Procalcitonin Serum Concentration During Pneumocystis Jiroveci Colonization or Pseudomonas Aeruginosa Infection/Colonization in Lung Transplant Recipients

• Published in: Transplantation proceedings Vol. 41; no. 8; pp. 3225 - 3227
• Main Authors: Zeglen, S, Wojarski, J, Wozniak-Grygiel, E, Siola, M, Szewczyk, M, Kucewicz-Czech, E, Nozynski, J, Zembala, M
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Amsterdam Elsevier Inc 01.10.2009; Elsevier
• Subjects: Adult; Biological and medical sciences; Calcitonin - blood; Calcitonin Gene-Related Peptide; Female; Fundamental and applied biological sciences. Psychology; Fundamental immunology; General aspects; Human infectious diseases. Experimental studies and models; Humans; Infectious diseases; Lung Transplantation - adverse effects; Lung Transplantation - mortality; Male; Medical sciences; Middle Aged; Pneumocystis carinii - growth & development; Pneumocystis carinii - isolation & purification; Pneumonia, Pneumocystis - blood; Postoperative Complications - blood; Protein Precursors - blood; Pseudomonas aeruginosa - growth & development; Pseudomonas aeruginosa - isolation & purification; Pseudomonas Infections - blood; Risk Factors; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Survival Analysis; Survivors; Tissue, organ and graft immunology; Pseudomonadales; Nosocomial infection; Lung; Procalcitonin; Transplantation; Concentration; Homotransplantation; Respiratory system; Fungi; Infection; Medicine; Treatment; Surgery; Pneumocystis jiroveci; Bacteriosis; Bacteria; Pseudomonadaceae; Graft; Pseudomonas aeruginosa; Serum; Fungi Imperfecti; Colonization
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2009.08.007

Abstract Background Allograft infection after lung transplantation (OLT) has a significant impact on outcomes and represents a diagnostic challenge. Pneumocystis jirovecii causes an opportunistic infection, life-threatening pneumonia among immunocompromised patients. Airway colonization with Pseudomonas aeruginosa is common in lung transplant recipients. The aim of the study was to evaluate procalcitonin (PCT) serum concentrations during P jiroveci and P aeruginosa colonization/infections in lung transplant recipients. Materials and methods Fifteen OLT patients were retrospectively enrolled into the study (10 men and 5 women) of overall mean age of 41.4 ± 14.6 years. In seven patients, P jiroveci cysts were diagnosed (group J) and in 13 patients, we isolated P aeruginosa (group A). In respiratory samples, P jiroveci was detected using an indirect immunofluorescence method, and P aeruginosa was isolated using routine microbiologic methods. PCT was measured using immunoluminescence assay. Results The average PCT value in group A was 0.30 ± 0.21 and in group J, 0.88 ± 0.43, a difference that was not significant. In group A, 3 patients (23.1%) has PCT values indicating moderate infection risk (PCT > 0.5) and one patient (7.7%), a high infection risk (PCT > 2.0 and <10). In group J, three patients (42.9%) has PCT values indicating moderate and one patient (14.3%), high infection risk. Conclusions Bronchial tree colonization with P jiroveci as well as P aeruginosa colonization can be associated with increased PCT suggesting a general, systemic response in addition to local colonization.