title: Pneumocystis pneumonia in children - the relevance of chemoprophylaxis in different groups of immunocompromised and immunocompetent paediatric patients.
abstract: BACKGROUND
  Pneumocystis jirovecii is an opportunistic pathogen causing pneumocystis pneumonia (PCP), a life-threatening infection, in immunocompromised patients. In this study, retrospective analysis of the presence of P. jirovecii DNA in different samples collected from children with suspected PCP was carried out.
  
  
  METHODS
  Three hundred and six specimens [152 bronchoalveolar lavage (BAL) specimens, 80 blood specimens, 18 bronchial secretions (BS), 34 induced sputum samples, 10 endotracheal aspirates (ETA), and 12 other type samples] obtained from patients with suspected PCP were examined by real-time PCR.
  
  
  RESULTS
  Forty (13.1%) patients were positive for P. jirovecii: 4 (7.7%) patients with malignancies, 3 (6.8%) transplant recipients, 15 (23.1%) other immunocompromised patients, and 18 (12.4%) immunocompetent patients. Pneumocystis jirovecii DNA was detected in 20.4% of BAL specimens, 11.1% of BS samples, 10% of ETA sample, 8.8% of induced sputum samples, and in 3.7% of blood samples. Comparing the frequency of the presence of P. jirovecii DNA between the group of children treated with PCP chemoprophylaxis (malignancy patients and transplant recipients) and a group of children not receiving this prophylaxis (other immunocompromised and immunocompetent children), we found that the occurrence of PCP was twice as high in the latter group of children (7.3% and 15.7%, respectively).
  
  
  CONCLUSIONS
  Respiratory samples, such as BS, BAL, or ETA specimens, are the material of choice for the diagnosis of PCP. Due to high incidence of PCP in certain groups of immunocompetent and immunocompromised patients, besides cancer patients and transplant recipients, consideration of PCP prophylaxis is required in these groups as well.
authors.affiliation: Department of Oncology, Hematology and Bone Marrow Transplantation, Poznan University of Medical Sciences, Poznan, Poland.
authors.forename: Olga
authors.initials: O
authors.lastname: Zajac-Spychała
authors.affiliation: Family Medicine Department, Poznan University of Medical Sciences, Poznan, Poland.
authors.forename: Ewelina
authors.initials: E
authors.lastname: Gowin
authors.affiliation: Department of Diabetology, Poznan University of Medical Sciences, Poznan, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Fichna
authors.affiliation: Department of Health Promotion, Poznan University of Medical Sciences, Poznan, Poland.
authors.forename: Jacek
authors.initials: J
authors.lastname: Wysocki
authors.affiliation: Department of Molecular Pathology, Institute of Human Genetics, Polish Academy of Sciences, Poznan, Poland.
authors.forename: Marta
authors.initials: M
authors.lastname: Fichna
authors.affiliation: Department of Molecular Pathology, Institute of Human Genetics, Polish Academy of Sciences, Poznan, Poland.
authors.forename: Arleta
authors.initials: A
authors.lastname: Kowala-Piaskowska
authors.affiliation: Department of Infectious Diseases, Poznan University of Medical Sciences, Poznan, Poland.
authors.forename: Iwona
authors.initials: I
authors.lastname: Mozer-Lisewska
authors.affiliation: Department of Molecular Pathology, Institute of Human Genetics, Polish Academy of Sciences, Poznan, Poland.
authors.forename: Jerzy
authors.initials: J
authors.lastname: Nowak
authors.affiliation: Department of Oncology, Hematology and Bone Marrow Transplantation, Poznan University of Medical Sciences, Poznan, Poland ; Department of Molecular Pathology, Institute of Human Genetics, Polish Academy of Sciences, Poznan, Poland ; Department of Medical Diagnostics, Poznan University of Medical Sciences, Poznan, Poland.
authors.forename: Danuta
authors.initials: D
authors.lastname: Januszkiewicz-Lewandowska
keywords: immunosuppression; pneumocystis; pneumonia