TITLE:
Prevalence of Pneumocystis jirovecii in Smear Negative Sputum Samples at the Coast General Teaching and Refferral Hospital in Kenya
AUTHORS:
Anne Saitoti, Fred Wamunyokoli, Christine Bii
KEYWORDS:
Pneumocystis jirovecii, Nested PCR, Pulmonary tuberculosis, Smear Negative
JOURNAL NAME:
Journal of Tuberculosis Research,
Vol.12 No.4,
December
9,
2024
ABSTRACT: Pneumcystis jirovecii is a pathogen that causes Pneumocystis pneumonia (PCP), an infection in (HIV/ADS) and other immunocompromised patients. The rare reports of P. jirovecii pneumonia in sub-Saharan Africa are controversial due to the high HIV/AIDS seropositivity. The study determined the significance of P. jirovecii in TB smear negative retreatment patients at the Coast General Teaching Referral Hospital-Mombasa. Sputum samples were subjected to toluidine blue O(TBO) stain for microscopy and polymerase chain reaction (PCR). A total of 100 TB smear negative participants were enrolled in the study and expectorated sputum was collected. Out of the 100 patients, 63 men and 37 women. Patients aged 31 to 53 made up 62% of the patients. The patients aged 31 to 53 made up 75% of the patients (Min = 11y, Max = 85y). The median age of the patients was 42 years. Nested PCR has a prevalence of 41% (41 instances). TBO staining has a prevalence of 29% (29 instances). Detecting an additional 13 more patients than toluidine O staining technique. The sensitivity of toluidine blue O staining was 33.82%, which indicates that it correctly identified 33.82% of true positive cases compared to PCR. The specificity of toluidine blue O staining was 97.82%, indicating that it had a high ability to correctly identify true negative cases compared to PCR, suggesting that it was good at ruling out non-P. jirovecii cases. The study confirms that P. jirovecii is as a significant cause of persistent symptoms in TB patients that could be responsible for persistent symptoms despite TB treatment. We recommend fungal diagnostics in such patients before retreatment.