title: Prevalence of Pulmonary Infections Caused by Atypical Pathogens in non-HIV Immunocompromised Patients.
abstract: Although atypical bacteria are important causes of lower airway infections, data on their role in immunocompromised patients are scarce. The aim of the study was to evaluate the prevalence of atypical pulmonary infections in patients with various types of immunosuppression, and to analyze clinical characteristics of these infections. Eighty non-HIV immunocompromised patients with different underlying diseases and clinical and radiological signs of pulmonary infection were enrolled. Due to incomplete data on eight patients, 72 patients were eligible for final analysis (median age 58 years). All patients underwent fiberoptic bronchoscopy and bronchoalveolar lavage. Bronchoalveolar lavage fluid (BALF) fluid samples were sent for direct microscopy, cultures, and fungal antigen detection, when appropriate. Commercial qualitative amplification assay (PNEUMOTRIS oligomix Alert Kit(®)), based on nested PCR method, was used to detect specific DNA sequences of L. pneumophila, C. pneumoniae, and M. pneumoniae in BALF. There were 61 (84.7 %) patients with hematologic diseases, 3 (4.2 %) after solid organ transplantation, and 8 (11.1 %) with miscellaneous diseases affecting immune status. Specific sequences of M. pneumoniae, C. pneumoniae, and L. pneumophila DNA were found in 7 (9.7 %), 2 (2.8 %), and 0 patients, respectively. In 8 of these patients co-infections with different microorganisms were demonstrated. Co-infection with A. baumanii and P. aeruginosa was diagnosed in three patients who died. We conclude that atypical lower airway infections are uncommon in immunocompromised patients. The majority of these infections are co-infections rather than single pathogen infections.
authors.affiliation: Department of Internal Medicine, Pneumology and Allergology, Medical University of Warsaw, 1A Banacha, 02-097, Warsaw, Poland.
authors.forename: E M
authors.initials: EM
authors.lastname: Grabczak
authors.affiliation: Department of Internal Medicine, Pneumology and Allergology, Medical University of Warsaw, 1A Banacha, 02-097, Warsaw, Poland. rkrenke@wum.edu.pl.
authors.forename: R
authors.initials: R
authors.lastname: Krenke
authors.affiliation: Department of Microbiology, Medical University of Warsaw, 1A Banacha, 02-097, Warsaw, Poland.
authors.forename: M
authors.initials: M
authors.lastname: Przybylski
authors.affiliation: Department of Hematology, Institute of Hematology and Transfusion Medicine, 14 Indiry Gandhi, 02-776, Warsaw, Poland.
authors.forename: A
authors.initials: A
authors.lastname: Kolkowska-Lesniak
authors.affiliation: Department of Internal Medicine, Pneumology and Allergology, Medical University of Warsaw, 1A Banacha, 02-097, Warsaw, Poland.
authors.forename: R
authors.initials: R
authors.lastname: Chazan
authors.affiliation: Department of Microbiology, Medical University of Warsaw, 1A Banacha, 02-097, Warsaw, Poland.
authors.forename: T
authors.initials: T
authors.lastname: Dzieciatkowski
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001992:Bronchoalveolar Lavage Fluid / Q000382:microbiology; D017714:Community-Acquired Infections / Q000453:epidemiology* / Q000276:immunology / Q000382:microbiology; D005260:Female; D006090:Gram-Negative Bacteria / Q000145:classification / Q000235:genetics / Q000472:pathogenicity*; D006801:Humans; D016867:Immunocompromised Host / Q000276:immunology*; D008171:Lung Diseases / Q000382:microbiology*; D008297:Male; D008875:Middle Aged; D011044:Poland / Q000453:epidemiology; D016133:Polymerase Chain Reaction; D015995:Prevalence; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000276:immunology / Q000382:microbiology; D055815:Young Adult
keywords: Atypical bacteria; Bronchoalveolar lavage fluid; Chlamydophila pneumoniae; Immunodeficiency; Legionella pneumophila; Mycoplasma pneumoniae; Respiratory infections