RT Journal Article
T1 Diversity of Pneumocystis jirovecii Across Europe: A Multicentre Observational Study.
A1 Alanio, Alexandre
A1 Gits-Muselli, Maud
A1 Guigue, Nicolas
A1 Desnos-Ollivier, Marie
A1 Calderon, Enrique J
A1 Di-Cave, David
A1 Dupont, Damien
A1 Hamprecht, Axel
A1 Hauser, Philippe M
A1 Helweg-Larsen, Jannik
A1 Kicia, Marta
A1 Lagrou, Katrien
A1 Lengerova, Martina
A1 Matos, Olga
A1 Melchers, Willem J G
A1 Morio, Florent
A1 Nevez, Gilles
A1 Totet, Anne
A1 White, Lewis P
A1 Bretagne, Stephane
K1 Europe
K1 Genotyping
K1 MLS typing
K1 Microsatellites
K1 Mixed infection
K1 Pneumocystis jirovecii
K1 Transmission
AB Pneumocystis jirovecii  is an airborne human -specific ascomycetous fungus responsible for  Pneumocystis   pneumonia (PCP) in immunocompromised patients , affecting >500,000 patients per year (www.gaffi.org). The understanding of its epidemiology is limited by the lack of standardised culture . Recent genotyping data suggests a limited genetic diversity of P. jirovecii. The objective of the study was to assess the diversity of P. jirovecii across European hospitals and analyse P. jirovecii diversity in respect to clinical data obtained from the patients .Genotyping was performed using six already validated short tandem repeat (STR) markers on 249 samples (median: 17 per centre interquartile range [11−20]) from PCP patients of 16 European centres.Mixtures of STR markers (i.e., ≥2 alleles for ≥1 locus) were detected in 67.6% (interquartile range [61.4; 76.5]) of the samples. Mixture was significantly associated with the underlying disease of the patient , with an increased proportion in HIV patients (78.3%) and a decreased proportion in renal transplant recipients (33.3%) (p<0.001). The distribution of the alleles was significantly different (p<0.001) according to the centres in three out of six markers. In analysable samples, 201 combinations were observed corresponding to 137 genotypes : 116 genotypes were country-specific; 12 in two; six in three; and two in four and one in five countries. Nine genotypes were recorded more than once in a given country. Genotype 123 (Gt123) was significantly associated with France (14/15, p<0.001) and Gt16 with Belgium (5/5, p<0.001). More specifically, Gt123 was observed mainly in France (14/15/16 patients ) and in renal transplant patient (13/15).Our study showed the wide population diversity across Europe , with evidence of local clusters of patients harbouring a given genotype . These data suggest a specific association between genotype and underlying disease , with evidence of a different natural history of PCP in HIV patients and renal transplant recipients .
PB The Lancet Publishing Group
YR 2017
FD 2017-06-29
LK http://hdl.handle.net/10668/11406
UL http://hdl.handle.net/10668/11406
LA en
NO Alanio A, Gits-Muselli M, Guigue N, Desnos-Ollivier M, Calderon EJ, Di Cave D, et al. Diversity of Pneumocystis jirovecii Across Europe: A Multicentre Observational Study. EBioMedicine. 2017 Aug;22:155-163.
DS RISalud
RD May 9, 2025