzus-mikroskopicky-dokaz-pri-vysetreniach-pneumocystozy-u-pacientov-zo-slovenska-v-rokoch-2001-2019\/"},"modified":"2022-02-10T02:22:05","modified_gmt":"2022-02-10T01:22:05","slug":"the-dna-evidence-of-pneumocystis-jirovecii-versus-microscopic-evidence-in-slovak-patients-examined-for-pne-umocystosis-during-the-years-2001-2019","status":"publish","type":"post","link":"https:\/\/www.newslab.sk\/en\/the-dna-evidence-of-pneumocystis-jirovecii-versus-microscopic-evidence-in-slovak-patients-examined-for-pne-umocystosis-during-the-years-2001-2019\/","title":{"rendered":"The DNA evidence of\u00a0Pneumocystis jirovecii versus microscopic evidence in Slovak patients examined for pne-umocystosis\u00a0during the years\u00a02001\u00a0\u2013 2019"},"content":{"rendered":"

*A rare case of autochthonous human dirofilariasis with the manifestation of pseudotumor of the epididymis caused by helminth Dirofilaria repens<\/strong><\/span><\/p>\n

 <\/p>\n

\u00davod<\/h3>\n

Pneumocystis jirovecii je oport\u00fanny mikroorganizmus, ktor\u00fd bol v minulosti ozna\u010dovan\u00fd ako Pneumocystis carinii. T\u00e1to atypick\u00e1 huba sp\u00f4sobuje u\u00a0 \u013eud\u00ed z\u00e1va\u017en\u00fa infekciu naz\u00fdvan\u00fa pneumocystov\u00e1 pneum\u00f3nia(1). Naj\u010dastej\u0161ie postihuje \u013eud\u00ed s oslaben\u00fdm imunitn\u00fdm syst\u00e9mom a v niektor\u00fdch pr\u00edpadoch m\u00f4\u017ee v\u00e1\u017ene ohrozi\u0165 \u017eivot. Medzi rizikov\u00fdch pacientov patria osoby s r\u00f4znymi chorobn\u00fdmi stavmi, ako s\u00fa n\u00e1dorov\u00e9 ochorenia, HIV infekcia, transplant\u00e1cie org\u00e1nov \u010di u\u017e\u00edvanie imunosupres\u00edvnej terapie a liekov. Pacienti s pneumocyst\u00f3zou klinicky vykazuj\u00fa sympt\u00f3my hor\u00fa\u010dky, ka\u0161\u013ea, d\u00fdchavi\u010dnosti a v z\u00e1va\u017en\u00fdch pr\u00edpadoch m\u00f4\u017ee d\u00f4js\u0165 k zlyhaniu d\u00fdchac\u00edch org\u00e1nov a\u017e smrti. Prim\u00e1rne sa Pneumocystis pren\u00e1\u0161a z \u010dloveka na \u010dloveka vzdu\u0161nou cestou, boli v\u0161ak op\u00edsan\u00e9 aj \u010fal\u0161ie sp\u00f4soby prenosu. Takisto sa m\u00f4\u017ee \u0161\u00edri\u0165 prostredn\u00edctvom asymptomatick\u00fdch nosi\u010dov, teda \u013eud\u00ed s norm\u00e1lnym imunitn\u00fdm syst\u00e9mom, ktor\u00ed s\u00fa kolonizovan\u00ed. Napriek statusu najbe\u017enej\u0161ej a najv\u00e1\u017enej\u0161ej oport\u00fannej respira\u010dnej infekcie u\u00a0 pacientov s\u00a0 AIDS v\u00a0 s\u00fa\u010dasnosti incidencia ochorenia v popul\u00e1cii kles\u00e1 v d\u00f4sledku zavedenia profylaxie a \u00fa\u010dinnej antiretrov\u00edrusovej terapie(2). \u010coraz \u010dastej\u0161ie sa v\u0161ak pneumocyst\u00f3za vyskytuje u HIV negat\u00edvnych pacientov lie\u010den\u00fdch protin\u00e1dorov\u00fdmi chemoterapeutikami a imunosupres\u00edvnou lie\u010dbou(3).
\nPou\u017e\u00edvan\u00fdm \u0161tandardom v laborat\u00f3rnej diagnostike pneumocyst\u00f3zy u pacientov so zn\u00ed\u017eenou imunitou je detekcia P. jirovecii v bronchoalveol\u00e1rnej lav\u00e1\u017ei (BAL) a vo vzork\u00e1ch indukovan\u00e9ho sp\u00fata prostredn\u00edctvom mikroskopick\u00e9ho d\u00f4kazu(4). Ide o mikroskopick\u00fd d\u00f4kaz c\u00fdst alebo trofick\u00fdch foriem parazita v p\u013e\u00facnom materi\u00e1li s pou\u017eit\u00edm viacer\u00fdch farbiacich techn\u00edk(5). Postupne v\u0161ak boli vyvinut\u00e9 vysokocitliv\u00e9 molekul\u00e1rne met\u00f3dy (PCR) detekcie P. jirovecii a konven\u010dn\u00e9 met\u00f3dy diagnostiky sa stali menej spo\u013eahliv\u00fdmi(6). Ako minim\u00e1lne invaz\u00edvny sp\u00f4sob diagnostiky pneumocyst\u00f3zy pred-stavuj\u00fa s\u00e9rologick\u00e9 met\u00f3dy.
\nV\u010faka vysokej \u00fa\u010dinnosti a dostupnosti peror\u00e1lnych a parenter\u00e1lnych foriem je liekom vo\u013eby trimetoprim-sulfametoxazol pri lie\u010dbe miernej a\u017e z\u00e1va\u017enej pneumocyst\u00f3zy u pacientov infikovan\u00fdch HIV, ale aj u pacientov, ktor\u00ed nie s\u00fa infikovan\u00ed HIV(7).<\/p>\n

Materi\u00e1l a\u00a0met\u00f3dy<\/strong><\/h3>\n

Po\u010das 19-ro\u010dn\u00e9ho obdobia sme v r\u00e1mci \u0161t\u00fadie vy\u0161etrili 3\u2009330 pacientov poch\u00e1dzaj\u00facich z cel\u00e9ho Slovenska pre podozrenie na infekciu sp\u00f4soben\u00fa P. jirovecii. Preva\u017ene i\u0161lo bronchoalveol\u00e1rne lav\u00e1\u017ee a\u00a0sp\u00fata.
\nPri mikroskopickom d\u00f4kaze sme pou\u017eili farbenie pod\u013ea Giemsa na detekciu trofozoitov a Gramovo a Weigertovo farbenie na determinovanie c\u00fdst(8,9). Na izol\u00e1ciu DNA zo vzoriek sme pou\u017eili komer\u010dne dostupn\u00fd DNeasy kit (Qiagen, Hilden, Nemecko). Z met\u00f3d molekul\u00e1rnej biol\u00f3gie sme aplikovali klasick\u00fa polymer\u00e1zov\u00fa re\u0165azov\u00fa reakciu (PCR) s pou\u017eit\u00edm primerov pAZ102-E a pAZ102-H, ktor\u00e9 amplifikuj\u00fa \u010das\u0165 g\u00e9nu ve\u013ekej podjednotky mitochondri\u00e1lnej rRNA(10). Pre real-time PCR sme pou\u017eili komer\u010dn\u00fa s\u00fapravu LightMix\u00ae Kit Pneumocystis jirovecii, kde ako cie\u013eov\u00fd fragment sa na amplifik\u00e1ciu vyu\u017eila 244 bp sekvencia multik\u00f3piov\u00e9ho MSG g\u00e9nu z P. jirovecii.
\nV\u00fdsledky boli analyzovan\u00e9 \u0161tatistick\u00fdm softv\u00e9rom OpenEpi, verzia 3.03 (http:\/\/www.openepi.com\/Menu\/OE_Me-nu.htm) a na vyhodnotenie \u0161tatistick\u00fdch rozdielov bol pou\u017eit\u00fd ch\u00edkvadr\u00e1tov\u00fd test, kde hodnota P < 0,05 sa pova\u017eovala za v\u00fdznamn\u00fa(11). V\u00fdpovedn\u00e9 hodnoty pou\u017eit\u00fdch testov sme vypo\u010d\u00edtali pomocou \u0161tatistick\u00e9ho programu MedCalc (http:\/\/www.medcalc.org\/calc\/diagnostic_test.php).<\/p>\n

V\u00fdsledky<\/h3>\n

Po\u010das 19 rokov po\u010det vy\u0161etren\u00ed a detekcia P. jirovecii st\u00fapa, \u010do je na grafe 1 vyzna\u010den\u00e9 trendov\u00fdmi line\u00e1rnymi spojnicami. Najvy\u0161\u0161\u00ed n\u00e1rast vzoriek pozorujeme v rokoch 2008 a\u017e 2015, kde sa po\u010det pacientov po\u010das 8 rokov zn\u00e1sobil 6\u00d7 (387 : 61 = 6,35). V nasleduj\u00facich rokoch od roku 2016 je mno\u017estvo vy\u0161etrovan\u00fdch pacientov relat\u00edvne stabiln\u00e9 v rozmedz\u00ed od 323 do 369.
\nMet\u00f3dami PCR sme pneumocysty zachytili u\u00a0 5,7\u00a0 % (190\/3\u2009330) vy\u0161etrovan\u00fdch pacientov, pri\u010dom mikroskopicky sme potvrdili mikroorganizmy u 1,9 % (64\/3\u2009330) pr\u00edpadov. U\u00a0 163 pacientov sme infekt dok\u00e1zali v\u00a0 BAL, u\u00a0 25 v sp\u00fate. Pr\u00edtomnos\u0165 P. jirovecii sa potvrdila hlavne u imunokompromitovan\u00fdch os\u00f4b s onkologick\u00fdm ochoren\u00edm 57,9 % (110\/190), ale aj u pacientov s chorobami d\u00fdchacej s\u00fasta-vy 23,2 % (44\/190), s infek\u010dn\u00fdmi a parazit\u00e1rnymi chorobami 9,4 % (18\/190), s in\u00fdmi ochoreniami 7,4 % (14\/190) a s HIV 2,1 % (4\/190). Najcitlivej\u0161\u00edmi skupinami pacientov z h\u013eadiska infekcie pneumocystami s\u00fa onkologick\u00ed jedinci a pacienti s chorobami d\u00fdchacej s\u00fastavy (graf 2).<\/p>\n

Z cel\u00e9ho s\u00faboru sme v rokoch 2001 \u2013 2012 vy\u0161etrili 803 pacientov pomocou klasickej PCR, kde sa n\u00e1m podarilo detegova\u0165 DNA P. jirovecii u 48 (6 %) pacientov a u 12 (1,5 %) z nich sme pneumocysty potvrdili aj mikroskopick\u00fdm d\u00f4kazom. V rokoch 2013 \u2013 2019 sme s vyu\u017eit\u00edm real-time PCR z 2\u2009527 os\u00f4b detegovali DNA P. jirovecii u 142 (5,6 %) a u 52 (2,1 %) z nich sme pneumocysty potvrdili aj mikroskopicky. Na obr\u00e1zku 1 s\u00fa zn\u00e1zornen\u00e9 niektor\u00e9 na\u0161e pozit\u00edvne prepar\u00e1ty c\u00fdst po farben\u00ed pod\u013ea Grama a\u00a0 Weigerta. Morfol\u00f3gia pneumoc\u00fdst je nepravideln\u00e1, maj\u00fa tvar \u201edefektnej lopty\u201c a s\u00fa s ve\u013ekos\u0165ou od 4 do 8\u2008\u03bcm. V cyste postupn\u00fdm delen\u00edm vznik\u00e1 8 jednojadrov\u00fdch teliesok, tzv. intracystick\u00e9 telieska (obr\u00e1zok 2).
\nS cie\u013eom pribl\u00ed\u017eenia klinickej manifest\u00e1cie infekcie sp\u00f4sobenej P. jirovecii u onkologick\u00e9ho pacienta, kde sme v na\u0161om laborat\u00f3riu potvrdili etiologick\u00fd agens, priklad\u00e1me rtg. sn\u00edmku s komplikovanou pneumocystovou infekciou s v\u00fdrazn\u00fdm \u0161kvrnit\u00fdm zatienen\u00edm oboch p\u013e\u00facnych kr\u00eddiel (obr\u00e1zok 3).
\n\u0160tatisticky v\u00fdznamn\u00e9 rozdiely pre pacientov s\u00a0 pneumocyst\u00f3zou sme potvrdili vzh\u013eadom na vekov\u00fa skupinu, odobrat\u00fd biologick\u00fd materi\u00e1l a stanoven\u00fa diagn\u00f3zu. Najvy\u0161\u0161\u00ed podiel infikovan\u00fdch sme detegovali u dospel\u00fdch jedincov vo veku od 21 do 40 rokov (9,7 %), \u010falej nasledovali deti 0 \u2013 10 rokov (6 %), star\u00ed \u013eudia nad 61 rokov (5,2 %), pacienti medzi 41. a 60. rokom \u017eivota (4,8 %) a najmenej u 10- a\u017e 20-ro\u010dn\u00fdch os\u00f4b (1,6 %). Tieto rozdiely boli \u0161tatisticky v\u00fdznamn\u00e9 (p = 0,009). V\u00e4\u010d\u0161\u00ed podiel infikovan\u00fdch pneumocystami tvorila skupina, v ktorej bol indikovan\u00fd odber sp\u00fata (9,8 %) ako v porovnan\u00ed s odberom BAL (5,4 %; p = 0,029). Signifikantn\u00e9 rozdiely v po\u010dtoch pacientov s pneumocyst\u00f3zou sme pozorovali aj v s\u00favislosti s predikovanou diagn\u00f3zou (p = 0,02). Najvy\u0161\u0161ie percento (12,5 %) pacientov s pneumocyst\u00f3zou tvorila skupina s diagn\u00f3zou infek\u010dn\u00fdch a parazit\u00e1rnych chor\u00f4b. Druh\u00fa, najviac zast\u00fapen\u00fa skupinu (5,8 %) infikovan\u00fdch tvorili pacienti s diagn\u00f3zou chor\u00f4b d\u00fdchacej s\u00fastavy, za ktorou nasledovali diagn\u00f3zy ako ostatn\u00e9 (5,7 %), onkologick\u00e9 choroby (5,1 %), choroby krvi a krvotvorn\u00fdch org\u00e1nov s \u00fa\u010das\u0165ou imunitn\u00fdch mechanizmov (3,7 %) a choroby obehovej s\u00fastavy (3,1 %). \u017diadnu signifikantn\u00fa s\u00favislos\u0165 sme nezistili medzi pr\u00edtomnos\u0165ou pneumocystovej infekcie a pohlav\u00edm (p > 0,05).
\n\u0160tatistick\u00e9 ukazovatele spo\u013eahlivosti mikroskopick\u00e9ho d\u00f4kazu P. jirovecii sme vyjadrili vzh\u013eadom na PCR, ktor\u00fa sme pova\u017eovali za zlat\u00fd \u0161tandard. Po prepo\u010dtoch n\u00e1m vy\u0161la 33,7 % citlivos\u0165, 100 % \u0161pecifickos\u0165, 100 % pozit\u00edvna pred-povedan\u00e1 hodnota a 96,1 % negat\u00edvna predpovedan\u00e1 hodnota mikroskopie v porovnan\u00ed s PCR po\u010das cel\u00e9ho 19-ro\u010dn\u00e9ho obdobia vy\u0161etrovania.<\/p>\n

Diskusia<\/h3>\n

Na Slovensku boli publikovan\u00e9 iba 2 pr\u00e1ce, ktor\u00e9 dokumentovali v\u00fdskyt \u010di diagnostick\u00e9 mo\u017enosti laborat\u00f3rnej diagnostiky Pneumocystis jirovecii(12,13). T\u00e1to pr\u00e1ca pod\u00e1va komplexn\u00fd preh\u013ead o\u00a0 pr\u00edtomnosti P. jirovecii u\u00a0 vy\u0161etrovan\u00fdch pacientov s p\u013e\u00facnymi komplik\u00e1ciami na Slovensku za obdobie 19 rokov a poskytuje mo\u017enosti laborat\u00f3rnej diagnostiky v podmienkach rutinn\u00e9ho laborat\u00f3ria.
\nZ\u00a0 cel\u00e9ho s\u00faboru vy\u0161etrovan\u00fdch sme pneumocysty detegovali hlavne u os\u00f4b s onkologick\u00fdm ochoren\u00edm (najm\u00e4 lymfatick\u00e1 leuk\u00e9mia). Sing et al.(14) diagnostikovali pneumocysty najviac u jedincov s HIV (6 %), potom nasledovali onkologick\u00ed (1,8\u00a0 %) a\u00a0 transplantovan\u00ed (1,5\u00a0 %) pacienti. V\u00a0 na\u0161om s\u00fabore vy\u0161etrovan\u00fdch nebol tak\u00fd ve\u013ek\u00fd po\u010det HIV os\u00f4b (1,1 %; 36\/3\u2009330), ak\u00fd mali Sing et al. (26,7 %; 89\/334), preto sme mali ove\u013ea ni\u017e\u0161ie percento HIV pacientov infikovan\u00fdch pneumocystami. Ale najviac pozit\u00edvnych pacientov na P. jirovecii tvorili imunosuprimovan\u00ed (60 %), podobne ako v pr\u00e1ci Singa et al. (94,3 %). Fillatre et al.(15) sa takisto vo svojej \u0161t\u00fadii zaoberali 293 pr\u00edpadmi pneumocyst\u00f3zy. Z celkov\u00e9ho s\u00faboru pacientov bolo 154 (52,6 %) pr\u00edpadov HIV negat\u00edvnych. Ako naj\u010dastej\u0161ie poruchy rozvoja pneumocyst\u00f3zy identifikovali hematologick\u00e9 malignity (32,5 %), \u010falej to boli sol\u00eddne n\u00e1dory (18,2 %), z\u00e1palov\u00e9 ochorenia (14,9 %), transplant\u00e1cie sol\u00eddnych org\u00e1nov (12,3 %) a vaskulit\u00edda (9,7 %). \u0160t\u00fadia Liu\u00a0 et\u00a0 al.(3) potvrdila, \u017ee najbe\u017enej\u0161ou pr\u00ed\u010dinou PJP s\u00fa hematologick\u00e9 malignity (29,1 %) podobne ako v \u0161t\u00fadii Fillatre et al.(15). N\u00e1m pribli\u017ene rovnak\u00e9 v\u00fdsledky dokumentovali aj Kim et al.(4), kde mal\u00edgne ochorenia dosahovali a\u017e 68,7 %, a Gazaignes et al.(16), ktor\u00ed detegovali PJP u pacientov s n\u00e1dorov\u00fdmi ochoreniami (60 %). Abastabar et al.(17) podobne ako my zistili, \u017ee prevalencia P. jirovecii sa l\u00ed\u0161i pod\u013ea veku pacientov. V ich \u0161t\u00fadii bol v\u0161ak \u010dastej\u0161\u00ed v\u00fdskyt PJP u pacientov vo vekovom rozmedz\u00ed 71 \u2013 80 rokov (> 80 %), respekt\u00edve vo veku 81 \u2013 90 rokov (100 %). Nezistili \u017eiadny v\u00fdznamn\u00fd rozdiel medzi mu\u017emi a \u017eenami, pokia\u013e ide o prevalenciu tohto ochorenia, podobne ako v na\u0161ej pr\u00e1ci. Vo v\u00e4\u010d\u0161ine pr\u00e1c vy\u0161la podstatne vy\u0161\u0161ia citlivos\u0165 PCR v porovnan\u00ed so \u0161tandardn\u00fdmi cytologick\u00fdmi farbiacimi technikami pri vy\u0161etrovan\u00ed BAL, indukovan\u00e9ho aj neindukovan\u00e9ho sp\u00fata(18-22). Wakefield\u00a0 et\u00a0 al.(23) uv\u00e1dzaj\u00fa 90\u00a0 % citlivos\u0165 PCR v porovnan\u00ed s 35 % citlivos\u0165ou klasick\u00e9ho mikroskopick\u00e9ho farbenia. Lipschik et al.(24) uv\u00e1dzaj\u00fa 93 % citlivos\u0165 a Chouaid et al.(22) dokonca a\u017e 100 % citlivos\u0165 a \u0161pecifickos\u0165 PCR v BAL a indukovanom sp\u00fate. Podobne ako vo v\u00e4\u010d\u0161ine pr\u00e1c sme zistili podstatne ni\u017e\u0161iu citlivos\u0165 mikroskopie v porovnan\u00ed s PCR met\u00f3dou. Mikroskopicky sme mali 66,3 % vzoriek falo\u0161ne negat\u00edvnych a touto met\u00f3dou sme zachytili v mas\u00edvnej v\u00e4\u010d\u0161ine cystick\u00e9 \u0161t\u00e1di\u00e1 a v jednom pr\u00edpade intracystick\u00e9 telieska pneumoc\u00fdst.
\nVzh\u013eadom na zvy\u0161uj\u00faci sa po\u010det imunosuprimovan\u00fdch jedincov je diagnostika P. jirovecii nevyhnutn\u00e1. Potvrdili sme to aj v na\u0161ej \u0161t\u00fadii, kde po\u010det vy\u0161etren\u00ed a detekcia tohto oport\u00fanneho patog\u00e9nu po\u010das rokov st\u00fapa a v 190 pr\u00edpadoch sa n\u00e1m podarilo odhali\u0165 kauz\u00e1lny agens zodpovedn\u00fd za v\u00e1\u017ene p\u013e\u00facne komplik\u00e1cie u imunokompromitovan\u00fdch pacientov.<\/p>\n

Po\u010fakovanie<\/h3>\n

Pr\u00e1ca bola podporen\u00e1 projektom KEGA 013TTU-4\/2019.<\/p>\n

 <\/p>\n

LITERAT\u00daRA<\/h3>\n

1. Center for Diseases Control and Prevention. 2020. Pneumocystis pneumonia. [online]. Georgia (Atlanta): U.S. Department of Health\u2008&\u2008Human Services.<\/p>\n

2. Truong, J., Ashurst, Jv. 2020. Pneumocystis (Carinii) jirovecii Pneu-monia. In StatPearls [online]. Treasure Island (FL): StatPearls Publishing.<\/p>\n

3. Liu, Y., Su, L., Jiang, S. J., Qu, H. 2017. Risk factors for mortality from Pneumocystis carinii pneumonia (PCP) in non-HIV patients: A meta-analysis. In Oncotarget., ro\u010d. 8, \u010d. 35, s. 59729-59739.<\/p>\n

4. Kim, T-O., Lee, J-K., Kwon, Y-S., Kim, Y-I., Lim, S-Ch., Kim, M-S., Kho, B. G., Park, Ch-K., Oh, I-J., Kim, Y-Ch., Park, H. Y., Shin, H.J. 2021. Clinical characteristic and prognosis of patients with Pneumocystis jirovecii pneumonia without a compromised illness. In PLOS ONE., ro\u010d. 16, \u010d. 2, s. 1-12.<\/p>\n

5. Salzer, H. J. F., Chafer, G., Hoenigl, M., Gunther, G., Hoffmann, C., Kalsdorf, B., Alanio, A., Lange, C. 2018. Clinical, diagnostic, and treatment disparities between HIV-infected and non-HIV infected immunocompromised patients with Pneumocystis jirovecii pneumonia. In Respiration., ro\u010d. 96, \u010d. 1, s. 1-14.<\/p>\n

6. Bateman, M., Oladele, R., Kolls, J. K. 2020. Diagnosing Pneumocystis jirovecii pneumonia: A review of current methods and novel approaches. In Medical Mycology., ro\u010d. 58, \u010d. 8, s. 1015-1028.<\/p>\n

7. Tasaka, S. 2020. Recent advances in the diagnosis and management of Pneumocystis pneumonia. In Tuberculosis and Respiratory Diseases., ro\u010d. 83, \u010d. 2, s. 132-140.<\/p>\n

8. Giemsa, G. 1904. Eine vereinfachung und vervollkommnung mein-er methylenazur methylenblau-eosin-f\u00e4rbemethode zur erzielung der ro-manowsky-nacht\u2019schen chromatin-f\u00e4rbung. In Zentralblatt f\u00fcr Bakteri-ologie, Parasitenkunde und Infektionskrankheiten der Tiere, I. Abteilung, originale., ro\u010d. 37, s. 308\u2013311.<\/p>\n

9. Garcia, L. S., Bruckner, D. A. 1997. Diagnostic Medical Parasitology. 3. vyd. Washington, D.C.: ASM Press, 1997, 937s. ISBN: 1-55581-116-7.<\/p>\n

10. Tamburrini, E., Mencarini, P., Luca, A. D., Antinori, A., Visconti, E., Am-massari, A., Ortona, L., Ortona, E., Siracusano, A., Vicari, E. 1993. Simple and rapid two-step polymerase chain reaction for diagnosis of\u00a0 P. carinii\u00a0 pneumonia. In Journal of Clinical Microbiology., ro\u010d. 31, \u010d. 10, s. 2788\u20132789.<\/p>\n

11. Markechov\u00e1, D., Tirp\u00e1kov\u00e1, A., Stehl\u00edkov\u00e1, B. 2011. Z\u00e1klady \u0161tatistiky pre pedag\u00f3gov. Nitra : FPV UKF v\u00a0Nitre, 405s.<\/p>\n

12. Albrecht, P., Horka, G. 1953. Pneumocystis pneumonia in western Slo-vakia. In Lek\u00e1rsky Obzor., \u010d. 2, s. 766-73.<\/p>\n

13. Boldi\u0161, V., Ondriska, F., Kov\u00e1\u010d, \u013d., Noh\u00fdnkov\u00e1, E., \u0160pitalsk\u00e1, E. 2013. Evidence of Pneumocystis jirovecii in human clinical samples in south-western Slovakia over a\u00a010-year period (2001\u20132010). In Biologia., ro\u010d. 68, \u010d. 4, s. 662-666.<\/p>\n

14. Sing, A., Terebesius, K., Roggenkamp, A., R\u00fcssmann, H., Tybus, K., Pfaff, F., Bogner, J. R., Emminger, Ch., Heesemann, J. 2000. Evaluation of diagnostic value and epidemiological implications of PCR for Pneumocystis carinii in different immunosuppressed and immunocompetent patient groups. In Journal of Clinical Microbiology., ro\u010d. 38, \u010d. 4, s. 1461-1467.<\/p>\n

15. Fillatre, P., Decaux, O., Jouneau, S., Revest, M., Gacouin, A., Rob-ert-Gangneux, F., Fresnel, A., Guiguen, C., Le Tulzo, Y., J\u00e9go, P., Tattevin, P. 2014. Incidence of Pneumocystis jirovecii pneumonia among groups at risk in HIV-negative patients. In The American Journal of Medicine., ro\u010d. 127, \u010d. 12, s. 1242.e11-1242.e17.<\/p>\n

16. Gazaignes, S., Bergeron, A., Menotti, J., Desseaux, K., Molina, J. M., De Castro, N. 2020. Pneumocystis jirovecii and quantitative PCR: pneu-monia or colonization? In Revue des Maladies Respiratoires., ro\u010d. 37, \u010d. 4, s. 299-307.<\/p>\n

17. Abastabar, M., Mosayebi, E., Shokohi, T., Hedayati, M. T., Jarabi Amiri, M. R., Seifi, Z., Hadghani, I., Aliyali, M., Saber, S., Sheikholeslami, M. F. 2019. A multi-centered study of Pneumocystis jirovecii colonization in patients with respiratory disorders: Is there a colonization trend in the elderly? In Current Medical Mycology., ro\u010d. 5, \u010d. 3, s. 19-25.<\/p>\n

18. Galan, F., Oliver, J. L., Roux, P., Poirot, J. L., Bereziat, G. 1991. Detection of Pneumocystis carinii DNA by polymerase chain reaction compared to direct microscopy and immunofluorescence. In The Journal of protozoology., ro\u010d. 38, \u010d. 6, s. 199S-200S.<\/p>\n

19. Kitada, K., Oka, S., Kohjin, T., Kimura, S.,\u00a0Nakamura, Y,\u00a0Shimada, K. 1993.\u00a0Pneumocystis carinii\u00a0pneumonia monitored by\u00a0P. carinii\u00a0shedding in sputum by the polymerase chain reaction.\u00a0In Internal Medicine., ro\u010d. 32, \u010d. 5, s. 370-373.<\/p>\n

20. Leigh, T. R., Gazzard, B. G., Rowbotoom, A., Collins, J. V. 1993. Quantitative and qualitative comparison of DNA amplification by PCR with immunofluorescence staining for diagnosis of Pneumocystis carinii pneumonia. In Journal of Clinical Pathology., ro\u010d. 46, \u010d. 2, s. 140-144.<\/p>\n

21. Olsson, M., Elvin, K., Lofdahl, S., Linder, E. 1993. Detection of Pneumocystis carinii DNA in sputum and bronchoalveolar lavage samples by polymerase chain reaction. In Journal of Clinical Microbiology., ro\u010d. 31, \u010d. 2, s. 221-226.<\/p>\n

22. Chouaid, C., Roux, P., Lavard, I., Poirot, J. L., Housset, B. 1995. Use of the polymerase chain reaction technique on induced-sputum samples for the diagnosis of Pneumocystis carinii pneumonia in HIV-infected patients. A clinical and cost-analysis study. In American Journal of Clinical Pathology., ro\u010d. 104, \u010d. 1, s. 72-75.<\/p>\n

23. Wakefield, A. E., Pixley, F. J., Banerji, S., Sinclair, K., Miller, R. F., Moxon, E. R., Hopkin, J.M. 1990. Amplification of mitochondrial ribosomal RNA sequences from Pneumocystis carinii of rat and human origin. In Molecular and Biochemical Parasitology., ro\u010d. 43, \u010d., s. 69-76.<\/p>\n

24. Lipschik, G. Y., Andrawis, V. A., Ognibene, F. P., Kovacs, J. A., Gill, V. J., Nelson, N. A., Lundgren, J. D., Nielsen, J. O. 1992. Improved diagnosis of Pneumocystis carinii infection by polymerase chain reaction on induced sputum and blood. In THE LANCET., ro\u010d. 340, \u010d. 8813, s. 203-206.<\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

*A rare case of autochthonous human dirofilariasis with the manifestation of pseudotumor of the epididymis caused by helminth Dirofilaria repens   \u00davod Pneumocystis jirovecii je oport\u00fanny mikroorganizmus, ktor\u00fd bol v minulosti ozna\u010dovan\u00fd ako Pneumocystis carinii. T\u00e1to atypick\u00e1 huba sp\u00f4sobuje u\u00a0 \u013eud\u00ed z\u00e1va\u017en\u00fa infekciu naz\u00fdvan\u00fa pneumocystov\u00e1 pneum\u00f3nia(1). Naj\u010dastej\u0161ie postihuje \u013eud\u00ed s oslaben\u00fdm imunitn\u00fdm syst\u00e9mom a v<\/p>\n","protected":false},"author":7,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_mi_skip_tracking":false,"footnotes":""},"categories":[1596],"tags":[1831,1827,1830,1832],"class_list":["post-2377","post","type-post","status-publish","format-standard","hentry","category-parazitologia-en","tag-microscopic-evidence","tag-pneumocystis-jirovecii-en","tag-pneumocystosis","tag-polymerase-chain-reaction-pcr","typ_clanku-original-work"],"acf":{"abstrakt":"

In the past, Pneumocystis jirovecii belonged to the Protozoa group, but is currently taxonomically included in the kingdom Fungi. P. jirovecii is an opportunistic pathogen, responsible for pneumocystis pneumonia with frequent complications of immunocompromised patients. Delayed initiation of appropriate therapy increases the risk of death in immunocompromised patient. The aim of this work was to determine and evaluate the reliability of meth-ods of laboratory diagnosis of pneumocystosis as well as the occurrence of this disease in patients from Slovakia during 19 years. The diagnosis is based on microscopic examination (Giemsa- and Gram-Weigert-staining) and detection of parasite DNA by classical or real-time PCR in bronchoalveolar lavage and sputum. We detected pneumocystis in 190 persons (5.7 %) from the whole group of patients. Cancer patients represented the riskiest group in terms of pneumocystosis, which was confirmed by the highest percentage (57.9 %) of individuals infected with P. jirovecii. We used a binary classification test for statistical evaluation and confirmed 33.7 % sensitivity and 100 % specificity of microscopy compared to PCR. Molecular methods are more sensitive in the detection of Pneumocystis jirovecii compared to microscopic evidence and currently represent a reliable detection system in the diagnosis of pneumocystosis.<\/p>\n

Keywords:<\/strong> Pneumocystis jirovecii, pneumocystosis, microscopic evidence, polymerase chain reaction (PCR)<\/p>\n","casopis":[{"ID":2417,"post_author":"7","post_date":"2022-02-08 13:25:20","post_date_gmt":"2022-02-08 12:25:20","post_content":"Druh\u00e9 vydanie \u010dasopisu laborat\u00f3rnej medic\u00edny 2021\/2<\/strong>\r\n

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  • Molekul\u00e1rny mechanizmus karcinogen\u00e9zy indukovanej prostredn\u00edctvom bakt\u00e9ri\u00ed<\/li>\r\n \t
  • Extracelul\u00e1rne vezikuly a ich potenci\u00e1lne vyu\u017eitie v klinickej praxi<\/li>\r\n \t
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  • Vyu\u017eitie hmotnostnej spektrometrie v diagnostike por\u00fach glykozyl\u00e1cie<\/li>\r\n<\/ul>","post_title":"newslab","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"newslab-7","to_ping":"","pinged":"","post_modified":"2022-02-10 02:23:00","post_modified_gmt":"2022-02-10 01:23:00","post_content_filtered":"","post_parent":0,"guid":"https:\/\/www.newslab.sk\/casopis\/newslab-7\/","menu_order":0,"post_type":"casopis","post_mime_type":"","comment_count":"0","filter":"raw"}],"strana":"64 - 68","upload_clanok":{"ID":2375,"id":2375,"title":"NEWSLAB 2-2021_Boldis","filename":"NEWSLAB-2-2021_Boldis-1.pdf","filesize":1769366,"url":"https:\/\/www.newslab.sk\/wp-content\/uploads\/2022\/02\/NEWSLAB-2-2021_Boldis-1.pdf","link":"https:\/\/www.newslab.sk\/en\/the-dna-evidence-of-pneumocystis-jirovecii-versus-microscopic-evidence-in-slovak-patients-examined-for-pne-umocystosis-during-the-years-2001-2019\/newslab-2-2021_boldis-2-2\/","alt":"","author":"7","description":"","caption":"","name":"newslab-2-2021_boldis-2-2","status":"inherit","uploaded_to":2377,"date":"2022-02-09 11:15:27","modified":"2022-02-09 11:15:27","menu_order":0,"mime_type":"application\/pdf","type":"application","subtype":"pdf","icon":"https:\/\/www.newslab.sk\/wp-includes\/images\/media\/document.png"}},"_links":{"self":[{"href":"https:\/\/www.newslab.sk\/en\/wp-json\/wp\/v2\/posts\/2377","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newslab.sk\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newslab.sk\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newslab.sk\/en\/wp-json\/wp\/v2\/users\/7"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newslab.sk\/en\/wp-json\/wp\/v2\/comments?post=2377"}],"version-history":[{"count":0,"href":"https:\/\/www.newslab.sk\/en\/wp-json\/wp\/v2\/posts\/2377\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.newslab.sk\/en\/wp-json\/wp\/v2\/media?parent=2377"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newslab.sk\/en\/wp-json\/wp\/v2\/categories?post=2377"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newslab.sk\/en\/wp-json\/wp\/v2\/tags?post=2377"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}