Title
Pneumocystis primary infection in infancy: Additional French data and review of the literature
Date Issued
01 February 2020
Access level
open access
Resource Type
conference paper
Author(s)
Nevez G.
Guillaud-Saumur T.
Cros P.
Papon N.
Vallet S.
Quinio D.
Minoui-Tran A.
Pilorgé L.
De Parscau L.
Sizun J.
Ponce C.
Vargas S.L.
Le Gal S.
Publisher(s)
Oxford University Press
Abstract
Data on features of Pneumocystis primary infection in infancy are still fragmented. To study Pneumocystis primary infection, 192 infants who were monitored for acute pulmonary disease or fever over a 40-month period were retrospectively investigated. P. jirovecii detection on archival nasopharyngeal aspirates was performed using a qPCR assay. Factors associated with P. jirovecii were assessed using univariate and multivariate analyses. P. jirovecii genotypes in infants and a control group of adults contemporaneously diagnosed with Pneumocystis pneumonia were identified using unilocus, bilocus, and multilocus sequence typing (MLST). P. jirovecii was detected in 35 infants (18.2%). The univariate analysis pointed out four factors: viral infection (P =. 035, OR [IC 95], 2.2 [1.1-4.7]), lower respiratory tract infection (P =. 032, OR [IC 95], 2.5 [1.1-5.9]), absence of hospital discharge after birth (P =. 003, OR (IC 95), 0.1 (0.02-0.5]), and the 63-189-day group (P <. 001, OR [IC 95], 42.2 [5.4-332]). The multivariate analysis confirmed these two latter factors (P =. 02, OR [IC 95], 0.1 [0.02-0.72]; P =. 005, OR [IC 95], 11.5 [2.1-63.5]). Thus, P. jirovecii acquisition mostly takes place in the community. A comparison of these data with those of previously published studies showed that median and interquartile range of positive-infant ages were close to those observed in Chile, Denmark, and Peru, highlighting similar characteristics. Common unilocus or bilocus genotypes were identified in infants and adults, whereas no MLST genotypes were shared. Therefore, a common reservoir made up of infected infants and adults is still hypothetical. Finally, primary infection is a worldwide phenomenon occurring at the same time in childhood regardless of geographical location, rather than an incidental event.
Start page
163
End page
171
Volume
58
Issue
2
Language
English
OCDE Knowledge area
Ciencias médicas, Ciencias de la salud
Pediatría
Subjects
Scopus EID
2-s2.0-85078551982
PubMed ID
Source
Medical Mycology
ISSN of the container
13693786
Sponsor(s)
The results were reported in part at ASM Microbe meeting, New Orleans, LA, USA, June 1–5, 2018. This study was supported by the European Commission (ERANet-LAC) within the framework of the project “Recognition of the primary infection by Pneumocystis in infants: a silent threat to public health” (CAPRI-PC HID-0254).
Sources of information:
Directorio de Producción Científica
Scopus