Procalcitonin upregulation is associated with pneumocystis jiroveci colonization as well as pseudomonas aeruginosa infection/colonisation in lung transplant recipients
S Zeglen, M Siola, E Wozniak-Grygiel, J Wojarski, M Szewczyk, M Zembala
Ann Transplant 2009; 14(1): 72-73
Background: Allograft infection after lung transplantation has a significant impact on the procedure outcome and could be a diagnostic challenge. Pneumocystis jirovecii is an opportunistic infection causing life-threatening pneumonia (PCP) in immunocompromised patients. Airway colonisation with Pseudomonas aeruginosa is common in lung transplant (LTx) recipients. The aim of the study was to compare a retrospective case review of Pneumocystis jiroveci and Pseudomonas aeruginosa infections in lung transplant's (LTx) recipients and compare them with serum procalcitonin concentrations (PCT).
Material/Methods: 15 LTx patients were retrospectively involved into the study (10 men and 5 women, mean age: 41.4±14.6 yr.). In 7 patients cysts of P. jiroveci were diagnosed (group J) and in 13 patients P. aeruginosa (group A) was isolated. In respiratory samples P. jiroveci was detected using indirectimmunoï¬‚uorescence method and P. aeruginosa was isolated using routine microbiological methods. PCT was measured using immunoluminescence assay (ILMA; BRAHMS PCT LIA, Berlin, Germany).
Results: Average PCT value in group A was 0.30±0.21 and in group J was 0.88±0.43, the difference was not significant. In group A 3 patients (23.1%) had PCT value indicating moderate infection risk (PCT >0.5) and 1 patient (7.7%) high infection risk (PCT >2.0 and <10). In group J 3 patients (42.9%) had PCT value indicating moderate and 1 patient (14.3%) high infection risk.
Conclusions: Bronchial tree colonization with Pneumocystis jiroveci as well as
Pseudomonas aeruginosa infection/colonization are associated with moderate
procalcitonin increase suggesting general systemic response, also during colonization of only bronchi of the transplanted lung.
Keywords: Lung Transplantation