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Volume 18, Number 5—May 2012

Letter

Possible Nosocomial Transmission of Pneumocystis jirovecii

Céline Damiani, Firas Choukri, Solène Le Gal, Jean Menotti, Claudine Sarfati, Gilles Nevez, Francis Derouin, and Anne TotetComments to Author 
Author affiliations: Centre Hospitalier Universitaire d’Amiens, Amiens, France (C. Damiani, A. Totet); Université de Picardie-Jules Verne, Amiens (C. Damiani, A. Totet); Hôpital Saint Louis, Paris, France (F. Choukri, J. Menotti, C. Sarfati, F. Derouin); Université Paris Diderot, Paris (F. Choukri, J. Menotti, C. Sarfati, F. Derouin); Centre Hospitalier Universitaire de Brest, Brest, France (S. Le Gal, G. Nevez); Université de Brest, Brest (S. Le Gal, G. Nevez)

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Table

Genotyping of Pneumocystis jirovecii in pairs of pulmonary and air samples from 15 patients with Pneumocystis pneumonia*

Patient no.† No. days between pulmonary and air sampling ITS genotype (no. sequenced clones)‡

DHPS genotype§
Pulmonary sample Air sample Pulmonary sample Air sample
1 6 Gg, Fg (3)¶ ND Wild ND
2 1 Ih (3) Eg (3) Wild ND
4 0 Gg (3) Gg (3) Wild Wild
5 0 Eg (3) Ec, Eg (3)¶ Wild Wild
6 0 Eg (3) Eg (3) Mutant 171# Mutant 171
7 1 Eg (3) ND Wild Wild
8 0 Eg (2) Eg (1) Wild ND
10 0 Eg (3) ND Mutant 171 ND
11 0 Be, Ec (3¶) Ec (3) Mutant 165** Mutant 165
13 2 Eg (3) ND Wild ND
15 0 Eg, Fg (3)¶ ND Wild + mutant 171 ND
16 0 Eg (3) ND Wild Wild
17 1 Ie, Ih (2) ND Wild ND
18 1 Bl (3) Bl (3) Wild + mutant 165 ND
19 0 Eg, Bl (3¶) ND Wild + mutant 165 ND

*ITS, internal transcribed spacers; DHPS, dihydropteroate synthase; ND, not determined.
†Patients are numbered as described in (6). Pulmonary samples were bronchoalveloar lavage specimens for patients 2, 4, 6, 7, 8, 10, 11, 18, and 19 and induced sputum specimens for patients 1, 5, 13, 15, 16, and 17.
P. jirovecii ITS genotype identification using sequence analysis with a prior cloning step and applying the score by Lee et al. (2).
§P. jirovecii DHPS genotype identification using a PCR restriction fragment length polymorphism assay (8).
¶Major ITS genotype, as identified in 2 of 3 clones.
#Mutant genotype with the mutation at position 171.
**Mutant genotype with the mutation at position 165.

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