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Dtsch Med Wochenschr 2012; 137(43): 2229-2231
DOI: 10.1055/s-0032-1327231
Korrespondenz | Correspondence
Kurze Mitteilung
© Georg Thieme Verlag KG Stuttgart · New York

Laborerhebung zur Häufigkeit von Pneumocystis jirovecii – Zwar ein besonderer Pilz, aber auch ein seltener Erreger?

Laboratory survey on the incidence of Pneumocystis jirovecii – Obviously a peculiar fungus, but also a rare pathogen?
H. Hof
1   MVZ Labor Dr. Limbach und Kollegen, Heidelberg
,
K. Oberdorfer
1   MVZ Labor Dr. Limbach und Kollegen, Heidelberg
,
T. Mertes
2   MVZ Labor Koblenz-Mittelrhein, Koblenz
,
B. Miller
3   MVZ Labor Seelig GbR, Karlsruhe
,
R. Schwarz
4   MVZ Labor Dr. Stein u. Kollegen, Mönchengladbach
,
T. Regnath
5   Labor Prof. Enders u. Partner, Stuttgart
,
T. Schmidt-Wieland
MVZ Labor Dr. Gärtner u. Kollegen, Ravensburg
,
N. Wellinghausen
MVZ Labor Dr. Gärtner u. Kollegen, Ravensburg
,
M. Holfelder
1   MVZ Labor Dr. Limbach und Kollegen, Heidelberg
› Author Affiliations
Further Information

Publication History

Publication Date:
17 October 2012 (online)

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Zusammenfassung

Pneumocystis jirovecii ist in vieler Hinsicht ein besonderer Pilz. Dieser opportunistische Erreger vermehrt sich im Menschen nur bei bestimmten Grundvoraussetzungen, wobei ein Defekt der T-Zell- abhängigen Infektabwehr besonders stark prädisponiert. Ganz offensichtlich wird die Häufigkeit dieses Erregers unterschätzt, denn eine Erhebung von Untersuchungsergebnissen (IFT und PCR) allein in wenigen Laboratorien im Jahre 2010 ergab eine Zahl von 412 Personen in Deutschland mit einem positiven Erregernachweis. Selbst wenn man annimmt, dass einige davon nur kolonisiert waren, spricht diese hohe Zahl für eine hohe Inzidenz der Pneumocystosis in abwehrgeschwächten Patienten in Deutschland.

Abstract

Pneumocystsis jirovecii is a peculiar fungus for a variety of reasons. This opportunistic pathogen multiplies in humans only under certain conditions; a defect in the T-cell defense system creates a predisposition to this infection. In 2010 a data survey (IFT as well as PCR) from a few laboratories in Germany revealed 412 positive individuals. Even if only a few patients test positive for the colonization stage of this pathogen, the sheer number of individuals testing positive for other stages of infection indicate that the incidence of pneumocystosis in immunocompromised patients in Germany is underestimated.

Schlüsselwörter

Pneumocystis jirovecii - PCR - IFT - Inzidenz

Keywords

Pneumocystis jirovecii - PCR - IFT - Incidence
 

  • Literatur

  • 1 Aliouat-Denis C-M, Martinez A, Aliouat EM et al. The pneumocystis life cycle. Mem Inst Oswaldo Cruz 2009; 104: 419-426
    CrossrefPubMedGoogle Scholar
  • 2 Balabanova Y, Gilsdorf A, Buda S et al. Communicable diseases prioritized for surveillance and epidemiological research: results of a standardized prioritization procedure in Germany, 2011. PLoS One 2011; 6: e25691
    CrossrefPubMedGoogle Scholar
  • 3 Blum T, Roth A, Mauch H et al. Pneumocystis jiroveci-Pneumonie bei immunsupprimierten Patienten ohne AIDS-Erkrankung – eine Fallserie. DMW 2006; 131: 1515-1520
    Article in Thieme ConnectPubMedGoogle Scholar
  • 4 Boer de MG, Bruijnesteijn van Coppenraet LE, Gaasbeek A et al. An outbreak of Pneumocystis jiroveci pneumonia with 1 predominant genotype among renal transplant recipients: interhuman transmission or a common environmental source?. Clin Infect Dis 2007; 44: 1143-1149
    CrossrefPubMedGoogle Scholar
  • 5 Borde JP, Offensperger WB, de With K. Aktuelle Diagnostik und Therapie der Pneumocystis-jirovecii-Pneumonie. DMW 2011; 136: 1426-1430
    Article in Thieme ConnectPubMedGoogle Scholar
  • 6 Castro de N, Neuville S, Sarfati C et al. Occurrence of Pneumocystis jiroveci pneumonia after allogeneic stem cell transplantation: a 6-year retrospective study. Bone Marrow Transplantation 2005; 36: 879-883
    CrossrefPubMedGoogle Scholar
  • 7 Frenkel JK. Pneumocystis pneumonia, an immunodeficiency-dependent disease (IDD): a critical historical overview. J Eukaryot Microbiol 1999; 46: 89S-92S
    PubMedGoogle Scholar
  • 8 Goldman AS, Goldman LR, Goldman TA. What caused the epidemic of Pneumocystis pneumonia in European premature infants in the mid-20th century?. Pediatrics 2005; 115: 725-736
    CrossrefPubMedGoogle Scholar
  • 9 Hardak E, Oren I, Dann EJ et al. The increased risk for pneumocystis pneumonia in patients receiving rituximab-CHOP-14 can be prevented by the administration of trimethoprim/sulfamethoxazole: a single-center experience. Acta Haematol 2011; 127: 110-114
    PubMedGoogle Scholar
  • 10 Harigai M, Tanaka Y, Maisawa S. Safety and efficacy of various dosages of ocrelizumab in Japanese patients with rheumatoid arthritis with an inadequate response to methotrexate therapy: A placebo-controlled double-blind parallel-group study. J Rheumatol 2012; 39: 486-495
    CrossrefPubMedGoogle Scholar
  • 11 Hof H. Pneumocystis jirovecii – ein besonderer Pilz. Pneumocystose – eine Infektion bei Abwehrschwäche. Der Bayerische Internist 2011; 31 Heft 6: 12-17
    PubMedGoogle Scholar
  • 12 Hof H. Pneumocystis jirovecii: a peculiar fungus posing particular problems for therapy and prophylaxis. Mycoses 2012; 54 (Suppl. 01) 1-7
    PubMedGoogle Scholar
  • 13 Krajicek BJ, Thomas CF, Limper AH. Pneumocystis pneumonia: current concepts in pathogenesis, diagnosis, and treatment. Clin Chest Med 2009; 30: 265-278
    CrossrefPubMedGoogle Scholar
  • 14 Li F, Jin HZ, Su F et al. Pneumocystis pneumonia in patients with immunobullous dermatoses. Int J Dermatol 2011; 50: 1144-1149
    CrossrefPubMedGoogle Scholar
  • 15 Linssen CF, Jacobs JA, Beckers P et al. Inter-laboratory comparison of three different real-time PCR assays for the detection of Pneumocystis jiroveci in bronchoalveolar lavage fluid samples. J Med Microbiol 2006; 55: 1229-1235
    CrossrefPubMedGoogle Scholar
  • 16 Marie I, Guglielmino E. Infections opportunistes non tuberculeuses au cours du traitement par les antiTNFα. Rev Med Intern 2010; 21: 353-360
    PubMedGoogle Scholar
  • 17 Matsumoto Y, Matsuda S, Tegoshi T. Yeast glucan in the cyst wall of Pneumocystis carinii. J Protozool 1989; 36: 21S-22S
    PubMedGoogle Scholar
  • 18 Matsumoto Y, Yamada M, Amagai T. Yeast glucan of Pneumocystis carinii cyst wall: an excellent target for chemotherapy. J Protozool 1991; 38: 6S-7S
    PubMedGoogle Scholar
  • 19 Medrano FJ, Montes-Cano M, Conde M et al. Pneumocystis jirovecii in general population. Emerg Infect Dis 2005; 11: 245-250
    CrossrefPubMedGoogle Scholar
  • 20 Mekinian A, Queyrel V, Durand-Joly I et al. Positive Pneumocystis jirovecii PCR in immunocompromised patients with a systemic disease: infection or colonisation?. Rev Med Interne 2010; 31: 194-199
    CrossrefPubMedGoogle Scholar
  • 21 Morris A, Norris KA. Colonization by Pneumocystis jirovecii and its role in disease. Clin Microbiol Rev 2012; 25: 297-317
    CrossrefPubMedGoogle Scholar
  • 22 Phipps LM, Chen SC, Kable K et al. Nosocomial Pneumocystis jirovecii pneumonia: lessons from a cluster in kidney transplant recipients. Transplantation 2011; 92: 1327-1334
    CrossrefPubMedGoogle Scholar
  • 23 Redhead SA, Cushion MT, Frenkel JK et al. Pneumocystis and Trypanosoma cruzi: nomenclature and typifications. J Eukaryot Microbiol 2006; 53: 2-11
    CrossrefPubMedGoogle Scholar
  • 24 Sivam S, Sciurba FC, Lucht LA et al. Distribution of Pneumocystis jirovecii in lungs from colonized COPD patients. Diagn Microbiol Infect Dis 2011; 71: 24-28
    CrossrefPubMedGoogle Scholar
  • 25 Tapparel L, Petignat PA, Praz G. Diagnostic of Pneumocystis jirovecii pneumonia in a non HIV patient. Rev Med Suisse 2010; 6: 1922-1925
    PubMedGoogle Scholar
  • 26 Thomas CF, Limper AH. Current insights into the biology and pathogenesis of Pneumocystis pneumonia. Nat Rev Microbiol 2007; 5: 298-308
    CrossrefPubMedGoogle Scholar