Prevalence and Genotype Distribution of Pneumocystis jirovecii in Cuban Infants and Toddlers with Whooping Cough

Abstract

e This study describes the prevalence and genotype distribution of Pneumocystis jirovecii obtained from nasopharyngeal (NP) swabs from immunocompetent Cuban infants and toddlers with whooping cough (WC). A total of 163 NP swabs from 163 young Cuban children with WC who were admitted to the respiratory care units at two pediatric centers were studied. The prevalence of the organism was determined by a quantitative PCR (qPCR) assay targeting the P. jirovecii mitochondrial large subunit (mtLSU) rRNA gene. Genotypes were identified by direct sequencing of mtLSU ribosomal DNA (rDNA) and restriction fragment length polymorphism (RFLP) analysis of the dihydropteroate synthase (DHPS) gene amplicons. qPCR detected P. jirovecii DNA in 48/163 (29.4%) samples. mtLSU rDNA sequence analysis revealed the presence of three different genotypes in the population. Genotype 2 was most common (48%), followed in prevalence by genotypes 1 (23%) and 3 (19%); mixed-genotype infections were seen in 10% of the cases. RFLP analysis of DHPS PCR products revealed four genotypes, 18% of which were associated with resistance to sulfa drugs. Only contact with coughers (prevalence ratio [PR], 3.51 [95% confidence interval {CI}, 1.79 to 6.87]; P ‫؍‬ 0.000) and exposure to tobacco smoke (PR, 1.82 [95% CI, 1.14 to 2.92]; P ‫؍‬ 0.009) were statistically associated with being colonized by P. jirovecii. The prevalence of P. jirovecii in infants and toddlers with WC and the genotyping results provide evidence that this population represents a potential reservoir and transmission source of P. jirovecii.

A Molecular Window into the Biology and Epidemiology of Pneumocystis spp

“…Other potential disadvantages include challenges in interpretation of band patterns with minor differences and in data exchangeability between different laboratories. RFLP has been used most extensively to detect mutations in the dhps gene of P. jirovecii (346)(347)(348)(349)(350)(351)(352)(353)(354). Recently, RFLP was adapted to identify polymorphisms of the P. jirovecii msg repertoire (355-357); we refer to this method as msg-RFLP henceforth.…”

First data on Pneumocystis jirovecii colonization in patients with respiratory diseases in North Lebanon

“…The very low number of samples in which Pneumocystis colonization was detected limits comparison with other studies. However, it should be noted that genotype 2 was also found to be predominant in Italy (39%) [18] and in Cuba (48%) [19] . Nevertheless, our results contrasted with a Spanish study that reported a predominance of genotype 1 in patients with pulmonary diseases (45%) [11] .…”

Epidemiological Outbreaks of Pneumocystis jirovecii Pneumonia Are Not Limited to Kidney Transplant Recipients: Genotyping Confirms Common Source of Transmission in a Liver Transplantation Unit

“…Thus, alternative molecular tools (9, 10), such as multilocus sequence typing (MLST), microsatellite genotyping, or PCR-restriction fragment length polymorphism (PCR-RFLP) analysis, have been used to trace strain circulation in the context of hospitals (11)(12)(13). Microsatellite genotyping may be more appropriate for detection of mixed infections (14), and PCR-RFLP analysis of the mitochondrial large-subunit rRNA gene (mtLSU) alone has appeared to be sufficient for roughly distinguishing between strains (12, 13), but MLST has been shown to be highly reproducible and facilitates comparison of data from different laboratories (11).…”