Histoplasma capsulatum and Pneumocystis jirovecii coinfection in hospitalized HIV and non-HIV patients from a tertiary care hospital in Mexico

Int J Infect Dis. 2019 Sep:86:65-72. doi: 10.1016/j.ijid.2019.06.010. Epub 2019 Jun 15.

Abstract

Background: Histoplasma capsulatum and Pneumocystis jirovecii are respiratory fungal pathogens that principally cause pulmonary disease. Coinfection with both pathogens is scarcely reported. This study detected this coinfection using specific molecular methods for each fungus in the bronchoalveolar lavage (BAL) of patients from a tertiary care hospital.

Materials and methods: BAL samples from 289 hospitalized patients were screened by PCR with specific markers for H. capsulatum (Hcp100) and P. jirovecii (mtLSUrRNA and mtSSUrRNA). The presence of these pathogens was confirmed by the generated sequences for each marker. The clinical and laboratory data for the patients were analyzed using statistical software.

Results: The PCR findings separated three groups of patients, where the first was represented by 60 (20.8%) histoplasmosis patients, the second by 45 (15.6%) patients with pneumocystosis, and the last group by 12 (4.2%) patients with coinfection. High similarity among the generated sequences of each species was demonstrated by BLASTn and neighbor-joining algorithms. The estimated prevalence of H. capsulatum and P. jirovecii coinfection was higher in HIV patients.

Keywords: Bronchoalveolar lavage; Coinfection; Histoplasmosis; Molecular diagnosis; Pneumocystosis.

MeSH terms

  • Adult
  • Aged
  • Bronchoalveolar Lavage
  • Coinfection / epidemiology*
  • Female
  • HIV Infections / complications
  • Histoplasma / genetics
  • Histoplasma / isolation & purification
  • Histoplasmosis / epidemiology*
  • Histoplasmosis / microbiology
  • Humans
  • Male
  • Mexico / epidemiology
  • Middle Aged
  • Pneumocystis carinii* / genetics
  • Pneumocystis carinii* / isolation & purification
  • Pneumonia, Pneumocystis / epidemiology*
  • Pneumonia, Pneumocystis / microbiology
  • Polymerase Chain Reaction
  • Tertiary Care Centers