Procalcitonin serum concentration during Pneumocystis jiroveci colonization or Pseudomonas aeruginosa infection/colonization in lung transplant recipients.
BACKGROUND
Allograft infection after lung transplantation (OLT) has a significant impact on outcomes and represents a diagnostic challenge. Pneumocystis jirovecii causes an opportunistic infection, life-threatening pneumonia among immunocompromised patients. Airway colonization with Pseudomonas aeruginosa is common in lung transplant recipients. The aim of the study was to evaluate procalcitonin (PCT) serum concentrations during P jiroveci and P aeruginosa colonization/infections in lung transplant recipients.


METHODS
Fifteen OLT patients were retrospectively enrolled into the study (10 men and 5 women) of overall mean age of 41.4 +/- 14.6 years. In seven patients, P jiroveci cysts were diagnosed (group J) and in 13 patients, we isolated P aeruginosa (group A). In respiratory samples, P jiroveci was detected using an indirect immunofluorescence method, and P aeruginosa was isolated using routine microbiologic methods. PCT was measured using immunoluminescence assay.


RESULTS
The average PCT value in group A was 0.30 +/- 0.21 and in group J, 0.88 +/- 0.43, a difference that was not significant. In group A, 3 patients (23.1%) has PCT values indicating moderate infection risk (PCT > 0.5) and one patient (7.7%), a high infection risk (PCT > 2.0 and <10). In group J, three patients (42.9%) has PCT values indicating moderate and one patient (14.3%), high infection risk.


CONCLUSIONS
Bronchial tree colonization with P jiroveci as well as P aeruginosa colonization can be associated with increased PCT suggesting a general, systemic response in addition to local colonization.
Department and Clinic of Cardiac Surgery and Transplantology, Silesian Centre for Heart Diseases, Zabrze, Poland. slawekzeglen@poczta.onet.pl
S
S
Zeglen
J
J
Wojarski
E
E
Wozniak-Grygiel
M
M
Siola
M
M
Szewczyk
E
E
Kucewicz-Czech
J
J
Nozynski
M
M
Zembala
D000328:Adult; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D005260:Female; D006801:Humans; D016040:Lung Transplantation / Q000009:adverse effects* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D045363:Pneumocystis carinii / Q000254:growth & development / Q000302:isolation & purification*; D011020:Pneumonia, Pneumocystis / Q000097:blood*; D011183:Postoperative Complications / Q000097:blood; D011498:Protein Precursors / Q000097:blood*; D011552:Pseudomonas Infections / Q000097:blood*; D011550:Pseudomonas aeruginosa / Q000254:growth & development / Q000302:isolation & purification*; D012307:Risk Factors; D016019:Survival Analysis; D017741:Survivors
C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide