Evidence map›Paper›PMID 23074306›Full record

ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2013

Near-universal prevalence of Pneumocystis and associated increase in mucus in the lungs of infants with sudden unexpected death.

Sergio L Vargas, Carolina A Ponce, Miriam Gallo, Francisco Pérez, J-Felipe Astorga, Rebeca Bustamante, Magali Chabé, Isabelle Durand-Joly, Pablo Iturra, Robert F Miller and 2 more

Open access · bronzeAbstract read
In one paragraph

Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers.

0numbers the graph read from it
0cells of the map it votes in
41citing papers in PubMed
3.5field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

41 citing papers in PubMed, 63 citations in OpenAlex.

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  5. Role of the FungusInternational journal of molecular sciences · 2024
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  6. Gut Mycobiome and Asthma.Journal of fungi (Basel, Switzerland) · 2024
    Review
  7. NovelJournal of fungi (Basel, Switzerland) · 2023
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  8. Journal of fungi (Basel, Switzerland) · 2023
    Article
  9. Article
  10. Targeted NGS-Based Analysis ofJournal of fungi (Basel, Switzerland) · 2022
    Article
  11. Article
  12. Review
  13. Transmission and Colonization ofJournal of fungi (Basel, Switzerland) · 2021
    Review
  14. Pneumocystis Mating-Type Locus and Sexual Cycle during Infection.Microbiology and molecular biology reviews : MMBR · 2021
    Review
  15. The association of trimethoprim-sulfamethoxazole with improved lung function in pediatric asthma.Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology · 2021
    Article
  16. Article
  17. Diagnosis ofJournal of fungi (Basel, Switzerland) · 2020
    Article
  18. Review
  19. Review
  20. The Contribution of Host Cells toPathogens (Basel, Switzerland) · 2019
    Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors at 5 institutions in 3 countries.

Sergio L VargasPrograma de Microbiología, Instituto de Ciencias Biomédicas, Facultad de Medicina Universidad de Chile, Santiago, Chile. svargas@med.uchile.cl
Carolina A Ponce
Miriam Gallo
Francisco Pérez
J-Felipe Astorga
Rebeca Bustamante
Magali Chabé
Isabelle Durand-Joly
Pablo Iturra
Robert F Miller
El Moukthar Aliouat
Eduardo Dei-Cas
University of Chile · CLInserm · FRCentre Hospitalier Universitaire de Lille · FRInstitut Pasteur de Lille · FRUniversity College London · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPneumocystis without obvious accompanying pathology is occasionally reported in autopsied infant lungs. Its prevalence and significance are unknown. Interestingly, this mild infection induces a strong activation of mucus secretion-related genes in young immunocompetent rodents that has not been explored in infants. Excess mucus is induced by multiple airway offenders through nonspecific pathways and would explain a cofactor role of Pneumocystis in respiratory disease. We undertook characterization of the prevalence of Pneumocystis and associated mucus in infant lungs.

methodsSamples from 128 infants (mean age, 101 days) who died suddenly and unexpectedly in Santiago during 1999-2004 were examined for Pneumocystis using nested polymerase chain reaction (nPCR) amplification of the P. jirovecii mtLSU ribosomal RNA gene and immunofluorescence microscopy (IF). Pneumocystis-negative infants 28 days and older and their age-closest positives were studied for MUC5AC expression and Pneumocystis burden by Western blot and quantitative PCR, respectively.

resultsPneumocystis DNA was detected by nPCR in 105 of the 128 infants (82.0%) and Pneumocystis organisms were visualized by IF in 99 (94.3%) of the DNA-positive infants. The infection was commonest at 3-4 months with 40 of 41 (97.6%) infants of that age testing positive. MUC5AC was significantly increased in Pneumocystis-positive tissue specimens (P = .013). Death was unexplained in 113 (88.3%) infants; Pneumocystis was detected in 95 (84.0%) of them vs 10 of 15 (66.7%) with explained death (P = .28).

conclusionsA highly focal Pneumocystis infection associated to increased mucus expression is almost universally present in the lungs of infants dying unexpectedly in the community regardless of autopsy diagnosis.

Indexed as

AutopsyColony Count, MicrobialDNA, FungalFemaleHumansInfantInfant, NewbornLungMaleMicroscopyMucin 5ACMucusNucleic Acid Amplification TechniquesPneumocystisPneumonia, PneumocystisPrevalenceDNA, FungalMUC5AC protein, humanMucin 5AC

Identifiers

PMID23074306
PMCPMC3526255
OpenAlexW2164938934

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.