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Volume 15, Number 10—October 2009

Research

Healthcare Worker Occupation and Immune Response to Pneumocystis jirovecii

Renuka TipirneniComments to Author , Kieran R. Daly, Leah G. Jarlsberg, Judy V. Koch, Alexandra Swartzman, Brenna M. Roth, Peter D. Walzer, and Laurence Huang
Author affiliations: San Francisco General Hospital/University of California, San Francisco, California, USA (R. Tipirneni, L.G. Jarlsberg, A. Swartzman, B.M. Roth, L. Huang); Veterans Affairs Medical Center/University of Cincinnati, Cincinnati, Ohio, USA (K.R. Daly, J.V. Koch, P.D. Walzer)

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Table 2

Bivariate associations with Pneumocystis jirovecii Msg levels*

Characteristic
No. persons
MsgA

MsgB

MsgC1
GM (95% CI)
p value
GM (95% CI)
p value
GM (95% CI)
p value
Total 126 11.8 (8.1–17.0) 2.6 (2.1–3.1) 17.8 (13.8–22.9)
Demographics
Age group, y
<30 33 12.0 (5.4–26.8) Ref 2.5 (1.7–3.7) Ref 16.3 (9.5–28.0) Ref
31–40 38 11.0 (5.7–21.3) 0.86 2.7 (1.8–3.9) 0.84 22.6 (14.9–34.4) 0.33
41–50 27 10.1 (4.5–22.4) 0.75 2.4 (1.6–3.7) 0.88 19.8 (11.6–33.7) 0.61
51–60 21 17.2 (6.3–46.4) 0.57 2.4 (1.4–4.2) 0.90 17.4 (8.8–34.3) 0.88
>60 5 12.8 (0.7–243.0) 0.95 3.3 (0.3–32.8) 0.66 4.8 (0.7–34.7) 0.11
Sex
M 54 14.3 (8.2–25.2) 0.37 2.9 (2.1–4.0) 0.26 22.7 (16.0–32.1) 0.10
F 72 10.2 (6.2–16.7) 2.3 (1.8–3.0) 14.8 (10.4–21.2)
Race
Asian 31 6.6 (3.1–14.4) 0.08 2.3 (1.6–3.3) 0.49 27.5 (17.6–42.9) 0.05
Other 92 14.4 (9.4–22.1) 2.7 (2.1–3.5) 15.3 (11.2–20.7)
Ethnicity
Hispanic/Latino 20 12.5 (5.5–28.5) 0.92 1.9 (1.3–2.7) 0.17 13.4 (6.2–29.1) 0.35
Non–Hispanic/Latino
105
11.9 (7.9–18.1)


2.7 (2.2–3.5)


18.7 (14.2–24.4)

Health conditions
Smoked
Ever 42 13.9 (7.1–27.1) 0.58 2.8 (1.9–4.1) 0.63 13.2 (8.4–20.9) 0.11
Never 83 11.2 (7.1–17.5) 2.5 (2.0–3.2) 20.5 (15.1–27.8)
Lung condition
Yes 20 11.3 (4.4–28.7) 0.88 2.5 (1.5–4.1) 0.83 14.1 (7.2–27.5) 0.45
No 105 12.2 (8.1–18.3) 2.6 (2.1–3.3) 18.5 (14.0–24.4)
Immune condition
Yes 8 13.1 (2.6–66.6) 0.90 2.9 (0.8–10.0) 0.76 24.0 (13.6–42.3) 0.26
No
117
11.9 (8.1–17.6)


2.6 (2.1–3.1)


17.3 (13.2–22.7)

Professional characteristics
Exposed to PCP patient
Ever 85 13.1 (8.3–20.7) 0.41 2.6 (2.0–3.3) 0.99 20.8 (15.8–27.3) 0.11
Never 41 9.4 (4.9–18.0) 2.6 (1.8–3.6) 12.9 (7.5–21.9)
Occupation
Clinical 103 13.4 (8.9–20.1) 0.14 2.6 (2.1–3.3) 0.80 21.1 (16.3–27.3) 0.004
Nonclinical 23 6.6 (2.6–16.6) 2.4 (1.5–4.0) 8.2 (4.0–17.0)

*Msg, major surface glycoprotein; GM, geometric mean; CI, confidence interval; Ref, reference category; PCP, P. jirovecii pneumonia. Serum antibody levels were calculated from standard curves derived by using a standard serum pool with an assigned value of 100 U; specimens below the curve were assigned the lowest possible value (1 U). Predictor variables were compared with the natural log of Msg levels using Student t test, then converted back to the original scale and presented as GM. Participants in this cross-sectional study were healthcare staff recruited during January 2007–February 2008 from San Francisco General Hospital.

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