Pneumocystis jirovecii pneumonia among pediatric inpatients before and
after COVID-19 pandemic: molecular diagnosis, predisposing factors, and
outcomes in Northeastern Iran
Abstract
Background: Pneumocystis pneumonia (PCP), caused by
P. jirovecii, is one of the opportunistic fungal infections that
can cause life-threatening pneumonia in children with underlying
diseases. Due to the similarity of the symptoms of PCP with other lung
infections, such as tuberculosis, differential and accurate diagnosis is
necessary. The current study investigated the molecular diagnosis of
P. jirovecii, predisposing factors, and the outcomes, among
pediatric inpatients in Northeastern Iran. Method: In this
study, 180 bronchoalveolar lavage (BAL) specimens were obtained from
hospitalized children with respiratory disorders. The specimens were
examined using Giemsa stain, and the genomic DNA was extracted according
to the protocol of the AmpliSens® kit. Real-time polymerase chain
reaction technique was used to detect P. jirovecii by the
AmpliSens Pneumocystis jirovecii ( carinii)-FRT PCR kit.
Results: Among the patients studied, 34 (18.9%) were positive,
and 8 (4.4%) were suspicious for the presence of P. jirovecii.
Among the 34 positive cases, 12 (35%) were related to before, and 22
(65%) were affected during the COVID-19 pandemic. Only 2 cases (5.88%)
of the positive cases detected by Real-time PCR method were observed
using Giemsa staining. Also, no correlation was observed between
positive cases of infection and the sex, the outcomes, and underlying
diseases. Conclusion: The results showed that PCP has a
relatively high prevalence among pediatric inpatients with respiratory
disorders. Neutropenia is a significant predisposing factor in these
patients. However, there is no correlation between PCP cases and the
outcomes and underlying diseases. Most of patients with PCP were
affected during the COVID-19 pandemic.