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Molecular and Microscopy Detection of Pneumocystis Jirovecii in Hospitalized Patients During the Covid-19 Pandemic Publisher



Matouri R1 ; Aboutalebian S1, 2 ; Nasri E3 ; Sadeghi S3 ; Rostami S3 ; Fakhim H3 ; Ghafel S2 ; Hosseini M2 ; Mousavi S1 ; Rouhi F1 ; Pestechian N1, 3 ; Mirhendi H1, 2
Authors
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Authors Affiliations
  1. 1. Department of Medical Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  2. 2. Mycology Reference Laboratory, Research Core Facilities Laboratory, Isfahan University of Medical Sciences, Isfahan, Iran
  3. 3. Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

Source: Frontiers in Medicine Published:2023


Abstract

Introduction: Early detection of Pneumocystis jirovecii as an opportunistic pathogen that may endanger predisposed persons, including COVID-19 patients, may help to choose the optimal management. Methods: In this study, 585, including 530 COVID-19 patients, with clinical and radiological evidence of respiratory diseases, were investigated for P. jirovecii screening. Clinical specimens were examined by direct microscopy and PCR, and randomly selected positive PCR products were confirmed through DNA sequence analysis. Results: Thirty-one (5.3%) samples were positive in P. jirovecii-specific nested-PCR, while by direct microscopic tests, Pneumocystis was observed in 22 (3.76%) samples. Males (61.7%) and patients over 50 years old (75.6%) were more commonly affected than others, and malaise and fatigue (84%), and wheezing (75%) were the most common symptoms, followed by fever (40.48%) and dyspnea (39.51%). Among the Pneumocystis-positive patients, three cases had coinfection with Aspergillus fumigatus, A. flavus, and A. niger (each n = 1), as documented by direct microscopy, culture, and species identification by PCR-sequencing. Conclusion: Pneumocystis pneumonia is still a diagnostic challenge; therefore, additional large-scale studies are needed to clarify the epidemiology of the disease in immunocompromised or COVID-19 patients. Copyright © 2023 Matouri, Aboutalebian, Nasri, Sadeghi, Rostami, Fakhim, Ghafel, Hosseini, Mousavi, Rouhi, Pestechian and Mirhendi.