Colonización por pneumocystis jirovecii en pacientes en tratamiento con anti-tnf-alfa

BRIEF SUMMARY OF DOCTORAL THESIS Tittle: Pneumocystis jirovecii colonization in patients in treatment with anti-TNF drugs Authors: Conferring a doctor's degree: Isabel Martín Garrido Directors: Enrique Calderón Sandubete MD, PhD. José Manuel Varela Aguilar MD, PhD. Francisco Javier Medrano Ortega MD, PhD. Tutor: Proffesor José Ricardo Villar Ortiz Introduction: Pneumocystis pneumonia (PcP) is an important opportunistic infection, with high mortality rate, not only in patients with acquired immunodeficiency syndrome (AIDS), but also in patients with autoimmune systemic disease, hematological or solid malignancies, transplant recipients or tumors, among others. There exists data that support the idea of which the colonization by P. jirovecii constitutes a risk for development of PCP in subjects submitted to some type of immunosuppression. Tumor necrosis factor alpha (TNF¿) is a pro-inflammatory cytokine that plays a fundamentally role in the control of the Pneumocystis jirovecii infection, for it, It is possible that the effect of the anti-TNF drugs, on having disabled the action of this cytokine, could favor the colonization by P. jirovecii or as PcP's later development in the patients who receive this type of treatments. It could be interesting to know P. jirovecii colonization state in order to know whose patients could receive effective chemoprophylaxis as in tuberculosis infection. Nowadays there is not sufficient information about the frequency of P. jirovecii colonization in patient in treatment with anti-TNF drugs. Objectives: The aims of our study were to obtain information about the colonization by P. jirovecii among patients with systemic diseases treated with different anti TNF drugs and if there were differences rates of colonization by drug or underlying disease. Likewise to know the epidemiological characteristics and the potential risk factors for colonization by P. jirovecii in these patients. Design: we examined oropharingeal washes collected from 19