title: Pneumocystosis: a network survey in the Paris area 2003-2008.
abstract: The aims of this network group were to collect epidemiological data of PcP cases in 14 hospitals in the Paris area and to determine the Di-Hydro Pteroate Synthase (DHPS) genotypes, genetic markers for possible sulfamide resistance. From January 1, 2003 to December 31, 2008, 993 (mean 166/year) PcP cases have been reported. Sixty-five percent of patients were HIV-positive. The median count of CD4 lymphocytes was 32/mm(3) (30 in HIV-positive patients, 152 in HIV-negative patients). In HIV-positive patients, PcP revealed the HIV infection in 39%. Among 304 PcP occurring in HIV known infected patients, no prophylaxis was prescribed for 64%; cotrimoxazole prophylaxis had been prescribed to 47 patients but only one of them had the right compliance. In HIV-negative patients (264), corticosteroids were prescribed in 59% and cytotoxic chemotherapies in 34%; 78% did not receive prophylaxis. One hundred sixty nine tumoral pathologies and 116 transplantations were notified. The mortality rate was 16% at day 14 (13% in HIV-positive patients, 26% in HIV-negative patients). Mutations in DHPS genes were detected in 18.5% of samples; 12.5% of patients were infected with several strains. The total annual number of cases has been stable for five years but the proportion of HIV-negative patients increased from 25% to 43%.
authors.affiliation: Hôpital St Antoine, Assistance Publique-Hôpitaux de Paris, Université Paris Descartes, Paris, France. denis.magne@sat.aphp.fr
authors.forename: D
authors.initials: D
authors.lastname: Magne
authors.forename: A
authors.initials: A
authors.lastname: Angoulvant
authors.forename: F
authors.initials: F
authors.lastname: Botterel
authors.forename: C
authors.initials: C
authors.lastname: Bouges-Michel
authors.forename: M-E
authors.initials: ME
authors.lastname: Bougnoux
authors.forename: P
authors.initials: P
authors.lastname: Bouree
authors.forename: C
authors.initials: C
authors.lastname: Chochillon
authors.forename: M
authors.initials: M
authors.lastname: Cornet
authors.forename: E
authors.initials: E
authors.lastname: Dannaoui
authors.forename: A
authors.initials: A
authors.lastname: Fekkar
authors.forename: G
authors.initials: G
authors.lastname: Galeazzi
authors.forename: H
authors.initials: H
authors.lastname: Yera
authors.forename: C
authors.initials: C
authors.lastname: Sarfati
authors.forename: P
authors.initials: P
authors.lastname: Roux
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D000935:Antifungal Agents / Q000494:pharmacology; D000970:Antineoplastic Agents / Q000008:administration & dosage; D018791:CD4 Lymphocyte Count; D015897:Comorbidity; D004094:Dihydropteroate Synthase / Q000235:genetics; D025141:Drug Resistance, Fungal; D005260:Female; D005838:Genotype; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology; D006761:Hospitals; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy / Q000453:epidemiology; D010297:Paris / Q000453:epidemiology; D045363:Pneumocystis carinii / Q000145:classification / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification*; D011020:Pneumonia, Pneumocystis / Q000453:epidemiology* / Q000382:microbiology; D013424:Sulfanilamides / Q000494:pharmacology; D014180:Transplantation
chemical_list: D000305:Adrenal Cortex Hormones; D000935:Antifungal Agents; D000970:Antineoplastic Agents; D013424:Sulfanilamides; D004094:Dihydropteroate Synthase