Genetic diversity of Pneumocystis carinii in HIV-positive and -negative patients as revealed by PCR-SSCP typing.
OBJECTIVE
To describe the epidemiology of severe Pneumocystis carinii pneumonia (PCP) in HIV-infected and non HIV-infected patients.


METHODS
Bronchoalveolar lavage specimens from 212 European patients with PCP were typed using PCR--single strand conformation polymorphism analysis of four genomic regions of P. carinii f. sp. hominis. Demographic and clinical information was obtained from all patients.


RESULTS
Twenty-three per cent of the patients were presumably infected with a single P. c. hominis type. The other patients presented with two (50%) or more (27%) types. Thirty-five genetically stable and ubiquitous P. c. hominis types were found. Their frequency ranged from 0.4% to 10% of all isolates, and up to 15% of those from a given hospital. There was no significant association between the P. c. hominis type or number of co-infecting types per patient and geographical location, year of collection, sex, age, or HIV status. No more than three patients infected with the same type were observed in the same hospital within the same 6 month period, and no epidemiological link between the cases was found.


CONCLUSIONS
The broad diversity of types observed seems to indicate that multiple sources of the pathogen co-exist. There was no evidence that in our study population inter-human transmission played a significant role in the epidemiology of P. carinii.
Division autonome de Médecine Préventive Hospitalière, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
P M
PM
Hauser
D S
DS
Blanc
P
P
Sudre
E
E
Senggen Manoloff
A
A
Nahimana
J
J
Bille
R
R
Weber
P
P
Francioli
D018893:Bronchoalveolar Lavage; D001992:Bronchoalveolar Lavage Fluid / Q000382:microbiology; D005819:Genetic Markers; D014644:Genetic Variation; D005838:Genotype; D018023:HIV Seronegativity; D006679:HIV Seropositivity / Q000150:complications* / Q000382:microbiology; D006801:Humans; D017720:Molecular Epidemiology; D011010:Pneumocystis / Q000145:classification / Q000235:genetics*; D011020:Pneumonia, Pneumocystis / Q000150:complications / Q000453:epidemiology / Q000382:microbiology*; D016133:Polymerase Chain Reaction; D018807:Polymorphism, Single-Stranded Conformational; D013997:Time Factors
D005819:Genetic Markers