title: Prevalence of Pneumocystis jirovecii pneumonia (2010-2013): the first Croatian report.
abstract: Pneumocystis jirovecii is an important cause of interstitial pneumonia particularly among immunocompromised hosts. We analysed the prevalence of P. jirovecii pneumonia (PCP) among HIV-infected and HIV-uninfected patients presented with interstitial pneumonia or acute respiratory syndrome hospitalized in six Croatian tertiary care hospitals. Over four-year period (2010-2013), a total of 328 lower respiratory tract samples: 253 (77.1%) bronchoalveolar lavage fluid, 43 (13.1%) tracheal aspirates and 32 (9.8%) bronchial aspirates from 290 patients were examined by real-time polymerase chain reaction (PCR). PCP was detected in 23 (7.9%) patients. The prevalence of PCP differed significantly among tested groups (χ2 = 95.03; d.f. = 3; p < 0.001). HIV-infected patients were more often positive (56.6%, 95%CI = 37.3-72.4) compared to other groups (patients with malignant disease 7.7%, 95%CI = 2.6-20.3; transplant patients 7.7%, 95%CI = 2.2-24.1; patients with other diagnosis 1.5%, 95%CI = 0.5-4.4). Majority of HIV-positive patients (80%) were newly diagnosed cases. Our results indicate that HIV-infected patients still represents the main risk group for P. jirovecii infection. PCP is responsible for pneumonia in 56.6% HIV-positive patients in Croatia, primarily those who do not know that they are HIV infected.
authors.affiliation: Croatian National Institute of Public Health Zagreb Croatia University of Zagreb School of Medicine Zagreb Croatia.
authors.forename: Andrea
authors.initials: A
authors.lastname: Babic-Erceg
authors.affiliation: Croatian National Institute of Public Health Zagreb Croatia University of Zagreb School of Medicine Zagreb Croatia.
authors.forename: Tatjana
authors.initials: T
authors.lastname: Vilibic-Cavlek
authors.affiliation: Croatian National Institute of Public Health Zagreb Croatia.
authors.forename: Marijan
authors.initials: M
authors.lastname: Erceg
authors.affiliation: Croatian National Institute of Public Health Zagreb Croatia University of Zagreb School of Medicine Zagreb Croatia.
authors.forename: Emilija
authors.initials: E
authors.lastname: Mlinaric-Missoni
authors.affiliation: University of Zagreb School of Medicine Zagreb Croatia University Hospital for Infectious Diseases "Dr Fran Mihaljevic" Zagreb Croatia.
authors.forename: Josip
authors.initials: J
authors.lastname: Begovac
mesh_terms: D000328:Adult; D000368:Aged; D001992:Bronchoalveolar Lavage Fluid / Q000382:microbiology / Q000821:virology; D002675:Child, Preschool; D015897:Comorbidity; D017523:Croatia / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000276:immunology* / Q000382:microbiology / Q000821:virology; D006801:Humans; D016867:Immunocompromised Host; D007223:Infant; D008297:Male; D008875:Middle Aged; D045363:Pneumocystis carinii / Q000276:immunology / Q000302:isolation & purification*; D011020:Pneumonia, Pneumocystis / Q000453:epidemiology / Q000276:immunology* / Q000382:microbiology / Q000821:virology; D015995:Prevalence; D060888:Real-Time Polymerase Chain Reaction; D012189:Retrospective Studies; D045169:Severe Acute Respiratory Syndrome / Q000453:epidemiology / Q000276:immunology* / Q000382:microbiology / Q000821:virology
keywords: Croatia; Pneumocystis jirovecii; prevalence; real-time PCR