Clinical characteristics of hospital-onset Pneumocystis pneumonia and genotypes of Pneumocystis jirovecii in a single tertiary centre in Korea
- Authors
- Kim, Tark; Lee, Sang-Oh; Hong, Hyo-Lim; Lee, Ju Young; Kim, Sung-Han; Choi, Sang-Ho; Kim, Mi-Na; Kim, Yang Soo; Woo, Jun Hee; Sung, Heungsup
- Issue Date
- 26-Feb-2015
- Publisher
- BioMed Central
- Keywords
- Pneumocystis pneumonia; Large ribosomal subunit of mitochondrial rRNA; Transmission; Epidemiology
- Citation
- BMC Infectious Diseases, v.15
- Journal Title
- BMC Infectious Diseases
- Volume
- 15
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/10867
- DOI
- 10.1186/s12879-015-0847-6
- ISSN
- 1471-2334
- Abstract
- Background: Pneumocystis pneumonia (PCP) may develop as a clinical manifestation of nosocomial pneumonia by means of either reactivation of resident Pneumocystis jirovecii or de novo infection. However, there have been no studies describing the clinical characteristics of hospital-onset PCP. Methods: A retrospective review of medical records was performed to identify episodes of hospital-onset PCP in a tertiary care centre in Korea between May 2007 and January 2013. We investigated whether human-to-human contact during hospitalisation contributed to PCP development by molecular analysis of the genes encoding mitochondrial large ribosomal subunit (mtLSU) rRNA and dihydropteroate synthase (DHPS) and a review of hospitalisation history. Results: During the study period, 129 patients (130 episodes) were diagnosed with PCP. Of these, respiratory specimens from 94 patients during 95 PCP episodes were available for analysis. Sixteen episodes (16.8%) were categorised as hospital-onset PCP. There was a trend toward a higher proportion of haematological malignancy (43.8% [7/16] vs. 20.3% [16/79]; P = 0.058) in patients with hospital-onset PCP compared to patients with community-onset PCP. mtLSU genotype 1 was the most common, occurring in 41 (43.2%) patients. There were four possible cases of nosocomial transmission. Mutation in DHPS was not observed in any PCP episode. Conclusions: PCP can be one of the causes of nosocomial pneumonia, although the mode of acquisition and transmission of Pneumocystis jirovecii remains uncertain. mtLSU genotype 1 is the predominant Pneumocystis jirovecii strain in Korea.
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