Abstract
Pneumocystis jirovecii colonization rates in healthy patients are unclear. Previously published studies suggest that the fungus could play a role in the physiopathology and progression of chronic respiratory diseases. The goal of this study was to determine the prevalence of colonization by this fungus in the lower respiratory tract of immunocompetent patients who are not at risk of dysbiosis. The presence of P. jirovecii was confirmed in the bronchoalveolar lavage (BAL) samples from adults who underwent bronchoscopy for non-infectious reasons, had no immunosuppressive factors, and had not been on antibiotic treatment for at least one month. The results were compared with those obtained in the study on the presence of Pneumocystis in environmental dust samples obtained by swabbing surfaces in the participating subjects' domestic settings. Real-time PCR was the technique used for detecting the fungus in both types of samples. A total of 97 BAL samples and 49 domestic environment samples were studied. The medical reasons for needing a bronchoscopy were, mainly, the examination of both pulmonary neoplasm in 55 patients (57%) and diffuse interstitial lung disease in 21 patients (22%). The overall prevalence of P. jirovecii in our population was 7.22% in BAL samples and 0% in domestic samples. The presence of P. jirovecii in the lower respiratory tract is relevantly linked with the patient's immune status, not with an underlying pathology. Prevalence is low in immunocompetent individuals who do not have any infectious pathology and are not having antimicrobial treatments. Our results do not enable us to figure out which the environmental niche of P. jirovecii is.
Published Version
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