Reply to Nevez et al.

Abstract

We appreciate the comments by Dr Nevez and coworkers regarding our article reporting the prevalence of Pneumocystis jirovecii colonization in preterm births and its potential relationship with respiratory distress syndrome [1]. They detected by mean of a quantitative polymerase chain reaction (qPCR) assay at mtLSUrRNA gene a 12.3% of P. jirovecii colonization in infants that is lower than the 25.5% of prevalence observed in our study [1, 2]. The authors think that these differences could be due to 4 causes: (i) study design (prospective vs. retrospective), (ii) the sizes of populations studied (128 vs. 81 babies), (iii) differences in PCR techniques used for DNA Pneumocystis identification, and (iv) geographical differences in P. jirovecii epidemiology . We agree with Dr Nevez and coworkers but think that mainly the lower level of colonization found in their study is explained by varying geographic exposure. In this sense, the prevalence of P. jirovecii colonization among cystic fibrosis patients from Brittany, the French region where is localized Brest, is 2.5% lower than 21.5% (P < .001) reported in cystic fibrosis patients from Seville [3, 4]. These data suggested that circulation and transmission of this fungus is more reduced in Brest than in Seville, probably due to climatic factors. Brest has a cool temperate maritime climate , whereas Seville has a hot Continental Mediterranean climate