title: Prematurity and protracted mechanical ventilation as risk factors for Pneumocystis jiroveci infection in HIV-negative neonates in an intensive care unit.
abstract: This work was undertaken to elucidate some aspects of the epidemiology of Pneumocystis pneumonia (PP). We studied 42 mechanically ventilated, human immunodeficiency virus (HIV)-negative, severely ill neonates treated at an intensive care unit. The study group included 40 premature neonates and two mature neonates with lethal congenital defects. Progressive respiratory dysfunction in PP necessitated mechanical ventilation. Infection was usually noticeable on the 22nd day of life or after 12 days of ventilation. The usual manifestations included apnea, pallor, copious frothy sputum, seizures, and feeding difficulties. The diagnosis was established by detecting Pneumocystis jiroveci cysts in bronchial lavage fluid specimens (88.1% sensitivity). PP was managed with cotrimoxazole and pentamidine combination therapy administered over 14 days. No clinical improvement was noted in four neonates and three of them died during therapy. Prematurity and protracted mechanical ventilation are two risk factors for P. jiroveci infection in severely ill neonates in an intensive care unit.
authors: Clinic of Obstetrics and Perinatology, Pomeranian Medical University, Szczecin, Poland.
authors: Agnieszka
authors: A
authors: Kordek
authors: Lidia
authors: L
authors: Kołodziejczyk
authors: Małgorzata
authors: M
authors: Adamska
authors: Bogumiła
authors: B
authors: Skotarczak
authors: Beata
authors: B
authors: Loniewska
authors: Beata
authors: B
authors: Pawlus
authors: Wanda
authors: W
authors: Kuźna-Grygiel
authors: Jacek
authors: J
authors: Rudnicki
authors: Ryszard
authors: R
authors: Czajka
mesh_terms: D000890:Anti-Infective Agents / Q000627:therapeutic use; D016009:Chi-Square Distribution; D003428:Cross Infection / Q000188:drug therapy / Q000209:etiology*; D005260:Female; D018023:HIV Seronegativity; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D008297:Male; D045363:Pneumocystis carinii; D011020:Pneumonia, Pneumocystis / Q000188:drug therapy / Q000209:etiology*; D012121:Respiration, Artificial / Q000009:adverse effects*; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000890:Anti-Infective Agents