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首页> 外文期刊>Journal of Clinical Microbiology >Epidemiological Outbreaks of Pneumocystis jirovecii Pneumonia Are Not Limited to Kidney Transplant Recipients: Genotyping Confirms Common Source of Transmission in a Liver Transplantation Unit
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Epidemiological Outbreaks of Pneumocystis jirovecii Pneumonia Are Not Limited to Kidney Transplant Recipients: Genotyping Confirms Common Source of Transmission in a Liver Transplantation Unit

机译：吉罗氏肺孢子虫肺炎的流行病学暴发并不局限于肾脏移植受者：基因分型证实了肝移植单元中常见的传播来源

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Over a 5-month period, four liver transplant patients at a single hospital were diagnosed with Pneumocystis jirovecii pneumonia (PCP). This unusually high incidence was investigated using molecular genotyping. Bronchoalveolar lavage fluids (BALF) obtained from the four liver recipients diagnosed with PCP were processed for multilocus sequence typing (MLST) at three loci (SOD, mt26s, and CYB). Twenty-four other BALF samples, which were positive for P. jirovecii and collected from 24 epidemiologically unrelated patients with clinical signs of PCP, were studied in parallel by use of the same method. Pneumocystis jirovecii isolates from the four liver recipients all had the same genotype, which was different from those of the isolates from all the epidemiologically unrelated individuals studied. These findings supported the hypothesis of a common source of contamination or even cross-transmission of a single P. jirovecii clone between the four liver recipients. Hospitalization mapping showed several possible encounters between these four patients, including outpatient consultations on one particular date when they all possibly met. This study demonstrates the value of molecular genotyping of P. jirovecii isolated from clinical samples for epidemiological investigation of PCP outbreaks. It is also the first description of a common source of exposure to a single P. jirovecii clone between liver transplant recipients and highlights the importance of prophylaxis in such a population.
机译：在5个月的时间里，在一家医院中有4名肝移植患者被诊断出患有吉氏肺孢子虫肺炎（PCP）。使用分子基因分型法研究了这种异常高的发病率。从四个诊断为PCP的肝脏接受者获得的支气管肺泡灌洗液（BALF）在三个基因座（ SOD ，mt26s和 CYB ）进行多基因座序列分型（MLST）。使用相同的方法对另外24例BALF样本进行了平行研究，该样本对jirovecii阳性，并从24例具有PCP临床症状的与流行病学无关的患者中采集。来自四个肝脏接受者的猪肺炎双孢杆菌分离株均具有相同的基因型，这与来自所有与流行病学无关的个体的分离株不同。这些发现支持了在四个肝脏接受者之间单一的罗氏疟原虫克隆的常见污染源甚至交叉传播的假说。住院地图显示这四名患者之间有几次可能的相遇，包括在某个特定日期都可能会面时进行的门诊。这项研究证明了从临床样本中分离出的吉氏疟原虫的分子基因分型对于PCP爆发的流行病学研究具有价值。这也是对肝移植受者之间暴露于单个罗威毕赤酵母克隆的常见暴露源的首次描述，并强调了在此类人群中进行预防的重要性。

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