No abstract

Background:The use of immune suppressive drugs for organ transplant recipients predisposes them to opportunistic infections, especially by fungal agents. Pneumocystis jiroveci, as an opportunistic pathogen, endangers the patients’ life in those with immune system disorders. Early detection of latent Pneumocystis infection in susceptible patients may help choose the optimal treatment for these patients.Objectives:The aim of this study was to identify and determine the colonization of latent P. jiroveci infection among lung transplant recipients.Patients and Methods:This cross-sectional descriptive study was conducted on lung transplant recipients. Bronchoalveolar lavage (BAL) specimens were collected from 32 patients undergoing bronchoscopy. The samples were aseptically homogenized by 10 mM dithiothreitol, and their DNA was extracted. The mtLSUrRNA gene of P. jiroveci was amplified using nested PCR in two stages. Nested PCR was performed using external primers of pAZ-102-E and pAZ102-H followed by using the PCR product of the first stage and internal primers of pAZ-102-E and pAZ102-L2.Results:The genome of P. jiroveci was revealed by a 346 bp PCR product in the initial amplification and a 120 bp product in the nested PCR. The results showed that seven BAL specimens (21.9%) from lung transplant recipients were positive for P. jiroveci.Conclusions:In molecular epidemiology studies, nested PCR has higher sensitivity than PCR. Results of this study support the colonization of P. jiroveci in patients receiving lung transplantation. Patients who are carriers of P. jiroveci are at a higher risk of P. jiroveci pneumonia.

BackgroundToxoplasma gondii is an opportunistic parasitic organism causing infection in many mammals, including immunosuppressed patients. Toxoplasmosis as an opportunistic infection is highly prevalent among patients receiving a kidney transplant.ObjectivesThe purpose of this study was to identify and determine the prevalence of Toxoplasma gondii in clinical samples collected from patients receiving renal transplants.Patients and MethodsA total of 50 blood samples and 40 lung lavage samples from transplanted patients admitted to the infectious wards and the patients undergoing bronchoscopy were collected. The B1 Gene of Toxoplasma gondii was amplified using PCR of the blood and bronoalveolar lavage BAL samples, and IgG and IgM antibodies against Toxoplasma were detected in serum samples using ELISA.ResultsOur results indicated that anti-toxoplasma specific IgG and IgM antibodies were prevalent among transplant recipients with values of 54% and 4% respectively. PCR was performed to detect Toxoplasma gondii in 3 blood and lavage samples (3.3%) with 100% sensitivity and 97.9% specificity.ConclusionsToxoplasma gondii pulmonary infection is measured along with brain toxoplasmosis in patients receiving a kidney transplant. After serological methods, PCR is the second useful method for Toxoplasma gondii screening. Proper prophylaxis before and after receiving a kidney transplant together with Toxoplasma gondii screening of donor and transplant is recommended.

Introduction:Pneumocystis jiroveci is an opportunistic infectious fungus in immunosuppressed patients, particularly in ones with acquired immunodeficiency syndrome (AIDS). The use of immunosuppressive drugs especially corticosteroids predisposes the transplanted patients to a variety of infectious diseases including Pneumocystis infection. In many developed countries, the incidence of Pneumocystis jiroveci pneumonia (PJP) is dwindling in transplant patients receiving appropriate prophylaxis. In this study, definitive diagnosis of Pneumocystis infection in a patient receiving kidney transplant was presented.Case Presentation:The patient was a 45-year-old man with a history of kidney transplantation 24 years ago, admitted to a specialized hospital in Tehran because of fever and respiratory distress. Upon admission, the patient showed symptoms of unconsciousness and shortness of breath. Paraclinical tests and complementary examinations such as microscopic observation and molecular analysis confirmed the definitive diagnosis of Pneumocystis infection. Specific treatment with trimethoprim/sulfamethoxazole was carried out alongside other therapeutic measures; but unfortunately the patient did not respond to the specific treatment and died in the course of a progressive disease.Discussion:The disease progress in these patients can still be fast and deadly. Applying rapid molecular diagnostic techniques to start appropriate and timely treatment is essential. Utilization of such diagnostic methods is recommended in our country.