Pulmonary Colonization with Pneumocystis cariniiin Human Immunodeficiency Virus-Negative Patients: Assessing Risk with Blood CD4+ T Cell Counts

Nevez, Gilles; Raccurt, C. P.; Vincent, P; Jounieaux, Vincent; Dei‐Cas, Eduardo

doi:10.1086/313478

Cited by 71 publications

(58 citation statements)

References 5 publications

(1 reference statement)

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“…P. carinii colonisation in HIV-positive homosexual men was shown to be associated with a low peripheral CD4+ cell count ,400=ìl [15]. The mean CD4+ cell counts among the colonised immunosuppressed individuals with and without HIV infection (58.6 and 281.5/ ìl, respectively) in the present study were consistent with the data from the latter reports [14,15]. No significant difference in the presence of PCP prophylaxis was found between the colonised patients with and without HIV infection in the present study.…”

Section: Discussionsupporting

confidence: 91%

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Pneumocystis carinii carriage in immunocompromised patients with and without human immunodeficiency virus infection

Takahashi¹,

Goto²,

Endo³

et al. 2002

Journal of Medical Microbiology

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Eighty-one bronchoalveolar lavage (BAL) specimens obtained from 26 HIV-infected, 45 non-HIV immunosuppressed and 10 immunocompetent patients with primary pulmonary diseases were analysed for the presence of Pneumocystis carinii by staining and by P. carinii 5S rDNA determined by PCR. P. carinii was observed by staining of BAL specimens from HIV-infected patients significantly more frequently than those from immunocompromised hosts without HIV infection (57.7% versus 20.0%, respectively). P. carinii 5S rDNA was detected by PCR assay in seven (26.9%) HIV-infected individuals, which was significantly more frequent than for four (8.9%) immunosuppressed patients without HIV infection, for whom staining was negative. None of these patients developed P. carinii pneumonia (PCP) within the follow-up period. BAL specimens from 10 immunocompetent patients with pulmonary disorders were negative for PCP by both staining and PCR assay.

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Section: Discussionsupporting

confidence: 91%

“…It has been reported that blood CD4+ cell counts ,400=ìl seem to pose an increasing risk for pulmonary colonisation with P. carinii among patients without HIV infection [14]. P. carinii colonisation in HIV-positive homosexual men was shown to be associated with a low peripheral CD4+ cell count ,400=ìl [15].…”

Section: Discussionmentioning

confidence: 99%

Pneumocystis carinii carriage in immunocompromised patients with and without human immunodeficiency virus infection

Takahashi¹,

Goto²,

Endo³

et al. 2002

Journal of Medical Microbiology

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“…Indeed, several populations have been identified as being colonized by the fungus. Low burden of P. jirovecii organisms have been detected using PCR assays in patients with various levels of immunodeficiency (Nevez et al, 1999a;Nevez et al, 1999b), with acute or chronic pulmonary diseases (Calderon et al, 1996;Armbruster et al, 1997;Sing et al, 1999b;Nevez et al, 2002), immunonaive infants with P. jirovecii primary infection (Nevez et al, 2001a, Vargas et al, 2001, pregnant women with physiological immunity changes (Vargas et al, 2003), and health care workers in contact with patients with PCP (Miller et al, 2001, Durand-Joly et al, 2003, reviewed in Peterson et al, 2005. In fact, Pneumocystis infections can have a large spectrum of presentations, of which PCP in immunocompromised patients may represent only a part, while mild infections such as colonization may constitute the major part.…”

Section: Colonized Subjects As Potential Sources Of P Jiroveciimentioning

confidence: 99%

NosocomialPneumocystis jiroveciiinfections

et al. 2008

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Summary :Airborne transmission of Pneumocystis sp. from host to host has been demonstrated in rodent models and several observations suggest that interindividual transmission occurs in humans. Moreover, it is accepted that the Pneumocystis organisms infecting each mammalian species are host specific and that the hypothesis of an animal reservoir for Pneumocystis jirovecii (P. jirovecii), the human-specific Pneumocystis species, can be excluded. An exosaprophytic form of the fungus cannot be strictly ruled out. However, these data point toward the potential for the specific host to serve as its own reservoir and for Pneumocystis infection in humans as an anthroponosis with humans as a reservoir for P. jirovecii. This review highlights the main data on host-to-host transmission of Pneumocystis in rodent models and in humans by the airborne route and provides a rationale for considering the occurrence of nosocomial infections and measures for their prevention KEY WORDS : Pneumocystis jirovecii, nosocomial infections, genotyping.

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“…Actually, it has been shown that pulmonary colonization with P. jiroveci occurs frequently in immunocompromised patients (20,25) and less frequently in persons who are apparently immunocompetent but who are suffering from lung disease (2,33). In a recent report, it was also shown that P. jiroveci organisms can transiently parasitize immunocompetent health care workers in close contact with PCP patients (23).…”

Section: Jiroveci Its Types In Infants 1175mentioning

confidence: 99%

Genotypes at the Internal Transcribed Spacers of the Nuclear rRNA Operon of Pneumocystis jiroveci in Nonimmunosuppressed Infants without Severe Pneumonia

Totet¹,

Pautard

Raccurt³

et al. 2003

J Clin Microbiol

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The frequency of Pneumocystis jiroveci (human-derived Pneumocystis) in immunocompetent infants developing acute respiratory syndromes has recently been evaluated and has been shown to be close to 25%. Until now, there have been no data on the genomic characteristics of the fungus in these patients, while molecular typing of P. jiroveci organisms was mostly performed with samples from immunosuppressed patients with pneumocystosis (Pneumocystis carinii pneumonia [PCP]). The present report describes the genotypes of P. jiroveci organisms in 26 nonimmunosuppressed infants developing a mild Pneumocystis infection contemporaneously with an episode of bronchioloalveolitis. The typing was based on sequence analysis of internal transcribed spacers (ITSs) 1 and 2 of the rRNA operon, followed by the use of two typing scores. By use of the first score, 11 P. jiroveci ITS types were identified: 10 were previously reported in immunosuppressed patients with PCP, while 1 was newly described. By use of the second score, 13 types were identified, of which 2 were newly described. The most frequent type was identified as type B 1 a 3 (first score), which corresponds to type Eg (second score). Mixed infections were diagnosed in three infants. The occurrence of such diversity of P. jiroveci ITS types, an identical main type, and mixed infections has previously been reported in immunosuppressed patients with PCP. Thus, the P. jiroveci ITS genotypes detected in immunocompetent infants and immunosuppressed patients developing different forms of Pneumocystis infection share characteristics, suggesting that both groups of individuals make up a common human reservoir for the fungus. Finally, the frequency of P. jiroveci in nonimmunosuppressed infants with acute respiratory syndromes and the genotyping results provide evidence that this infant population is an important reservoir for the fungus.

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Pulmonary Colonization with Pneumocystis cariniiin Human Immunodeficiency Virus-Negative Patients: Assessing Risk with Blood CD4+ T Cell Counts

Cited by 71 publications

References 5 publications

Pneumocystis carinii carriage in immunocompromised patients with and without human immunodeficiency virus infection

Pneumocystis carinii carriage in immunocompromised patients with and without human immunodeficiency virus infection

NosocomialPneumocystis jiroveciiinfections

Genotypes at the Internal Transcribed Spacers of the Nuclear rRNA Operon of Pneumocystis jiroveci in Nonimmunosuppressed Infants without Severe Pneumonia

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