Diversity of Pneumocystis jirovecii Across Europe: A Multicentre Observational Study
Pneumocystis jirovecii is an airborne human-specific ascomycetous fungus responsible for Pneumocystis pneumonia (PCP) in immunocompromised patients, affecting >500,000 patients per year (www.gaffi.org). The understanding of its epidemiology is limited by the lack of standardised culture. Recent g...
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| Format: | Article |
| Language: | English |
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Elsevier
2017-08-01
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| Series: | EBioMedicine |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352396417302621 |
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| author | Alexandre Alanio Maud Gits-Muselli Nicolas Guigue Marie Desnos-Ollivier Enrique J. Calderon David Di Cave Damien Dupont Axel Hamprecht Philippe M. Hauser Jannik Helweg-Larsen Marta Kicia Katrien Lagrou Martina Lengerova Olga Matos Willem J.G. Melchers Florent Morio Gilles Nevez Anne Totet Lewis P. White Stéphane Bretagne |
| author_facet | Alexandre Alanio Maud Gits-Muselli Nicolas Guigue Marie Desnos-Ollivier Enrique J. Calderon David Di Cave Damien Dupont Axel Hamprecht Philippe M. Hauser Jannik Helweg-Larsen Marta Kicia Katrien Lagrou Martina Lengerova Olga Matos Willem J.G. Melchers Florent Morio Gilles Nevez Anne Totet Lewis P. White Stéphane Bretagne |
| author_sort | Alexandre Alanio |
| collection | DOAJ |
| description | Pneumocystis jirovecii is an airborne human-specific ascomycetous fungus responsible for Pneumocystis pneumonia (PCP) in immunocompromised patients, affecting >500,000 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.
Genotyping was 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. |
| first_indexed | 2024-12-13T08:07:17Z |
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| institution | Directory Open Access Journal |
| issn | 2352-3964 |
| language | English |
| last_indexed | 2024-12-13T08:07:17Z |
| publishDate | 2017-08-01 |
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| series | EBioMedicine |
| spelling | doaj.art-3ff76584905b403481aebab08285d62c2022-12-21T23:54:18ZengElsevierEBioMedicine2352-39642017-08-0122C15516310.1016/j.ebiom.2017.06.027Diversity of Pneumocystis jirovecii Across Europe: A Multicentre Observational StudyAlexandre Alanio0Maud Gits-Muselli1Nicolas Guigue2Marie Desnos-Ollivier3Enrique J. Calderon4David Di Cave5Damien Dupont6Axel Hamprecht7Philippe M. Hauser8Jannik Helweg-Larsen9Marta Kicia10Katrien Lagrou11Martina Lengerova12Olga Matos13Willem J.G. Melchers14Florent Morio15Gilles Nevez16Anne Totet17Lewis P. White18Stéphane Bretagne19Laboratoire de Parasitologie-Mycologie, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Paris, FranceLaboratoire de Parasitologie-Mycologie, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Paris, FranceLaboratoire de Parasitologie-Mycologie, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Paris, FranceInstitut Pasteur, CNRS, Unité de Mycologie Moléculaire, Centre National de Référence Mycoses Invasives et Antifongiques, URA3012, Paris, FranceCIBER de Epidemiología y Salud Pública, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío, CSIC, Universidad de Sevilla, SpainDepartment of Clinical Sciences and Translational Medicine, University of Rome “Tor Vergata”, ItalyHospices Civils de Lyon, Institut des Agents Infectieux, Parasitologie Mycologie, Hôpital de la Croix-Rousse, Integrative Physiology of the Brain Arousal Systems, Centre de Recherche en Neurosciences de Lyon, INSERM U1028-CNRS UMR 5292, Faculté de Médecine, Université Claude Bernard Lyon 1, Lyon F-69000, FranceInstitute for Medical Microbiology, Immunology and Hygiene, University Hospital Cologne, GermanyInstitute of Microbiology, Lausanne University Hospital, University of Lausanne, Lausanne, SwitzerlandDepartment of Infectious Diseases, Rigshospitalet-Copenhagen University Hospital, Copenhagen, DenmarkDepartment of Biology & Medical Parasitology, Wroclaw Medical University, Wroclaw, PolandDepartment of Microbiology and Immunology, Catholic University Leuven, Leuven, Belgium and National Reference Centre for Mycosis, Department of Laboratory Medicine, University Hospitals Leuven, Leuven, BelgiumDepartment of Internal Medicine - Hematology and Oncology, University Hospital Brno, Brno, Czech RepublicTB, HIV and Opportunistic Diseases and Pathogens, Global Health and Tropical Medicine, Lisboa, PortugalDepartment of medical microbiology, Radboud University Medical Centre, Nijmegen, The NetherlandsParasitology and Mycology laboratory, Nantes University Hospital, Nantes, FranceUniversity of Brest, GEIHP EA 3142, Laboratory of Parasitology and Mycology, Brest University Hospital, Brest, FranceUniversity of Picardy-Jules Verne, EA 4285 UMR-I 01 INERIS, Department of Parasitology and Mycology, Amiens University Hospital, Amiens, FrancePublic Health Wales, Microbiology Cardiff, UHW, Heath Park, Cardiff, UKLaboratoire de Parasitologie-Mycologie, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Paris, FrancePneumocystis jirovecii is an airborne human-specific ascomycetous fungus responsible for Pneumocystis pneumonia (PCP) in immunocompromised patients, affecting >500,000 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. Genotyping was 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.http://www.sciencedirect.com/science/article/pii/S2352396417302621Pneumocystis jiroveciiGenotypingEuropeTransmissionMixed infectionMLS typingMicrosatellites |
| spellingShingle | Alexandre Alanio Maud Gits-Muselli Nicolas Guigue Marie Desnos-Ollivier Enrique J. Calderon David Di Cave Damien Dupont Axel Hamprecht Philippe M. Hauser Jannik Helweg-Larsen Marta Kicia Katrien Lagrou Martina Lengerova Olga Matos Willem J.G. Melchers Florent Morio Gilles Nevez Anne Totet Lewis P. White Stéphane Bretagne Diversity of Pneumocystis jirovecii Across Europe: A Multicentre Observational Study EBioMedicine Pneumocystis jirovecii Genotyping Europe Transmission Mixed infection MLS typing Microsatellites |
| title | Diversity of Pneumocystis jirovecii Across Europe: A Multicentre Observational Study |
| title_full | Diversity of Pneumocystis jirovecii Across Europe: A Multicentre Observational Study |
| title_fullStr | Diversity of Pneumocystis jirovecii Across Europe: A Multicentre Observational Study |
| title_full_unstemmed | Diversity of Pneumocystis jirovecii Across Europe: A Multicentre Observational Study |
| title_short | Diversity of Pneumocystis jirovecii Across Europe: A Multicentre Observational Study |
| title_sort | diversity of pneumocystis jirovecii across europe a multicentre observational study |
| topic | Pneumocystis jirovecii Genotyping Europe Transmission Mixed infection MLS typing Microsatellites |
| url | http://www.sciencedirect.com/science/article/pii/S2352396417302621 |
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