Pneumocystis jirovecii detection and genotyping from HIV-positive and HIV-negative Mexican patient samples

Abstract

Introduction: Pneumocystis jirovecii is an atypical fungus particularly detected in HIV-positive or transplanted patients. Objective: To detect and genotype Pneumocystis jirovecii in patient samples from two hospitals in Mexico City. Method: Eighty-nine respiratory tract samples, corresponding to 53 patients (30 HIV-positive and 23 HIV-negative) with respiratory symptoms and to 11 healthy individuals included as negative control, were processed. DNA was extracted and amplified by nested polymerase chain reaction from the internal transcribed spacer, with one fragment being obtained at each round (693 and 550 bp). Genotypes and their phylogenetic relationship were determined by sequencing the 550 bp fragment. Results: Forty-eight samples from 30 HIV-positive patients were received from a single hospital, out of which 11 (36.6 %) were positive for Pneumocystis jirovecii. No sample was positive in HIV-negative patients or healthy subjects. The most frequently detected haplotypes were Eg and Em. Conclusions: The frequency of Pneumocystis jirovecii infection was high in the studied Mexican population. The most common genotype was different from those reported in other countries. It is necessary to address this health problem through early detection of this infection.

Global prevalence, mortality, and main characteristics of HIV-associated pneumocystosis: A systematic review and meta-analysis

“…Five studies were conducted from the USA [ 50 – 52 , 68 , 73 ]; three studies, each were conducted in South Africa [ 67 , 72 , 90 ], Japan [ 81 , 84 , 85 ], and Thailand [ 61 , 78 , 86 ]; two studies, each were conducted in Iran [ 75 , 80 ], France [ 45 , 66 ], and Mexico [ 40 , 47 ]; one study each was conducted in Ethiopia [ 39 ], Tanzania [ 60 ], Malawi [ 57 ], Spain [ 38 ], Cameroon [ 76 ], India [ 54 ], Taiwan [ 89 ], Zambia [ 79 ], and a study was from five European countries (France, Austria, Belgium, Croatia, Germany) [ 70 ].…”

“…Our random-effects model showed that in twenty-nine eligible studies [ 38 – 40 , 45 , 47 , 50 – 52 , 54 , 57 , 60 , 61 , 66 – 68 , 70 , 72 , 73 , 75 , 76 , 78 – 81 , 84 – 86 , 89 , 90 ], the pooled prevalence of HAP was 35.4% (95% CI:23.8 to 47.9; I 2 : 99.4%) ( Table 2 ). There is a negligible publication bias between studies (intercept: 6.946; 95% CI:-24.750 to 38.642; P = 0.6566).…”

“…The results of the random-effect model showed that in twenty-nine eligible studies [ 38 – 40 , 45 , 47 , 50 – 52 , 54 , 57 , 60 , 61 , 66 – 68 , 70 , 72 , 73 , 75 , 76 , 78 – 81 , 84 – 86 , 89 , 90 ], the pooled prevalence of PCP among the HIV-negative population was 10.158% (95% CI:2 to 25.3; I 2 : 99.9%). Also, analysis of publication bias using the Egger test model indicated an intercept rate of 14.326% (95% CI: -2.023 to 30.675; P = 0.0834)( Table 2 ).…”

“…The results of the random effect model in twenty-nine included studies [ 38 – 40 , 45 , 47 , 50 – 52 , 54 , 57 , 60 , 61 , 66 – 68 , 70 , 72 , 73 , 75 , 76 , 78 – 81 , 84 – 86 , 89 , 90 ] indicated that the prevalence of PCP among the HIV-positive population is almost 12 times higher than HIV-negative population (OR: 11.710; 95% CI:5.420 to 25.297; I 2 : 93.1%; P<0.0001) ( Table 2 ; Fig 2 ). Also, the Egger test assay result indicated a negligible publication bias among analyzed studies (intercept: 1.416; 95% CI: 0.133 to 2.966; P = 0.1437) ( Table 2 ; S1 Fig ).…”

“…The results of the OR analysis of patient gender captured from six studies [ 48 , 60 , 62 , 74 , 76 , 82 ] indicated that HIV-positive men had a 7% higher chance rate for PCP compared to women (OR:1.073; 95% CI:0.674 to 1.706; I 2 : 0%; P = 0.959)( Table 2 ). The results of standard mean difference (SMD) analysis of patient’s age captured from twenty-one studies [ 40 , 41 , 44 , 48 , 49 , 53 , 55 , 56 , 58 , 59 , 61 – 65 , 74 , 77 , 82 , 88 , 91 , 92 ], including 1583 PCP patients among 2044 HIV-positive cases, indicated that there is no significant difference between HIV/AIDS patients with PCP and without PCP (SMD: -0.140; 95% CI:-0.315 to -0.034; I 2 : 78.6%;P = 0.000).…”