Abstract
The reservoir and mode of transmission of Pneumocystis jirovecii remain uncertain. We conducted a cross-sectional study of 126 San Francisco General Hospital staff in clinical (n = 103) and nonclinical (n = 23) occupations to assess whether occupational exposure was associated with immune responses to P. jirovecii. We examined antibody levels by ELISA for 3 overlapping fragments that span the P. jirovecii major surface glycoprotein (Msg): MsgA, MsgB, and MsgC1. Clinical occupation participants had higher geometric mean antibody levels to MsgC1 than did nonclinical occupation participants (21.1 vs. 8.2, p = 0.004); clinical occupation was an independent predictor of higher MsgC1 antibody levels (parameter estimate = 0.89, 95% confidence interval 0.29-1.48, p = 0.003). In contrast, occupation was not significantly associated with antibody responses to either MsgA or MsgB. Healthcare workers may have occupational exposure to P. jirovecii. Humans may be a reservoir for P. jirovecii and may transmit it from person to person.
Highlights
The reservoir and mode of transmission of Pneumocystis jirovecii remain uncertain
We investigated whether healthcare workers (HCWs) occupation was associated with immune response to P. jirovecii
When a person is repeatedly exposed to P. jirovecii, MsgC1 possibly acts as a recall antigen and elicits higher amnestic responses than primary antigens, such as MsgA and MsgB
Summary
The reservoir and mode of transmission of Pneumocystis jirovecii remain uncertain. Humans may be a reservoir for P. jirovecii and may transmit it from person to person. Several studies have found that P. jirovecii can colonize immunocompetent humans and suggest that such persons may serve as potential reservoirs [24]. The question that arises is whether person-to-person transmission occurs through immunocompetent hosts, such as HCWs, who may be transiently colonized with P. jirovecii during brief clinical interactions with PCP patients and subsequently transmit the infection to other immunocompromised patients. Pneumocystis jirovecii Immune Responses across studies [25,26,27,28,29,30,31] These studies compared different groups of HCWs and did not include a control group without patient contact
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