Pneumocystis jiroveciihaplotypes at the internal transcribed spacers of the rRNA operon in French HIV-negative patients with diverse clinical presentations ofPneumocystisinfections

Abstract

Pneumocystis jirovecii, a transmissible fungus, is the causative agent of pulmonary infections. Its genomic diversity has appeared in reports from around the world but data on P. jirovecii genotypes in France are still limited. This study describes the typing of P. jirovecii isolates from 81 HIV-negative patients monitored at Brest University Hospital, Brittany, France, 40 of whom developed Pneumocystis pneumonia (PcP), and remaining 41 patients were colonized by the fungus. The isolates were assayed at the internal transcribed spacer (ITS)1 and ITS2 under improved amplification conditions to avoid in vitro ITS recombination. P. jirovecii ITS haplotypes were identified in 56/81 patients (31 PcP patients and 25 patients who were colonized) which revealed a high diversity in that 27 different haplotypes were identified. Eg was the most frequent haplotype (31/56, 55.3%), followed by Ec and Ai (5/56, 8.9% each). In contrast, Ne, usually the second most frequent haplotype in Europe and the USA, was observed in only 2/56 patients (3.6%). Mixed infections were detected in 18/56 patients (32.1%; 12 PcP patients and six who were colonized). No significant differences were observed in haplotype diversity, frequency of peculiar haplotypes, and mixed infection occurrence, between the two patient populations. The study, conducted with the largest HIV-negative patient population investigated so far, shows that ITS typing remains an efficient method for characterizing P. jirovecii among human populations, whatever their clinical presentation of Pneumocystis infections.

Molecular epidemiology of Pneumocystis jiroveci in human immunodeficiency virus-positive and -negative immunocompromised patients in The Netherlands

“…In our study, one previously undescribed subtype was found, ITS type Bj. None of the ITS typed samples suggested mixed infection, in contrast to a large percentage of mixed infections found in other studies (Matsumura et al , 2011; Le Gal et al , 2013; Rabodonirina et al , 2013; Sheikholeslami et al , 2013).…”

“…However, in a recent study conducted in Iran, no difference was shown in the most prevalent subtype in patients either infected with HIV, or with an underlying malignancy or with an acute exacerbation of chronic obstructive pulmonary disease (Sheikholeslami et al , 2013). A recent French study (Le Gal et al , 2013) showed a high percentage of Ec and Ai (8.9 % each) in HIV-negative patients either colonized with P. jiroveci or suffering from PCP. In our study, both HIV-positive and HIV-negative patients were included.…”

Genetic Polymorphisms of 3 Cases Pneumocystis jirovecii in Shanxi Province PR China

“…So far, the epidemiological studies on P. jirovecii ITS genotypes in Europe, Africa, America and other Asian countries showed that there have been at least 62 ITS genotypes reported in GenBank [1]. Genotype 1 was the most common ITS genotypes based on worldwide studies [18][19][20][21][22][23]. The most prevalent genotype of ITS in Japan was Genotype 10 [24], which was observed in our study.…”

Pneumocystis jirovecii in Patients With Cystic Fibrosis: A Review

“…Thus, the presence of genotype 2 in the aforementioned CF infant may reflect particular geographical characteristics of the fungus in infants living in this region. ITS haplotype Jf has rarely been described in France, whatever the patient population (range, 0–7.5%), whereas Eg is the most frequent haplotype (range, 42.8–64.5%) (Nevez, 2003 ; Le Gal et al, 2013b , 2015b ). The presence of type Jf in this infant could simply be a random event.…”