Circulation of Pneumocystis dihydropteroate synthase mutants in France.
Data on the prevalence of Pneumocystis jirovecii (P. jirovecii) dihydropteroate synthase (DHPS) mutants in France are still limited. In this study, mutant prevalence in the Brest region (western France) was determined. Archival pulmonary specimens from 85 patients infected with P. jirovecii and admitted to our institution (University Hospital, Brest) from October 2007 to February 2010 were retrospectively typed at the DHPS locus using a polymerase chain reaction-restriction fragment length polymorphism assay. Type identification was successful in 66 of 85 patients. Sixty-four patients were infected with a wild type, whereas mutants were found in 2 patients (2/66, 3%). Medical chart analysis revealed that these 2 patients usually lived in Paris. Another patient usually lived on the French Riviera, whereas 63 patients were from the city of Brest. Thus, the corrected prevalence of mutants in patients who effectively lived in our geographic area was 0% (0/63). Taking into account that i) Paris is characterized by a high prevalence of mutants from 18.5% to 40%, ii) infection diagnoses were performed in the 2 Parisians during their vacation <30 days, iii) infection incubation is assumed to last about 2 months, the results provide evidence of mutant circulation from Paris to Brest through infected vacationers. The study shows that the usual city of patient residence, rather than the city of infection diagnosis, is a predictor of mutants and that P. jirovecii infections involving mutants do not represent a public health issue in western France.
UEB, University of Brest, LUBEM EA 3882, SFR 148, Brest, France. solene.legal@chu-brest.fr
Solène
S
Le Gal
Céline
C
Damiani
Maëla
M
Perrot
Amélie
A
Rouillé
Michèle
M
Virmaux
Dorothée
D
Quinio
Elodie
E
Moalic
Philippe
P
Saliou
Christian
C
Berthou
Yann
Y
Le Meur
Anne
A
Totet
Gilles
G
Nevez
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D004094:Dihydropteroate Synthase / Q000235:genetics*; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D017720:Molecular Epidemiology; D058889:Molecular Typing; D050505:Mutant Proteins / Q000235:genetics*; D045363:Pneumocystis carinii / Q000145:classification / Q000201:enzymology* / Q000235:genetics; D011020:Pneumonia, Pneumocystis / Q000453:epidemiology / Q000382:microbiology*; D016133:Polymerase Chain Reaction; D011110:Polymorphism, Genetic; D012150:Polymorphism, Restriction Fragment Length; D012189:Retrospective Studies; D055815:Young Adult
D050505:Mutant Proteins; D004094:Dihydropteroate Synthase