Investigating of Infectivity and Epidemiology of Pneumocystis Carinii
Investigating of Infectivity and Epidemiology of Pneumocystis Carinii
Sara safari,1,*
1. Master of Microbiology, Microbiology, Islamic Azad, Zanjan Branch
Introduction: The most frequent opportunistic illness among people living with HIV infection is Pneumocystis jiroveci pneumonia (PJP), formerly known as Pneumocystis carinii pneumonia (PCP). Although the exact point of entrance for P carinii is unknown, inhalation is most likely the method of transmission because the organism has rarely been discovered in the lung. In animals, airborne transmission has been shown. The bacterium is mostly dormant and slightly distributed throughout the lung in most people, showing no signs of a host reaction (latent infection). The bacterium proliferates in vulnerable (immunocompromised) hosts, filling the alveolar gaps and triggering phagocytosis and an aggressive response from the alveolar macrophages. Pneumocystis pneumonia in sick newborns thickens the alveolar septum and causes an influx of lymphocytes and plasma cells into the interstitial space. Severe hypoxia and compromised breathing are the outcomes of the infection. Pneumonitis is consistently characterized by tachypnea and fever, and radiography can show diffuse bilateral alveolar illness. Finding P carinii in lung tissue or lower airway fluids is necessary for the diagnosis. These specimens can be taken via bronchoalveolar lavage, lung biopsy, sputum induction, or needle lung aspiration. The organism can be identified by the Gomori, Giemsa, fluorescence-labelled antibody, or toluidine blue O stains. Serologic investigations for antigens and antibodies are useless for making a precise diagnosis. This study aimed to investigate the infectivity and epidemiology of Pneumocystis Carinii.
Methods: The study, titled Investigating the infectivity and epidemiology of Pneumocystis Carinii, was conducted by searching scientific databases such as Science Direct, Springer, Google Scholar, and PubMed.
Results: The findings indicate that pneumonia is a common infection in individuals with acquired immune deficiency syndrome (AIDS) and tends to arise in people with compromised cell-mediated immunity. The illness may arise from severe protein-calorie deficiency alone. Individuals using immunosuppressive medications for cancer treatment or organ transplantation are more vulnerable to P. carinii pneumonitis. Humoral antibodies do not offer disease protection; rather, they may develop in response to infection or experimental immunization. Both IgG and IgM antibodies may be present. With a particular antibody present, alveolar macrophages actively engulf and consume the parasite. Immunocompromised children and adults do not exhibit the significant plasma cell infiltration of the alveolar septae seen in infected newborns. Rats, rabbits, mice, dogs, sheep, goats, ferrets, chimps, guinea pigs, horses, and monkeys have all been reported to harbor Pneumocystis carinii in their lungs. Reports of the organism have been made in humans and lower animals on every continent. There is evidence of animal-to-animal transmission through the air. Subclinical infection must be extremely common since humoral antibodies to P. carinii may be present in up to 70% of healthy people.
Conclusion: P. carinii vaccination does not protect against pneumonia, according to experimental research. However, preventive use of aerosolized pentamidine, dapsone, or trimethoprim-sulfamethoxazole can prevent the illness. Atovaquone, trimethoprim-sulfamethoxazole, trimetrexate, and pentamidine isethionate are the four medications currently approved for the treatment of P. carinii pneumonitis. Trimethoprim-sulfamethoxazole is the recommended medication due to its higher efficacy and lower toxicity. Antibiotics are primarily suggested for the treatment of mild, moderate, or severe PJP. It has been demonstrated that trimethoprim-sulfamethoxazole (TMP-SMX) is more successful than other treatment regimens and is on par with intravenous pentamidine in terms of effectiveness. Only patients with severe patient-centered pain who are HIV-positive are treated with corticosteroids as an initial supplemental therapy. The management of disease can benefit greatly from preventive measures (such as quitting smoking and receiving chemotherapy).