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Typing of Pneumocystis jirovecii by multilocus sequencing: evidence of outbreak?

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Abstract

Different reports of Pneumocystis jirovecii pneumonia (PcP) outbreaks on oncology and transplant units suggest the possibility of a person-to-person transmission. Based on these reports, we searched retrospectively for possible PcP clusters in UZ Leuven in 2013. A movement and transmission map was established for all patients (n = 21) with a positive PcP PCR on BAL fluid. BAL fluid samples from all patients with a positive PCR on the mitochondrial large subunit mRNA of P. jirovecii and possible cross exposure were typed with multilocus sequence typing (MLST). Five patients with a positive PcP PCR could have contact with another PcP patient. Another five patients with a weak positive PcP PCR on BAL fluid during the same period were also included. Based on the MLST typing of the BAL samples of these ten patients, there was no evidence of a PcP outbreak in UZ Leuven in 2013. MLST has proven to be a useful tool in genotyping and outbreak detection. From this case series, it could be concluded that current infection control precautions for P. jirovecii are appropriate in UZ Leuven. However, there is need for an international Pneumocystis database and more clarity in the geographic distribution of different P. jirovecii genotypes.

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Authors and Affiliations

  1. Department of Microbiology and Immunology, KU Leuven – University of Leuven, B-3000, Leuven, Belgium

    M. Depypere, V. Saegeman & K. Lagrou

  2. Department of Laboratory Medicine and National Reference Center for Medical Mycology, University Hospitals Leuven, B-3000, Leuven, Belgium

    K. Lagrou

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  1. M. Depypere
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  2. V. Saegeman
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  3. K. Lagrou
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Correspondence to M. Depypere.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

For this type of study formal consent is not required.

Informed consent

Informed consent was not obtained, because of the retrospective character of the study and no mention of personal patient information. Leftovers of stored broncho-alveolar lavage fluids were used for analysis. Ethical approval was given by the ethical board hospital hygiene of the Catholic University Leuven, approved on March 20, 2015, without need for informed consent of the patients.

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Depypere, M., Saegeman, V. & Lagrou, K. Typing of Pneumocystis jirovecii by multilocus sequencing: evidence of outbreak?. Eur J Clin Microbiol Infect Dis 35, 911–916 (2016). https://doi.org/10.1007/s10096-016-2615-y

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  • DOI: https://doi.org/10.1007/s10096-016-2615-y

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