Alanio, Alexandre ORCID: 0000-0001-9726-3082, Gits-Muselli, Maud, Guigue, Nicolas, Desnos-Ollivier, Marie, Calderon, Enrique J., Di Cave, David, Dupont, Damien ORCID: 0000-0002-6992-1073, Hamprecht, Axel ORCID: 0000-0003-1449-5780, Hauser, Philippe M., Helweg-Larsen, Jannik, Kicia, Marta ORCID: 0000-0003-0588-0644, Lagrou, Katrien, Lengerova, Martina, Matos, Olga ORCID: 0000-0001-5793-7716, Melchers, Willem J. G., Morio, Florent ORCID: 0000-0002-5859-6105, Nevez, Gilles, Totet, Anne, White, Lewis P. and Bretagne, Stephane (2017). Diversity of Pneumocystis jirovecii Across Europe: A Multicentre Observational Study. EBioMedicine, 22. S. 155 - 164. AMSTERDAM: ELSEVIER SCIENCE BV. ISSN 2352-3964

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Abstract

Pneumocystis jirovecii is an airborne human-specific ascomycetous fungus responsible for Pneumocystis pneumonia (PCP) in immunocompromised patients, affecting N500,000 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. Genotypingwas 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. (C) 2017 The Authors. Published by Elsevier B.V.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Alanio, AlexandreUNSPECIFIEDorcid.org/0000-0001-9726-3082UNSPECIFIED
Gits-Muselli, MaudUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Guigue, NicolasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Desnos-Ollivier, MarieUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Calderon, Enrique J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Di Cave, DavidUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Dupont, DamienUNSPECIFIEDorcid.org/0000-0002-6992-1073UNSPECIFIED
Hamprecht, AxelUNSPECIFIEDorcid.org/0000-0003-1449-5780UNSPECIFIED
Hauser, Philippe M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Helweg-Larsen, JannikUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kicia, MartaUNSPECIFIEDorcid.org/0000-0003-0588-0644UNSPECIFIED
Lagrou, KatrienUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lengerova, MartinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Matos, OlgaUNSPECIFIEDorcid.org/0000-0001-5793-7716UNSPECIFIED
Melchers, Willem J. G.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Morio, FlorentUNSPECIFIEDorcid.org/0000-0002-5859-6105UNSPECIFIED
Nevez, GillesUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Totet, AnneUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
White, Lewis P.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bretagne, StephaneUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-223716
DOI: 10.1016/j.ebiom.2017.06.027
Journal or Publication Title: EBioMedicine
Volume: 22
Page Range: S. 155 - 164
Date: 2017
Publisher: ELSEVIER SCIENCE BV
Place of Publication: AMSTERDAM
ISSN: 2352-3964
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
REAL-TIME PCR; KIDNEY-TRANSPLANT RECIPIENTS; TRANSCRIBED SPACER REGIONS; 4 GENOMIC REGIONS; IMMUNOCOMPROMISED PATIENTS; GENETIC DIVERSITY; CARINII; PNEUMONIA; HOMINIS; INFECTIONMultiple languages
Medicine, General & Internal; Medicine, Research & ExperimentalMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/22371

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