Abstract
To date, investigations of Pneumocystis jiroveci circulation in the human reservoir through the dihydropteroate synthase (DHPS) locus analysis have only been conducted by examining P. jirovecii isolates from immunosuppressed patients with Pneumocystis pneumonia (PCP). Our study identifies P. jirovecii genotypes at this locus in 33 immunocompetent infants colonized with P. jirovecii contemporaneously with a bronchiolitis episode and in 13 adults with PCP; both groups of patients were monitored in Amiens, France. The results have pointed out identical features of P. jirovecii DHPS genotypes in the two groups, suggesting that in these two groups, transmission cycles of P. jirovecii infections are linked. If these two groups represent sentinel populations for P. jirovecii infections, our results suggest that all persons parasitized by P. jirovecii, whatever their risk factor for infection and the form of parasitism they have, act as interwoven circulation networks of P. jirovecii.
Highlights
To date, investigations of Pneumocystis jirovecii circulation in the human reservoir through the dihydropteroate synthase (DHPS) locus analysis have only been conducted by examining P. jirovecii isolates from immunosuppressed patients with Pneumocystis pneumonia (PCP)
Genotyping of P. jirovecii at the internal transcribed spacer (ITS) locus showed that these infants were infected with similar genotypes as those previously reported in compromised hosts with PCP; this similarity is compatible with the hypothesis that both groups of patients make up a common human reservoir for the fungus [19]
Most studies on P. jirovecii DHPS genotyping have focused on the relationship between P. jirovecii DHPS mutants and prior sulfonamide exposure on the one hand, and PCP outcome on the other hand [2,3,4,5,6,7,8,9,10,11,12,13,22,23,24]
Summary
Investigations of Pneumocystis jirovecii circulation in the human reservoir through the dihydropteroate synthase (DHPS) locus analysis have only been conducted by examining P. jirovecii isolates from immunosuppressed patients with Pneumocystis pneumonia (PCP). The existence of similar genomic characteristics at another locus, in particular at the DHPS locus, among P. jirovecii isolates from these two groups would provide additional arguments in favor of the fungus’ circulating within a reservoir made up of persons with different clinical forms of P. jirovecii infection. For these reasons, we retrospectively investigated for DHPS genotyping archival P. jirovecii isolates from immunocompetent infants colonized with P. jirovecii and from immunocompromised adults with PCP. The results of this study were reported in part in a conference report [20]
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