Estudio de prevalencia de Pneumocystis Jirovecii en una cohorte de pacientes con insuficiencia cardiaca

Pneumocystis Jirovecii es un hongo atípico responsable de la neumonía en individuos inmunodeprimidos (principalmente VIH+). La colonización por Pneumocystis –descrita como la presencia de ADN del patógeno en ausencia de signos y síntomas de neumonía- ha sido demostrada en sujetos con enfermedades crónicas pulmonares, especialmente en el EPOC. Este estudio investiga acerca de la relación entre la colonización por P. Jirovecii y la insuficiencia cardiaca, para lo cual se llevó a cabo un estudio transversal en una cohorte de pacientes con insuficiencia cardiaca. Se obtuvieron 72 muestras de lavado orofaríngeo que se analizaron utilizando la técnica de PCR. El estudio reveló que solo uno de los pacientes estaba colonizado por el microorganismo, por lo que se concluyó que Pneumocystis Jirovecii no juega un papel en la fisiopatología de la insuficiencia cardiaca

Pneumocystis jirovecii in Spanish Patients With Heart Failure

[Objective] Pneumocystis colonization is frequent in patients with chronic obstructive pulmonary disease (COPD) producing local and systemic inflammation. Heart failure is also a common comorbidity among patients with COPD. Heart failure is a chronic, frequent, and disabling condition with high morbidity and mortality, but with a modifiable course where endothelial dysfunction and pulmonary arterial hypertension have great importance. Animal models have shown that Pneumocystis infection can cause relevant functionally changes in vascular responses in the lung, promoting the development of pulmonary hypertension. Pneumocystis colonization could be a hidden cause of worsening heart failure through it capacity to induce inflammatory response with subsequent endothelial dysfunction and pulmonary hypertension. The aim of the present study was to investigate the prevalence of Pneumocystis jirovecii colonization in heart failure patients and its possible association with reduced or preserved ejection fraction.[Methods] A cross-sectional study was carried out including 36 heart failure patients and 36 control cases. Identification of P. jirovecii colonization was performed by means of molecular techniques in oropharyngeal washing.[Results] Pneumocystis-DNA was identified in oropharyngeal washing in 1 (2.7%) of 36 heart failure patients and in 3 (8.3%) of 36 controls.[Conclusions] Pneumocystis colonization does not seem to have a role in the pathophysiology of heart failure.This work was supported by the Red Iberoamericana sobre Pneumocystosis (212RT0450) in the framework of the Ibero-American Programme for Science, Technology and Development (CYTED).Peer reviewe