Xth EMOP, August 2008

Nosocomial Pneumocystis jirovecii infections

¹ Laboratoire de Parasitologie et Mycologie, Hôpital Augustin Morvan, CHU et Laboratoire de Parasitologie et Mycologie (EA 3882, Biodiversité et Écologie microbienne), Faculté de Médecine, Université de Bretagne Occidentale, (École doctorale, ED 373), Brest, France
² Institut Pasteur de Lille, (EA3609, Ecologie du Parasitisme) et Laboratoire de Parasitologie, Faculté de Pharmacie, Lille France
³ Laboratoire de Parasitologie et Mycologie, Hôpital de la Croix Rousse, CHU de Lyon et UMR 145, IRD/Université de Montpellier, France
⁴ Institut Pasteur de Lille, (EA3609, Ecologie du Parasitisme) et Service de Parasitologie-Mycologie, Centre de Biologie-Pathologie, CHRU de Lille, France
⁵ Institut de Microbiologie, Centre Hospitalier Universitaire Vaudois et Université de Lausanne, Suisse
⁶ Laboratoire de Parasitologie et Mycologie médicales, (EA3609, Ecologie du Parasitisme) CHU et Université de Picardie Jules Verne, Amiens, France

^* Correspondence: Gilles Nevez, Laboratoire de Parasitologie et Mycologie, Hôpital Augustin Morvan, CHU, F-29609 Brest, France. Tel.: 33 (0)2 98 01 33 08 – Fax: 33(0)2 98 22 39 87. E-Mail: gilles.nevez@chu-brest.fr

Abstract

Airborne transmission of Pneumocystis sp. from host to host has been demonstrated in rodent models and several observations suggest that interindividual transmission occurs in humans. Moreover, it is accepted that the Pneumocystis organisms infecting each mammalian species are host specific and that the hypothesis of an animal reservoir for Pneumocystis jirovecii (P. jirovecii), the human-specific Pneumocystis species, can be excluded. An exosaprophytic form of the fungus cannot be strictly ruled out. However, these data point toward the potential for the specific host to serve as its own reservoir and for Pneumocystis infection in humans as an anthroponosis with humans as a reservoir for P. jirovecii. This review highlights the main data on host-to-host transmission of Pneumocystis in rodent models and in humans by the airborne route and provides a rationale for considering the occurrence of nosocomial infections and measures for their prevention