title: Increased prevalence of Pneumocystis jirovecii colonisation in acute pulmonary exacerbations of cystic fibrosis.
abstract: This study examined the prevalence of Pneumocystis jirovecii in the sputum of adults with cystic fibrosis during clinical stability and acute pulmonary exacerbation.
  
  
  
  This was a prospective, longitudinal observational study of patients attending the Manchester Adult Cystic Fibrosis Centre. Sputum samples were analysed for P. jirovecii DNA using PCR at enrolment and up to 5 follow-up visits. Patients were classified as stable or exacerbating using a modified Fuch's pulmonary exacerbation score.
  
  
  
  226 samples were tested from 111 patients. P. jirovecii was more likely to be detected in samples at acute pulmonary exacerbation (7/76 (9.2%)) compared with stable visits (3/150 (2%)), p = 0.03. P. jirovecii was detected less frequently if patients had received co-trimoxazole within 3 months of sample collection (0% versus 29.7%, p = 0.03).
  
  
  
  Prevalence of P. jirovecii in stable patients is low, but P. jirovecii is detected in approximately 1 in 10 patients experiencing an acute pulmonary exacerbation.
authors.affiliation: Manchester Adult Cystic Fibrosis Centre, University Hospital of South Manchester NHS Foundation Trust, Southmoor Road, Manchester, M23 9LT, UK; University of Manchester, Institute of Inflammation and Repair, UK. Electronic address: heathergreen2@nhs.net.
authors.forename: Heather D
authors.initials: HD
authors.lastname: Green
authors.affiliation: Manchester Adult Cystic Fibrosis Centre, University Hospital of South Manchester NHS Foundation Trust, Southmoor Road, Manchester, M23 9LT, UK; University of Manchester, Institute of Inflammation and Repair, UK.
authors.forename: Rowland J
authors.initials: RJ
authors.lastname: Bright-Thomas
authors.affiliation: University of Manchester, Institute of Inflammation and Repair, UK; Central Manchester University Hospitals NHS Trust, Clinical Virology Department and PHE Public Health Laboratory, Clinical Sciences Building, Manchester Royal Infirmary, Manchester, M13 9WL, UK.
authors.forename: Ken J
authors.initials: KJ
authors.lastname: Mutton
authors.affiliation: Central Manchester University Hospitals NHS Trust, Clinical Virology Department and PHE Public Health Laboratory, Clinical Sciences Building, Manchester Royal Infirmary, Manchester, M13 9WL, UK.
authors.forename: Malcolm
authors.initials: M
authors.lastname: Guiver
authors.affiliation: Manchester Adult Cystic Fibrosis Centre, University Hospital of South Manchester NHS Foundation Trust, Southmoor Road, Manchester, M23 9LT, UK; University of Manchester, Institute of Inflammation and Repair, UK.
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Jones
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003550:Cystic Fibrosis / Q000150:complications*; D004271:DNA, Fungal / Q000032:analysis; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016720:Pneumocystis Infections / Q000453:epidemiology*; D045363:Pneumocystis carinii / Q000302:isolation & purification*; D016133:Polymerase Chain Reaction; D015995:Prevalence; D011446:Prospective Studies; D013183:Sputum / Q000382:microbiology*; D055815:Young Adult
chemical_list: D004271:DNA, Fungal
keywords: Cystic fibrosis; Pneumocystis jirovecii; Pulmonary exacerbation