title: Pneumocystis jirovecii and microbiological findings in children with severe pneumonia in Nairobi, Kenya.
abstract: OBJECTIVE
  To determine the significance of Pneumocystis jirovecii infection in the Kenyan paediatric population.
  
  
  METHODS
  Sixty samples of induced sputum from children aged < or =23 months, half of whom were human immunodeficiency virus (HIV) positive, admitted with severe pneumonia in Nairobi were subjected to immunofluorescent staining for detection of P. jirovecii and microbiological culture.
  
  
  RESULTS
  P. jirovecii was detected in 8/60 (13%) as a copathogen with other respiratory pathogens. Five of eight samples with >5 oocysts were from HIV-positive children aged < or =6 months, while equivocally scored samples (< or =5 oocysts) were from HIV-negative children aged >6 months. Klebsiella pneumoniae was significantly recovered in 26/ 60 (43%), followed by Escherichia coli 11/60 (18%) and Staphylococcus aureus 8/60 (13%). Streptococcus pneumoniae, Haemophilus influenzae and Pseudomonas aeruginosa were isolated infrequently. Candida albicans was recovered from 27/60 (45%), while the frequency of C. tropicalis, C. glabrata and C. parapsilosis was 7%, 5% and 3% respectively. Multidrug resistance among E. coli and K. pneumoniae were: sulphamethoxazoletrimethoprim 100% vs. 69%, chloramphenicol 55% vs. 73% and ampicillin 100% vs. 89%.
  
  
  CONCLUSIONS
  Paediatricians in Kenya should be aware of Pneumocystis pneumonia, irrespective of the patient's HIV status.
authors.affiliation: Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi.
authors.forename: C C
authors.initials: CC
authors.lastname: Bii
authors.forename: J
authors.initials: J
authors.lastname: Kose
authors.forename: H
authors.initials: H
authors.lastname: Taguchi
authors.forename: E
authors.initials: E
authors.lastname: Amukoye
authors.forename: T T
authors.initials: TT
authors.lastname: Ouko
authors.forename: L C
authors.initials: LC
authors.lastname: Muita
authors.forename: O
authors.initials: O
authors.lastname: Mugasia
authors.forename: N
authors.initials: N
authors.lastname: Wamae
authors.forename: S
authors.initials: S
authors.lastname: Kamiya
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology / Q000382:microbiology; D002675:Child, Preschool; D006801:Humans; D015994:Incidence; D007223:Infant; D007630:Kenya / Q000453:epidemiology; D045363:Pneumocystis carinii / Q000302:isolation & purification*; D011020:Pneumonia, Pneumocystis / Q000453:epidemiology / Q000382:microbiology*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014505:Urban Population